Citation Nr: 20004205 Decision Date: 01/16/20 Archive Date: 01/16/20 DOCKET NO. 16-24 873 DATE: January 16, 2020 ORDER Service connection for benign paroxysmal positional vertigo is denied. FINDINGS OF FACT 1. The Veteran had active service from June 1966 to January 1970. 2. The Veteran did not experience benign paroxysmal positional vertigo in service; a current diagnosis is not causally or etiologically related to service and has not been medically associated with a service-connected disability. CONCLUSION OF LAW Benign paroxysmal positional vertigo was not incurred in service and nor is it due to a service-connected disability. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. § 3.303 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran contends that benign paroxysmal positional vertigo is related to service and to service-connected hearing loss, tinnitus, and headaches. Therefore, both direct and secondary service connection will be addressed. Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). Turning first to direct service connection, the Veteran was diagnosed with benign paroxysmal positional vertigo in 2015. Therefore, a current disability is shown, and the first element of direct service connection is met. As to an in-service incurrence, at his hearing, the Veteran testified that he developed vertigo as a result of an in-service car accident. He contended that he reported it at separation. However, service treatment records (STRs) show that he did not report a car accident at separation and had no complaints of, treatment for, or a diagnosis related to symptoms of dizziness or vertigo. Therefore, the second element of direct service connection is not met and the medical evidence does not support the claim for direct service connection. Turning to secondary service connection, as noted, a current diagnosis of benign paroxysmal positional vertigo is shown. Further, the Veteran is service connected for bilateral hearing loss, tinnitus, and headaches. Therefore, the first two elements of secondary service connection have been met. As to nexus, in a December 2015 VA examination, the clinician opined that vertigo was less likely than not related to service-connected hearing loss and tinnitus. He reasoned that hearing loss and tinnitus were due to in-service noise exposure and that noise exposure would not lead to vertigo. Further, he stated that there were no other events in the claims file that could be linked to vertigo. This evidence weighs against the claim. In a March 2016 private opinion, the clinician wrote that he had been treating the Veteran since 2008. He stated that hearing loss contributed to symptoms of vertigo but offered no rationale. This evidence weighs in favor of the claim. In a December 2016 VA opinion, the clinician wrote that the Veteran’s vertigo was less likely than not a result of service-connected hearing loss and tinnitus. The clinician reasoned that vertigo was not diagnosed until 2015 and that hearing loss and tinnitus would not cause vertigo, as the two disabilities were due to in-service noise exposure and first occurred so many years prior to the diagnosis of vertigo. This evidence weighs against the claim. The Board has the responsibility of weighing conflicting medical opinions and may place greater weight on one physician’s opinion over another depending upon factors such as reasoning employed by the physicians and the extent to which they reviewed prior clinical records and other evidence. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 30004 (2008); Prejean v. West, 13 Vet. App. 444, 448-49 (2000) (stating that factors for assessing the probative value of a medical opinion include the thoroughness and detail of the opinion). In this case, the Board affords the VA examiners’ opinions more probative weight. The VA examiners reviewed the claims file, to include STRs, and provided detailed rationales for the opinions rendered. On the other hand, the private clinician offered a bare conclusion without any support. Therefore, the medical evidence does not support the claim that benign paroxysmal vertigo is due to service-connected hearing loss and tinnitus. As to the Veteran’s contention that benign paroxysmal positional vertigo is due to service-connected headaches, the evidence reflects that no clinical records have shown a connection between the two disorders. Therefore, the medical evidence does not support that benign paroxysmal positional vertigo is due to service-connected headaches. The Board has considered the Veteran’s lay statements that benign paroxysmal positional vertigo began in service and is related to hearing loss, tinnitus, and headaches. He is competent to report symptoms because this requires only personal knowledge, as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his current disorder due to the medical complexity of the matters involved. Such competent evidence has been provided by the medical personnel who have examined the Veteran during his current appeal and by service records obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to the lay statements. As such, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Ragofsky, Attorney Advisor The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.