Citation Nr: 21075315 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 19-34 207 DATE: December 20, 2021 REMANDED Service connection for vertigo, claimed as secondary service-connected tinnitus, is remanded. Service connection for a sleeping disorder, claimed as secondary service-connected tinnitus, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1960 to October 1963. These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In November 2021 correspondence, the Veteran withdrew his request for a hearing. His request for a hearing before the Board is accordingly deemed to be effectively withdrawn. See 38 C.F.R. § 20.704(e). 1. Service connection for vertigo, claimed as secondary service-connected tinnitus, is remanded. 2. Service connection for a sleeping disorder, claimed as secondary service-connected tinnitus, is remanded. The Veteran argues that he experiences vertigo and insomnia as a result of his service-connected tinnitus. See May 2018 VA Form 21-4138. A June 2018 VA medical opinion opined that the Veteran's vertigo was less likely than not proximately due to or the result of tinnitus. The rationale was that "there is no clinical evidence that has been shown to connect [vertigo] to tinnitus." A June 2018 VA medical opinion concluded that the Veteran's sleeping disorder was less likely than not proximately due to or the result of tinnitus. The Board finds that the June 2018 VA medical opinions are inadequate for rating purposes as the examiner did not adequately address aggravation. See El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013). In January 2020, the Veteran submitted several internet articles suggesting an association between tinnitus and sleeping problems. One of these articles also instructed: "See your doctor as soon as possible if ... [y]ou have hearing loss or dizziness with the tinnitus." This evidence also suggests a possible relationship between tinnitus and vertigo. Based on the evidence of record, the Board finds that these matters should be remanded for another VA examination(s). Additionally, on remand the RO should obtain all relevant VA treatment records dated from November 2019 to the present before the issues on appeal are decided on the merits. Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Obtain all VA treatment records from November 2019 to the present. If no records are available, the claims folder must indicate this fact. Any additional records identified by the Veteran during the course of the remand should also be obtained, following the receipt of any necessary authorizations from the Veteran, and associated with the claims file. 2. After obtaining any additional records to the extent possible, provide an examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) to determine the nature and etiology of the Veteran's vertigo and sleeping disorder. All indicated tests and studies should be conducted, and all findings reported in detail. The examiner is asked to address the following: (a) Provide a diagnosis for any vertigo or sleeping disorder found. If no such disorder is diagnosed, the examiner should indicate whether the Veteran's reported equilibrium or sleeping symptomatology causes any functional impairment. (b) For any vertigo or sleeping disorder/functional impairment diagnosed, please opine as to whether it is at least as likely as not that such disorder is proximately due to his service-connected tinnitus. (c) For any vertigo or sleeping disorder/functional impairment diagnosed, please opine as to whether it is at least as likely as not that such disorder was aggravated by his service-connected tinnitus. A complete rationale should be given for all opinions and conclusions expressed. Please note that separate opinions addressing proximate cause and aggravation are needed. In offering this opinion, the examiner must acknowledge and discuss the Veteran's competent lay statements of his disability and any lay evidence regarding the onset of his disability, as well as the internet articles submitted in support of his claim in January 2020 suggesting a possible relationship between tinnitus and sleep impairment and dizziness. If unable to provide a medical opinion, provide a statement as to whether there is any additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. Jarrette A. Marley Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Cannon, Brian 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.