Citation Nr: 21029324 Decision Date: 05/13/21 Archive Date: 05/13/21 DOCKET NO. 17-14 156A DATE: May 13, 2021 REMANDED Entitlement to service connection for Meniere's Syndrome, to include as secondary to service-connected left ear hearing loss, is remanded. Entitlement to an initial compensable rating for left ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from November 1984 to March 1993. In January 2021 the Veteran testified before the undersigned Veterans Law Judge (VLJ) in a Virtual Board Hearing. A transcript of that proceeding has been prepared and is associated with the file. 1. Entitlement to service connection for Meniere's Syndrome is remanded. The Veteran asserts that her Meniere's Syndrome is a result of her left ear hearing loss due to her years as a signal intelligence and Morse code intercept and analyst. VA provided a negative nexus opinion in November 2015 based on a December 2014 Hearing Loss and Tinnitus examination. The rationale provided is insufficient for adjudication purposes as the examiner noted the Veteran's Meniere's symptomology and concluded, "Meniere's Disease is the term given to the condition having the following four symptoms [episodic, fluctuating hearing loss; vertigo; tinnitus; and aural fullness], after thorough testing has determine no other cause." No other discussion or rationale was provided that addressed those symptoms with regard to the Veteran and her symptoms. The Board notes that for an opinion to be adequate, it must include consideration of the Veteran's statements, be based on accurate factual premises, and contain a rationale sufficient to support its conclusions. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); see also Kowalski v. Nicholson, 19 Vet. App. 171, 179 (2005) (a VA examination must be based on an accurate factual premise); see also Nieves-Rodriguez, 22 Vet. App. at 301 (explaining that a medical report without "a reasoned medical explanation" lacks probative value). In addition to the insufficient nexus opinion, the Board notes that the Veteran has not been afforded a VA Meniere's examination or testing to assist in the development of her claim. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). Finally, the Board notes that the most recent VA treatment records in the file are from April 2019. The Veteran's current treatment records showing her treatment for Meniere's are necessary for the adjudication of her claim. Accordingly, the Board finds that a remand is required to provide the Veteran with an examination and obtain a medical opinion regarding her claim for Meniere's Syndrome. 2. Entitlement to an initial compensable rating for left ear hearing loss is remanded. The Veteran testified that her hearing loss has become worse since her last examination. The Board observes that the most recent VA examination to determine the severity of the Veteran's hearing loss was in November 2015. The Board notes that the current level of disability is most important in claims for an increased rating. Where the evidence of record does not reflect the current state of the Veteran's disability, a VA examination must be conducted. Schafrath v. Derwinski, 1 Vet. App. 589 (1991); 38 C.F.R. § 3.327(a); see also Snuffer v. Gober, 10 Vet. App. 400, 403 (1997) ("[W]here the appellant complained of increased hearing loss two years after his last audiology examination, VA should have scheduled the appellant for another examination."). Accordingly, a remand is required to obtain a current VA examination to assess the severity of the Veteran's service-connected left ear hearing loss. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records from April 2019 to present. 2. After records development is completed, schedule the Veteran for a VA examination to determine whether it is at least as likely as not (50 percent probability or greater) that any current disability of Meniere's Syndrome had its onset during service or is otherwise related to an in-service injury, event, or disease, to include her years as a signal intelligence and Morse code intercept and analyst. The examiner must also address whether the Veteran's Meniere's Syndrome is at least as likely as not (a) caused by, or (b) aggravated by (worsened beyond natural progression) her service-connected left ear hearing loss. The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which she has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran the examiner should provide a fully reasoned explanation. A rationale for all opinions expressed is requested as adjudicators are precluded from making any medical findings. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of her service-connected left ear hearing loss. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Nelson 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.