Citation Nr: 20021277 Decision Date: 03/25/20 Archive Date: 03/25/20 DOCKET NO. 12-17 519 A DATE: March 25, 2020 REMANDED Entitlement to service connection for a disability manifested by dizziness, to include as secondary to service-connected disabilities and medication intake for treatment of service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from October 2004 to December 2005 and has a verified period of active duty for training (ACDUTRA) from May 1998 to July 1998. In November 2014, the Board denied the Veteran claim, finding that he did not have a chronic dizziness disorder. The Veteran timely appealed the Board’s denial to the United States Court of Appeals for Veterans Claims (Court), and by a December 2015 Memorandum Decision, the court set aside and remanded the Board’s denial of service connection for dizziness. Although Court found the Board’s findings adequate that the Veteran is competent to report experiencing dizziness and not competent to diagnose a dizziness disorder as related to service, the Court found that, based on the medical evidence of record, the Board should have considered whether dizziness is a symptom secondary to a service-connected disability or medication intake for treatment of a service-connected disability. Thereafter, in August 2016, the Board remanded the claim to provide the Veteran with a VCAA notice of how substantiate his claim on secondary basis, as well as to obtain an addendum medical opinion for secondary service connection. The Veteran underwent an in-person VA ear conditions examination in October 2016, at which time the examiner concluded that he did not have a diagnosis of peripheral vestibular condition and that he only felt dizzy in elevators but otherwise denied In a subsequent October 2017 Remand, the Board found that the 2016 opinion was not supported by any rationale; while the examiner relied on findings within the VA examination, the examiner ignored other probative evidence of record showing that dizziness was reported on various occasions. The Board remanded the claim in order to obtain an additional medical opinion. An addendum opinion was obtained in December 2017, and the VA examiner stated that it remained unknown whether the prescribed medications for treatment of his service-connected disabilities caused his dizziness. The examiner then opined that it was less likely than not that the dizziness was caused by the prescribed medications; however, an opinion regarding aggravation was not provided. In August 2018, the Board again denied the Veteran’s claim, finding that the Veteran did not have a chronic dizziness disorder and that the dizziness symptom was not caused or aggravated by a service-connected disability. The Veteran timely appealed the Board’s denial to the Court, and in a November 2019 Order, the Court granted a Joint Motion for Partial Remand (JMPR), which found that the Board relied on a December 2017 opinion that was deemed to be inadequate. Specifically, the JMPR noted that while the December 2017 examiner indicated that it was unclear whether the prescribed Zolpidem and Ropinirole are the specific causes of the Veteran’s dizziness, but later opined that it was less likely than not that the Veteran’s dizziness was caused by those medications; the JMPR agreed that such inconsistency renders the opinion inadequate to decide the claim. In addition, the JMPR found that the 2017 examiner’s failure to address whether the Veteran’s use of the medications aggravated his dizziness; thereby rendering the opinion inadequate. Consistent with findings of the JMPR, the Board finds that an additional remand is necessary to obtain an addendum medical opinion. The matters are REMANDED for the following action: 1. Ensure that all outstanding VA treatment records are associated with the claims file. 2. Thereafter, obtain another medical opinion from an appropriate VA examiner to assist in determining the likely etiology of the claimed dizziness. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. After a review of the record, the examiner is asked to respond to the following: Provide an opinion as to whether the Veteran’s use of the prescribed medications to treat his service-connected disabilities caused OR aggravate his dizziness. (Continued on the next page)   A complete rationale should be provided for all opinions for both causation and aggravation. Please note that permanent aggravation is not necessary to establish service connection. 3. Thereafter, readjudicate the remanded claim. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Yaffe, Associate Counsel 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.