Citation Nr: 22015064 Decision Date: 03/16/22 Archive Date: 03/16/22 DOCKET NO. 15-14 457 DATE: March 16, 2022 REMANDED Entitlement to service connection for Meniere's syndrome, to include as secondary to service-connected bilateral hearing loss and tinnitus, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1962 to March 1966. This case is before the Board of Veterans' Appeals (Board) on appeal from a July 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office. In November 2020, the Board denied the Veteran's service connection claim for Meniere's syndrome. The Veteran appealed this decision to the United States Court of Appeals for Veterans Claims (Court). In a November 2021 order, the Court granted a Joint Motion for Remand to vacate the Board's November 2020 decision and remanded the matter for readjudication. In particular, the Court found that the Board failed to adequately explain the reasons for assigning significant probative weight to the October 2019 VA opinion, and did not provide adequate reasons or bases for its denial of service connection based on continuity of symptomatology reported by the Veteran. Now the matter is returned to the Board. The Veteran is seeking service connection for Meniere's syndrome and contends that his condition is due to acoustic trauma sustained in service. The Veteran provided that his symptoms of dizziness and balance issues had its onset in service after significant military noise exposure. See June 2014 Statement in Support of Claim. The Veteran also submitted an article that suggests Meniere's syndrome can be related to his hearing loss when it manifests years after noise exposure. See April 2015 Correspondence. The Board notes that the Veteran is currently service-connected for bilateral hearing loss and tinnitus. A medical opinion on etiology of the Veteran's Meniere's syndrome was obtained in October 2019. The October 2019 VA examiner gave a negative opinion and reasoned that the first evidence of record showing the Veteran's Meniere's disease was in July 1991, which was over 20 years after his separation. However, the Board notes that the examiner did not discuss the Veteran's competent and credible report of the in-service onset of his symptoms of dizziness and balance issues after acoustic trauma due to noise, although it was listed on the evidence reviewed for the opinion. Also, the examiner did not address the article submitted by the Veteran suggesting a causal relationship between Meniere's syndrome and hearing loss. Based on the above, the Board finds that the October 2019 VA medical opinion was not adequate, and a remand of the matter is required in order to make a fully informed decision. Accordingly, the matter is REMANDED for the following action: 1. The Agency of Original Jurisdiction (AOJ) must obtain a medical opinion from an appropriate audiologist regarding the Veteran's service connection claim for Meniere's syndrome. If the examiner determines that an updated examination is necessary, the AOJ should schedule one for the Veteran. The examiner should review the Veteran's claims file and a copy of this REMAND order before rendering the requested addendum opinion. The examiner must opine whether the Veteran's current Meniere's syndrome is at least as likely as not (50 percent or greater probability) related to his service or had its onset in service. In particular, the examiner is asked to consider the Veteran's report of symptoms of dizziness and balance issues having its onset in service after significant military noise exposure. See e.g., June 2014 Statement in Support of Claim. The examiner is advised that the Veteran is competent to report his symptoms and history. Such reports, including those of continuity of symptomatology, must be acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran's reports, the examiner must provide an explanation for such rejection. The examiner must opine whether the Veteran's current Meniere's syndrome is at least as likely as not (50 percent or greater probability) proximately due to or aggravated beyond its natural progression by his service-connected bilateral hearing loss and/or tinnitus. When rendering this opinion, the examiner is asked to address the articles submitted by the Veteran to support his claim, which suggest a causal relationship between Meniere's syndrome and hearing loss. See April 2015 Correspondence. The Board emphasizes that the examiner must provide a complete written rationale for any opinion offered. Also, importantly, if the examiner cannot provide an opinion, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond based on given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner does not have the knowledge or training. 2. After completing the above actions and any other necessary development, the issue on appeal must be readjudicated. If the claim remains denied, a Supplemental Statement of the Case must be provided to the Veteran and his representative. After the Veteran and his representative have had an adequate opportunity to respond, the appeal must be returned to the Board for appellate review. MICHAEL LANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. E. Kim, 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.