Citation Nr: 18159365 Decision Date: 12/19/18 Archive Date: 12/18/18 DOCKET NO. 11-31 741 DATE: December 19, 2018 ORDER Service connection for a disability manifested by dizziness or vertigo, secondary to the Veteran's service-connected posttraumatic stress disorder (PTSD), is granted. REMANDED Entitlement to service connection for traumatic brain injury (TBI) is remanded. FINDING OF FACT The Veteran’s dizziness is at least as likely as not proximately due to or the result of his service-connected PTSD. CONCLUSION OF LAW The criteria to establish service connection for a disability manifested by dizziness or vertigo as secondary to the Veteran's service-connected PTSD have been met. 38 U.S.C. §§ 1110, 1154, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from September 1952 to June 1954 with combat service in Korea. In addition to other awards and decorations, he is in receipt of the Combat Infantryman’s Badge. This appeal was remanded by the Court of Appeals for Veterans Claims in June 2018. There has been an extensive appellate history regarding the Veteran’s TBI claim. Additional evidentiary development remains necessary on the TBI portion of the Veteran’s claim. However, the Veteran has also more specifically claimed service connection for dizziness. For the reasons below, the Board finds it appropriate at this time to bifurcate or separate claims of service connection for TBI and for disability manifested by dizziness. The Veteran has variously related his symptom of dizziness to his cardiovascular, ear, TBI, and psychological ailments. See, e.g., VA opinion, February 2017 (PTSD); Statement in Support of Claim, July 2011 (TBI); VA examination, September 2008 (Hearing loss/tinnitus); Statement in Support of Claim, March 1993 (cardiovascular). The Court of Appeals for Veterans Claims has held that a Veteran’s claim is not limited only to a particular diagnosis or named disability, but is to be considered as a claim for any disability that is reasonably encompassed by the type of affliction posed by the described symptoms. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). Furthermore, while the necessary elements are not met at this time to grant service connection for TBI, there is adequate evidence to grant service connection for disability manifested by dizziness or vertigo. In that manner, it is of the greatest benefit to the Veteran to bifurcate the claims. Service connection for a disability manifested by dizziness or vertigo as secondary to the Veteran's service-connected PTSD is granted. Service connection may be granted for a disability which is proximately due to or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310; Allen v. Brown, 1 Vet. App. 439 (1995). To establish secondary service connection, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) competent evidence establishing a medical relationship between the service-connected disability and the current disability for which compensation is sought. See Wallin v. West, 11 Vet. App. 509 (1998). The necessary medical relationship may be shown by evidence that the nonservice-connected disability is proximately due to or the result of a service-connected disability, or that the nonservice-connected disease or injury increased in severity beyond its natural progression due to a service-connected disability. 38 C.F.R. § 3.310. The latter circumstance is known by the legal term of “aggravation.” 38 C.F.R. § 3.310(b). Here, there is a long history of reports of dizziness by the Veteran. See VA audiology clinic note, May 2018; VA orthopedic treatment note, August 1992. The Veteran is competent to report this condition as it is observable with his own senses. The Board also has no reason to doubt his credibility in this regard, particularly as the history has been very consistent over time. Service connection is in effect for the Veteran’s PTSD since February 2003. Rating decision, May 2003. Also, a recent VA medical opinion states that it is at least as likely as not that the Veteran’s dizziness is related to his PTSD based on the description of his dizziness, the time of its onset, as well as the results of brain imaging, carotid doppler and echocardiogram studies all showing significant abnormalities to account for the dizziness. The opining physician also found the weight of the evidence supported a relationship between the Veteran’s dizziness and his anxiety because the dizziness worsened considerably in 1993 at a time when other anxiety symptoms also peaked. VA opinion, February 2017. As such, the elements for secondary service connection are met. Service connection for dizziness or vertigo, secondary to PTSD, is granted. 38 C.F.R. § 3.310. REASONS FOR REMAND Entitlement to service connection for traumatic brain injury (TBI) is remanded. The Board cannot make a fully-informed decision on the issue of service connection for TBI because no VA examiner has adequately considered the Veteran’s reported exposure to concussive blasts and explosions during his combat service in Korea, being “stunned” by several of these exposures, and experiencing episodes of dizziness since, then opining whether it is at least as likely as not that the Veteran incurred traumatic brain injury during service. A prior remand by the Board confers upon the Veteran, “as a matter of law, the right to compliance with the remand orders.” Stegall v. West, 11 Vet. App. 268, 271 (1998). An additional medical opinion is necessary. The matter is REMANDED for the following action: Schedule the Veteran for an examination with a neurologist. The examiner is instructed that the Veteran experienced combat exposure during his military service in Korea, and to assume as credible that the Veteran experienced concussive forces or effects of the firing of large weapons, such as 105 mm guns, being “stunned several times” by the force of artillery fire, suffering chest pains from the force of nearby blasts, and being near tanks while firing. A more thorough history of the symptoms experienced during service should be obtained from the Veteran if determined to be necessary by the examiner to establish the Veteran’s state of consciousness or other elements of his medical state at the time of the events in question. The examiner is also instructed that the Veteran has credibly reported experiencing episodes of dizziness since service. Considering all the evidence in the claims file, the examiner is then asked to opine whether it is at least as likely as not that the Veteran experienced a traumatic brain injury during service. Please include an adequate discussion of the medical reasoning for the conclusion reached. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. McDonald