Citation Nr: 18156802 Decision Date: 12/11/18 Archive Date: 12/10/18 DOCKET NO. 15-04 562 DATE: December 11, 2018 ORDER Entitlement to service connection for a peripheral vestibular disorder (claimed as motion sickness) is granted. FINDING OF FACT The evidence of record is at least in equipoise as to whether the Veteran has a peripheral vestibular disorder that is related to her period of active service. CONCLUSION OF LAW The criteria for entitlement to service connection for a peripheral vestibular disorder have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from September 2002 to November 2003. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts. Entitlement to service connection for motion sickness. Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). In general, service connection requires: (1) evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of an in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge when all evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the claimant. Gilbert, 1 Vet. App. at 53. The Veteran seeks service connection for a peripheral vestibular disorder, which she contends had its onset in service. The Board concludes that the Veteran experiences a current peripheral vestibular disorder manifested by pain which began during active service. 38 U.S.C. §§ 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The Veteran began experiencing motion sickness after becoming sick from her flight training in an altitude chamber in December 2002. Service treatment records (STRs) reflect the event. The day after her training, the Veteran was treated for decompression sickness. Symptoms included a headache, joint pain, and chest tightness. The Veteran resumed flight training, but continued to suffer from airsickness. STRs show the Veteran was seen by a military doctor on five occasions. The Veteran was unable to satisfactorily complete her flying mission without incapacitating airsickness. Therefore, in September 2003, the Veteran was disqualified from flying status and honorably discharged in November 2003. In October 2012, the Veteran was afforded a VA examination for ear conditions. The Veteran stated that she now has motion sickness even when riding in or driving a car, as well as when she is traveling on a plane or train. The VA examiner diagnosed the Veteran with a peripheral vestibular disorder, specifically motion sickness. The VA examiner stated that the Veteran’s motion sickness impacts her ability to work. Prior to her enlistment in the United States Air Force, the Veteran was employed as a flight attendant. The Veteran is no longer able to work in that profession. In the October 2012 VA examination, the VA examiner stated that the Veteran’s claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury, event, or illness. The VA examiner stated that the Veteran’s lack of any problems with motion sickness prior to the altitude simulation and her chronic problems with motion sickness thereafter suggest a causal relationship between the altitude simulation/decompression chamber and the onset of motion sickness. The VA examiner also stated that there were no abnormal findings on the complete otoneurologic examination. STRs and the October 2012 VA examination confirm an in-service event and a nexus between the Veteran’s motion sickness and the in-service event. However, it is unclear whether the Veteran has a current diagnosis for VA purposes. While the VA examiner indicated that the Veteran suffers from a peripheral vestibular disorder, the statement regarding no abnormal findings on the complete otoneurologic examination brings the current diagnosis prong of service connection into doubt. Although the conflicting statements from the VA examiner cast doubt on whether there is a diagnosed peripheral vestibular disorder, Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), allows service connection in this case. The Veteran has a disorder, which, per the record, results in functional loss and presents occupational impairment. Under 38 C.F.R. § 4.1, the term "disability" means impairment in earning capacity resulting from diseases and injuries and their residual conditions. See Hunt v. Derwinski, 1 Vet. App. 292, 296 (1991); See also Allen v. Brown, 7 Vet. App. 439 (1995); See Saunders. Saunders held that where pain alone results in functional impairment, even if there is no identified underlying diagnosis, it can constitute a disability. While subjective pain in and of itself will not establish a current disability, the Veteran’s pain in this case reaches the level of functional impairment of earning capacity. Saunders at 1364-68. The Veteran was previously employed as a flight attendant. The Veteran’s continued motion sickness inhibits her ability to perform the duties of a flight attendant. The Veteran's medical records, including the October 2012 VA ear conditions examination, show the Veteran currently experiences motion sickness. There is also evidence of motion sickness in service and evidence of continuous symptoms in the years since service which indicates that the current peripheral vestibular disorder was incurred in service. The Veteran is competent to report her symptoms of a peripheral vestibular disorder within her personal knowledge. Layno v. Brown, 6 Vet. App. 465, 469-70 (1994); Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Veteran maintains that she continues to suffer from motion sickness. There is nothing in the claims file that explicitly contradicts these reports. In light of this evidence, the Board finds that the reports of peripheral vestibular disorder symptoms in the years since service are credible. The Board finds the VA examiner's positive opinion to be the most probative evidence of record. The Veteran has presented evidence as to the existence of a peripheral vestibular disorder. Accordingly, the claim for service connection for a peripheral vestibular disorder is granted. 38 U.S.C. § 5107(b); Gilbert. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Mahaffey, Associate Counsel