Citation Nr: 21025308 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 15-45 875 DATE: April 27, 2021 REMANDED Entitlement to service connection for Meniere's Disease, including as secondary to service-connected bilateral hearing loss or tinnitus, is remanded. REASONS FOR REMAND The Veteran served in the United States Army from September 1966 to September 1968, which included service in the Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision by a Department of Veteran Affairs (VA) Regional Office (RO). This claim was previously remanded by the Board in September 2018 and September 2020 for additional development. This matter has since returned to the Board for further appellate review. Further development is necessary with respect to the Veteran's claim of entitlement to service connection for Meniere’s disease. A remand by the Board confers upon the claimant, as a matter of law, the right to compliance with the remand order. Stegall v. West, 11 Vet. App. 268 (1998). Where the remand orders of the Board are not complied with, the Board itself errs in failing to insure compliance. Id. at 271. Here, the Board previously noted in its September 2020 Remand that the Veteran was afforded a VA examination in October 2019 in order to establish the nature and etiology of the Veteran's Meniere's disease, as well as to determine whether it was either at least as likely as not (50 percent or more probability) related to an in-service injury, event, or disease, or at least as likely as not proximately due to or aggravated beyond its natural progression by the Veteran's service-connected bilateral hearing loss or tinnitus. The examiner opined that the Veteran's medical records did not show Meniere's disease while in service, nor was there any chronicity or "continuity of care" of a condition related to Meniere's disease between service and the Veteran's diagnosis in 2009. Additionally, while the examiner opined that the Veteran's Meniere's disease was not proximately due to his hearing loss because "current medical literature does not state that hearing loss causes Meniere's Disease," the examiner failed to opine on whether the Veteran's bilateral hearing loss aggravated his Meniere's disease beyond its natural progression or whether it was proximately due to or aggravated beyond its natural progression by his tinnitus, as instructed in the September 2018 remand. The Veteran was provided with an additional VA examination in October 2020. The examiner opined that the Veteran’s Meniere's disease was less likely than not incurred in or caused by the Meniere's disease claimed as dizziness and loss of equilibrium seen in military service. In support, the examiner provided that there was a lack of objective evidence showing a relationship between the two. In regard to the issue of whether the Veteran’s Meniere’s disease was not aggravated beyond its natural progression by the service-connected hearing loss, the examiner appears to have not addressed this issue as previously directed. The examiner opined that the Veteran’s Meniere’s disease was not aggravated beyond its natural progression by the service-connected tinnitus. There was no discussion of why the available evidence was insufficient or any citations to medical support. Also, the October 2020 VA examiner did not address whether the Veteran’s Meniere’s Disease was caused by his service-connected tinnitus. In sum, there has not been substantial compliance with the Board’s previous remand directives regarding the issue of service connection for Meniere’s Disease. Therefore, a remand is warranted to obtain a VA medical opinion. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matter is REMANDED for the following action: Obtain an opinion from a VA examiner addressing the Veteran's Meniere's disease. The examiner must review the claims file and provide specific, thorough responses to each of the following: i. Whether it is at least as likely as not that the Veteran's Meniere's disease was aggravated beyond its natural progression by the Veteran's service-connected bilateral hearing loss and/or tinnitus. ii. Whether it is at least as likely as not that the Veteran's Meniere's disease was caused by his service-connected tinnitus. A complete rationale for all opinions must be provided. It is not sufficient to just state that the evidence does not support an etiological relationship. Ashley Castillo Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Dodd, Ryan 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.