Citation Nr: 21012332 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 18-09 626 DATE: March 4, 2021 ORDER Entitlement to service connection for Meniere’s syndrome is granted. FINDING OF FACT The evidence is at least as evenly balanced as to whether the Veteran’s Meniere’s syndrome is related to an in-service left ear injury. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran’s favor, the criteria for service connection for Meniere’s syndrome have been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.   REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Army from May 1969 to September 1975.  This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO).  In that decision, the RO, among other things, denied service connection for Meniere’s syndrome.  In March 2015 the Veteran filed a notice of disagreement (NOD), and a statement of the case (SOC) was issued in January 2018. In February 2018 the Veteran filed an appeal to the Board and requested a videoconference hearing before a Veterans Law Judge. In February 2021, the Veteran and his wife testified before the undersigned Veterans Law Judge in a videoconference hearing. Although a transcript of that hearing is not yet of record, given the Board is granting the specific benefit sought by the Veteran, one is not necessary. 1. Entitlement to service connection for Meniere’s syndrome is granted.  Service connection will be granted if the evidence demonstrates that current disability resulted from an is no injury or disease incurred in active military service.  38 U.S.C. § 1110; 38 C.F.R. § 3.303(a).  Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service incurrence of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018).  Consistent with this framework, service connection is warranted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303(d).  The November 2015 VA examiner diagnosed vertigo and referenced Meniere’s syndrome. Therefore, a current disability has been demonstrated.   As to the in-service injury element, in his written statements, statements to physicians, and hearing testimony, the Veteran described a June 1969 medical procedure that damaged his eardrum. The Veteran’s statements are competent and credible. The in-service injury element has therefore been met. The dispositive issue is whether there is a nexus between the Veteran’s in-service left inner ear injury and his current Meniere’s syndrome. A November 2015 VA nurse practitioner opined that it is less likely than not that the Veteran’s Meniere’s syndrome was proximately due to or the result of hearing loss and tinnitus or related to service. The VA examiner’s rationale as to direct service connection was based primarily on the absence of complaints, treatment, or a diagnosis of Meniere’s syndrome in service and the fact that the Veteran did not seek treatment for his left ear until many years after service. As the VA examiner appeared to discount the Veteran’s lay statements based on the absence of contemporaneous medical evidence, her opinion is of little, if any, probative weight. Buchanan v. Nicholson, 451 F.3d 1331, 1336, n. 1 (Fed. Cir. 2006) (noting that VA's examiner's opinion, which relied on the absence of contemporaneous medical evidence, "failed to consider whether the lay statements presented sufficient evidence of the etiology of [the veteran's] disability such that his claim for service connection could be proven without contemporaneous medical evidence"). In a January 2021 letter, Dr. R.K., DO, the Veteran’s private physician indicated that he had reviewed the Veteran’s left ear history dating back to the 1969 procedure that damaged his eardrum and that, based on this review, he strongly believed that the Veteran’s current vertigo is related to the in-service inner left ear injury. While Dr. R.K.’s rationale was not extensive, reading his opinion as a whole and in the context of the evidence of record, it reflects a sufficiently definitive conclusion based on an analysis of the relevant facts. See Monzingo v. Shinseki, 26 Vet. App. 97, 106 (2012) (the fact that the rationale provided by an examiner “did not explicitly lay out the examiner’s journey from the facts to a conclusion,” did not render the examination inadequate); Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012) (medical reports must be read as a whole and in the context of the evidence of record). The opinion is therefore afforded significant probative weight on the dispositive nexus issue. Consideration has also been given to the testimony of the Veteran and his wife regarding the continuous vertigo symptoms since service. The Veteran and his wife are competent to report symptoms and injuries that are capable of lay observation, such as the in-service inner ear injury and subsequent imbalance symptoms.  Jandreau v. Nicholson, 492 F.3d 1372, 1377, n. 4 (Fed. Cir. 2007).  The Board finds these statements credible, particularly given the consistency of the statements with each other and the other evidence of record. For the foregoing reasons, the evidence is at least evenly balanced as to whether the Veteran’s Meniere’s syndrome is related to service. As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, entitlement to service connection for Meniere’s syndrome is warranted.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.  Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Henderson, 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.