Citation Nr: 21075031 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 16-09 666 DATE: December 17, 2021 REMANDED Entitlement to service connection for an inner ear disorder including secondary to tinnitus, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1982 to December 1985. This case comes before the Board of Veterans' Appeals (Board) on appeal from a September 2014 rating decision of the Department of Veteran Affairs (VA) Regional Office (RO). Inner ear disorder Remand is required to comply with the June 2021 remand directives. The Board is obligated by law to ensure that the RO complies with its directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). RO compliance with remand directives is not optional or discretionary and the Board errs as a matter of law when it fails to ensure remand compliance. Stegall, 11 Vet. App. at 271. The issue was framed as Meniere's syndrome. The Veteran sought service connection for vertigo. A private examiner diagnosed the Veteran with Meniere's syndrome in August 2013. The June 2021 Board decision remanded the appeal for a VA examination which includes any diagnostic testing. The Veteran received a July 2021 VA examination. The examiner diagnosed abnormal vestibular function and dizziness and giddiness but only provided an opinion for Meniere's syndrome. The claim should be broadened to include any inner ear disorder. See Clemons v. Shinseki, 23 Vet. App. 1 (2009) (Board must consider any disability that "may reasonably be encompassed by" a description of the claim, symptoms reported, and other evidence). The July 2021 VA examiner diagnosed a disorder but then stated, "records are silent for CAT scans or MRIs of the brain, neurologist opinions, or additional vestibular balance Tests to help in objectively evaluating the Veteran. I will be glad to review new and material evidence as and when presented by the veteran for evaluation of the claimed conditions." The examiner essentially dismisses the evidence because it is not new and material, which is a legal term not relevant to this Veteran's claim. Lastly, the June 2021 Board decision requested a direct service connection opinion and a secondary service connection opinion. The examiner opined the Veteran does not have a diagnosis of Meniere's syndrome that is at least as likely as not incurred in, or caused by, the vestibular disorder during service. The examiner did not provide an opinion for the other disorders diagnosed in the VA examination, and did not address secondary service connectionthat is, whether it is at least as likely as not that the Veteran's service-connected tinnitus caused or aggravated (incrementally increased) any inner ear disorder, including after the Veteran's separation from service. Generally, a medical opinion should address the appropriate theories of entitlement. Stefl v. Nicholson, 21 Vet. App. 120, 123-24 (2007). Thus, remand is required to obtain an adequate examination and opinion. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination for his inner ear disorder. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: First, is any inner ear disorder (including abnormal vestibular function, dizziness, and Meniere's syndrome) at least as likely as not related to service, including noise exposure during service? Second, is any inner ear disorder (including abnormal vestibular function, dizziness, and Meniere's syndrome) at least as likely as not proximately due to service-connected tinnitus? Third, is any inner ear disorder (including abnormal vestibular function, dizziness, and Meniere's syndrome) at least as likely as not incrementally increased by his service-connected tinnitus? The term "incremental increase" in disability means additional impairment of earning capacity. Objective measurement or numerical quantification is not required to ascertain an increase in disability. Moreover, any "incremental increase in disability" need not be permanent. A rationale should be provided for all requested opinions. David Gratz Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Bruton, C 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.