Citation Nr: 18159176
Decision Date: 12/19/18	Archive Date: 12/18/18

DOCKET NO. 17-21 066
DATE:	December 19, 2018
REMANDED
Service connection for Meniere’s disease, to include as secondary to bilateral hearing loss or tinnitus, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from April 1966 to April 1968.  Subsequently, he had several years of reserve service.
Service connection for Meniere’s disease, to include as secondary to bilateral hearing loss or tinnitus, is remanded.
Additional development is needed for the Veteran’s claim.  The Veteran asserts that he has Meniere’s disease related to his service-connected hearing loss and/or tinnitus.  Private and VA treatment records indicate the Veteran has Meniere’s disease with symptom onset in 2005.  The March 2016 VA examiner opined that the Veteran’s Meniere’s disease is less likely than not related to hearing loss and tinnitus because Meniere’s disease is a disease of the endolymphatic system and there is no medical evidence to support that Meniere’s disease is a result of hearing loss and tinnitus.  
This opinion is inadequate, however, because the examiner did not address whether the Veteran’s service-connected hearing loss and/or tinnitus could aggravate his Meniere’s disease.  Further, the examiner did not provide an opinion on whether Meniere’s disease could be causally related to the Veteran’s service.  During his period of active duty, the Veteran’s military occupational specialty was tank unit commander, and VA has conceded in-service noise exposure.  Therefore, an addendum opinion should be obtained that addresses all theories of entitlement. 
Additionally, the record does not appear to include a complete copy of the Veteran’s service treatment records, particularly those from his period of active duty.  The majority of the examinations and audiological evaluations of record are from the 1970s and 1980s during the Veteran’s reserve service.  The record includes only one audiological evaluation from the Veteran’s period of active duty, which is from his enlistment examination.  The record contains the Report of Medical History at the time of separation but not a separation examination or audiological evaluation.  Additional attempts should be made to obtain the Veteran’s complete service treatment records.  
The matter is REMANDED for the following action:
1. Obtain and associate with the claims file the Veteran’s complete service treatment records.  Requests for federal records should continue until the records are received or deemed unavailable.
2. Then, request an addendum medical opinion from an otolaryngologist or other appropriate medical professional to determine the nature and etiology of the Veteran’s Meniere’s disease.  Schedule an examination only if deemed necessary by the examiner.  The examiner should review the claims file and address the following:
a.	Was the Veteran’s Meniere’s disease at least as likely as not aggravated (worsened) by his service-connected hearing loss and/or tinnitus?  If aggravation is found, please identify a baseline level of disability prior to aggravation.
b.	Is the Veteran’s Meniere’s disease at least as likely as not related to service?  Note that VA conceded in-service noise exposure from the Veteran’s work as a tank commander.
Consider all relevant lay and medical evidence.  All opinions must be supported by a comprehensive rationale.  If the opinion cannot be provided without resort to speculation, the examiner should explain why, and state whether the inability is due to the absence of evidence or limits of scientific/medical knowledge. 
 
KRISTY L. ZADORA
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A.P. Armstrong