Citation Nr: 20021969 Decision Date: 03/30/20 Archive Date: 03/30/20 DOCKET NO. 18-29 685 DATE: March 30, 2020 ORDER Service connection for a vestibular disorder, as currently diagnosed, is granted. FINDING OF FACT The weight of the evidence supports a finding that the Veteran’s vestibular disorder is at least as likely as not related to acoustic trauma in service. CONCLUSION OF LAW The criteria for service connection for a 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 from August 1966 to April 1967. This matter comes before the Board of Veterans’ Appeals (Board) from a July 2013 rating decision. The April 2018 statement of the case indicates that the present appeal comes from an April 2015 rating decision. This, however, is inaccurate. A review of the record reveals that, at the time of the April 2015 rating decision, the Veteran already had a pending appeal for the issue of service connection for a vestibular disorder. As such, the Board finds that the present appeal is a continuation of that prior appeal, which stems from the abovementioned July 2013 rating decision. Entitlement to service connection for a vestibular disorder is granted. The Veteran seeks service connection for a disability described as a vestibular disorder. 07/31/2012, Statement in Support of Claim. He has asserted that this disability is related to his service-connected bilateral hearing loss disability. Id. Medical records show multiple diagnoses for the Veteran’s symptoms. An October 2010 VA neurology note indicates a history of ataxia and vertigo. 11/04/2015, CAPRI, at 71. (Ataxia describes a lack of muscle control or coordination of voluntary movements, such as walking or picking up objects. See Mayo Clinic, “Ataxia,” https://www.mayoclinic.org/diseases-conditions/ataxia/symptoms-causes/syc-20355652.) A May 2011 VA treatment note shows diagnoses of imbalance and vertigo. 12/14/2012, CAPRI, at 100. A June 2013 VA ear examination is negative for an ear or peripheral vestibular condition; the examiner, however, noted the Veteran’s reported history (“several years”) of intermittent vertigo and chronic ataxia. The June 2013 VA examiner noted that the etiology of the vertigo and ataxia remained unknown and opined that these symptoms were less likely than not related to his service-connected hearing loss and tinnitus. The examiner’s opinion was the lack of evidence to support a conclusion that the Veteran’s symptoms were ear/vestibular-related. 06/19/2013, VA examination. In contrast, an April 2014 private treatment note from Dr. P.R.L. shows a finding of severe loss of vestibular function, described by the treating provider as “likely secondary to acoustic trauma.” Dr. P.R.L. noted the Veteran’s reported history of “wobbliness” and gait issues since an episode of acoustic trauma in service. 05/15/2014, Medical Treatment Record - Non-Government Facility, at 3. Dr. P.R.L. completed a DBQ for ear conditions, where he described the Veteran’s symptoms as dizziness and imbalance. 09/17/2014, Other. In August 2015, Dr. P.R.L. issued what appears to be a medical opinion at the Veteran’s request. In it, Dr. P.R.L. indicated that he could not completely attribute the Veteran’s hearing loss to a single episode of acoustic trauma in service, as his hearing loss is likely due to cumulative noise exposure and aging. Dr. P.R.L. further indicated that it is not possible to attribute most of the Veteran’s loss of vestibular function to his episode of acoustic trauma in service. He did, however, concede that the episode of acoustic trauma in service may have contributed to some degree, albeit it would only have been a minor component. Dr. P.R.L. further indicated that the exact etiology of the Veteran’s hearing loss and imbalance remained unknown. 02/27/2018, Medical Treatment Record - Non-Government Facility, at 1. The Veteran underwent a second VA examination in December 2018. The examination report shows a diagnosis of benign paroxysmal positional vertigo (BPPV). The examiner opined that this condition is less likely than not due to the Veteran’s service-connected tinnitus and hearing loss. The examiner’s rational was simply that vertigo is due to inner ear canal problems and not caused by tinnitus or hearing loss. This one-sentence explanation does not equal to a comprehensive medical rationale. Furthermore, there is no clear indication, however, that the examiner considered the aggravation prong of secondary service connection. For these reasons, the Board finds that the December 2018 opinion is inadequate and of little weight. For service connection to be warranted, the evidence must show that the Veteran’s claimed disability is at least as likely as not related to service or a service-connected disability. After careful review of the relevant evidence, the Board finds that there is enough evidence to support such a finding. First, the medical evidence establishes that the Veteran does have an ear/vestibular disorder. Private treatment records from Dr. P.R.L., an ENT specialist, weigh heavily in this regard. Furthermore, Dr. P.R.L. has conceded that the Veteran’s episode of acoustic trauma in service may have contributed to the Veteran’s loss of vestibular function. The Board finds that Dr. P.R.L.’s opinion is enough to meet the evidentiary threshold for service connection, as it identifies acoustic trauma in service as a possible contributory factor for the development of the Veteran’s current disability. The Veteran’s reports of symptoms since service also weigh in favor of this conclusion. Similarly, the Veteran’s reports of worsening vestibular symptoms appear to track his complaints of worsening hearing loss, suggesting a connection between the two.   In sum, resolving doubt in favor of the Veteran, the Board finds that his current vestibular disorder, as currently diagnosed, is related to acoustic trauma in service. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. López, 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.