PERIPHERAL VESTIBULAR DISORDERS

Summary

The Veteran served from December 1974 to November 2000. The Veteran sought service connection for vertigo, claiming it was secondary to his service-connected tinnitus and bilateral hearing loss. The Board reviewed the case based on evidence of record as of the March 2025 agency of original jurisdiction decision. The Veteran had a June 2025 VA examination where vertigo was diagnosed, but the VA examiner opined it was not related to service or his service-connected conditions, failing to provide adequate rationale. However, a November 2024 private medical opinion found it more likely than not that the vertigo was secondary to the service-connected tinnitus and bilateral hearing loss. This private opinion cited medical literature linking hearing loss and balance disorders due to shared inner ear pathology and noted no other contributing causes for the Veteran's vertigo. The Board found the private opinion persuasive due to its thorough rationale and consideration of the Veteran's history, deeming the VA opinion unprobative for its lack of rationale. Resolving reasonable doubt in the Veteran's favor, the Board granted service connection for vertigo.

Rationale

Current diagnosis of vertigo; Secondary to service-connected tinnitus/bilateral hearing loss; Persuasive private medical opinion with thorough rationale

Full Decision Text

Citation Nr: A26026945
Decision Date: 03/25/26	Archive Date: 03/25/26

DOCKET NO. 250618-555724
DATE: March 25, 2026

ORDER

Service connection for vertigo is granted.

FINDING OF FACT

Resolving reasonable doubt in favor of the Veteran, his vertigo is secondary to his service-connected tinnitus/bilateral hearing loss.

CONCLUSION OF LAW

The criteria for service connection for vertigo have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service from December 1974 to November 2000.

In November 2024, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of this issue most recently addressed in a December 2023 rating decision. In March 2025, the agency of original jurisdiction (AOJ) issued the supplemental claim decision on appeal, which implicitly found that new and relevant evidence had been received and denied the claim based on the evidence of record at the time of that decision. 

In the June 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the direct review docket.

Therefore, the Board may only consider the evidence of record at the time of the March 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a supplemental claim are included with this decision. 

Service connection for vertigo is granted.

The Veteran seeks service connection for vertigo, to include as secondary to his service-connected tinnitus/bilateral hearing loss.

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

Service connection may also be granted for a disability that is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists, and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. 38 C.F.R. § 3.310(a)-(b). Secondary causation exists when, but for the service-connected disability, the non-service-connected was caused by a service-connected disability either in a direct, etiological way or via multiple steps in a causal chain. Spicer v. McDonough, 61 F.4th 1360, 1365 (Fed. Cir. 2023) (citations omitted). Secondary aggravation exists when the non-service-connected disability not caused by a service-connected disability would be less severe were it not for a service-connected disability. Id. at 1364. For example, secondary aggravation may be established where the natural progression of the non-service-connected disability could have been arrested or improved but for the service-connected disability. Id.

Here, the record reflects that the Veteran has a current diagnosis of vertigo and has been awarded service connection for tinnitus and bilateral hearing loss.

In October 2023, the Veteran underwent a VA examination, wherein he was diagnosed with vertigo. The clinician opined that the Veteran's vertigo was not related to service and was not caused or aggravated by the Veteran's service-connected tinnitus or bilateral hearing loss. However, the examiner did not provide adequate rationale for
 disability would be less severe were it not for a service-connected disability. Id. at 1364. For example, secondary aggravation may be established where the natural progression of the non-service-connected disability could have been arrested or improved but for the service-connected disability. Id.

Here, the record reflects that the Veteran has a current diagnosis of vertigo and has been awarded service connection for tinnitus and bilateral hearing loss.

In October 2023, the Veteran underwent a VA examination, wherein he was diagnosed with vertigo. The clinician opined that the Veteran's vertigo was not related to service and was not caused or aggravated by the Veteran's service-connected tinnitus or bilateral hearing loss. However, the examiner did not provide adequate rationale for this conclusion.

In November 2024, the Veteran submitted a private opinion in support of his appeal. Therein, the clinician recounted that he reviewed the Veteran's claims file and found that it was more likely than not that his vertigo was secondary to his service-connected tinnitus and bilateral hearing loss. In so finding, he drew on the fact that the Veteran's service-connected tinnitus and bilateral hearing loss are evidence of damage to his inner ear caused by his in-service noise exposure, and cited to medical literature showing that people who have hearing loss are much more likely to have balance disorders due to the fact that both disorders are "located in the inner ear in a common space, and they share similar biological and physiological features." The clinician further noted that, apart from his in-service noise exposure and resultant tinnitus/bilateral hearing loss, the Veteran did not have any other known causes that would have contributed to his vertigo.

The Board finds this opinion persuasive as it considers the Veteran's relevant medical history and provides a thorough rationale. Moreover, it is the only probative opinion of record. In this regard, as the October 2023 VA opinion failed to provide a rationale, it is of no probative value.

Accordingly, based on the above and resolving any reasonable doubt in favor of the Veteran, the Board finds that service connection for vertigo is warranted. 

 

 

M. Donohue

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A.Z., 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.