Citation Nr: 21067881 Decision Date: 11/05/21 Archive Date: 11/05/21 DOCKET NO. 16-53 613 DATE: November 5, 2021 REMANDED Entitlement to service connection for a peripheral vestibular disorder, to include vertigo, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from March 1968 to March 1972. This case comes before the Board of Veterans' Appeals (Board) on appeal of a May 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). When this case was last before the Board in November 2018 and July 2021, it was remanded for additional development. The case has now been returned to the Board for further appellate consideration. Although the Board regrets the delay, remand is required to ensure there is a complete record on which to decide the Veteran's claim. Entitlement to service connection for a peripheral vestibular disorder, to include vertigo is remanded. The Veteran has been provided VA examinations in April 2013, April 2017, November 2020, and August 2021. A negative opinion was provided by the April 2013 VA examiner. The examiner stated the Veteran's vertigo was less likely than not incurred in or caused by an in-service event as the Veteran's in-service complaints of a dizzy spell were due to an injury in which he fell through a window. However, the examiner did not provide supporting rationale for this opinion. The examiner also failed to address the Veteran's history of stapedectomy surgery and his lay statements that he has experienced periods of imbalance since he was 20 years old. The Board notes no direct service connection opinion was provided in the April 2017 VA examination. In November 2020, the examiner opined the Veteran's vertigo was less likely than not caused or aggravated by his service-connected bilateral hearing loss or tinnitus. The examiner provided references to medical literature supporting his opinion for both causation and aggravation. However, a direct service connection opinion was not provided. In August 2021, the examiner opined that the Veteran's bilateral peripheral vestibule disorder was less likely than not due to the documented fall through an 8-foot window in June 1971. The examiner noted that there was no evidence of dizziness at the separation examination. However, the examiner failed to address the Veteran's history of stapedectomy surgery and his lay statements that he has experienced periods of imbalance since he was 20 years old. Accordingly, there has not been substantial compliance with the prior remand order and an additional VA opinion is warranted. See Stegall v. West, 11 Vet. App. 268 (1998). The matter is REMANDED for the following action: 1. Obtain a VA opinion from an appropriate clinician regarding the etiology of the Veteran's bilateral peripheral vestibule disorder and vertigo. The claims file, including a copy of this remand, must be made available to and reviewed by the clinician. The necessity of an in-person examination is left to the discretion of the cilician. After review of the claims file, the clinician is asked to provide a response to the following: (a.) Is it at least as likely as not that the Veteran's bilateral peripheral vestibule disorder and vertigo was incurred in or caused by an in-service injury, event, or illness? A complete rationale should be provided. In providing his or her opinion, the clinician shall address the Veteran's June 1971 injury in which he fell through a window and subsequent reports of dizziness; the Veteran's statements that he has experienced periods of imbalance since he was 20 years old, during his military service; and the Veteran's Stapedectomy surgery in the early 1970s. (Continued on the next page) While it is the responsibility of the examiner to perform their own independent review of the medical literature, the examiner is directed to provide written consideration of the November 2013 Hearing Loss VA examination during which he reported periods of dizziness going back to his military service and the January 2014 VAMC ENT note during which the Veteran stated he has experienced progressively worsening imbalance a couple of times per week since he was 20 years old. A. S. CARACCIOLO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Laura C. Owens 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.