PERIPHERAL VESTIBULAR DISORDERS

Summary

The veteran served from March 1968 to March 1971. He appealed the denial of an increased rating for tinnitus and sought a separate rating for vertigo. The Board reviewed the evidence of record from the time of the prior decision, including August 2024 and March 2026 VA examination reports. The August 2024 report indicated dizziness occurred 1-4 times per month, with unsteady gait. The March 2026 report diagnosed vertigo with dizziness occurring more than once weekly and staggering more than once weekly. The Board found this objective evidence warranted the maximum 30 percent rating for vertigo under Diagnostic Code 6204, granting a separate rating for this condition. The Board noted that the Veteran was already rated 10 percent for tinnitus under Diagnostic Code 6260. Once vertigo symptoms were detached, the Board found no basis for a higher rating for tinnitus alone, as the current 10 percent rating was the maximum schedular rating and the condition did not meet criteria for an extraschedular rating. The Board also considered, but denied, an extraschedular rating for tinnitus, finding it did not meet the two-element test for exceptional disabilities with marked interference with employment. The Board acknowledged the examiner's notes regarding interference with task completion due to vertigo symptoms but found no evidence of inability to secure or follow substantially gainful employment, thus denying a TDIU claim.

Rationale

Objective evidence from VA examinations supports 30% rating; Vertigo symptoms include dizziness and staggering; Separated from tinnitus disability

Full Decision Text

Citation Nr: A26039286
Decision Date: 04/28/26	Archive Date: 04/28/26

DOCKET NO. 260325-640760
DATE: April 28, 2026

ORDER

Entitlement to a separate rating of 30 percent for vertigo is granted.

Entitlement to an initial rating in excess of 10 percent for tinnitus is denied.

FINDING OF FACT

1. The Veteran's tinnitus resulted in a perception of sound.

2. The Veteran's vertigo resulted in dizziness and occasional staggering.

CONCLUSION OF LAW

1. The criteria for a rating in excess of 10 percent for tinnitus are not met.  38 U.S.C. § 1155; 38 C.F.R. § 4.87, Diagnostic Code 6260.  

2. The criteria for a separate rating of 30 percent for vertigo have been met.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.87, Diagnostic Code 6204.  

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from March 1968 to March 1971.  

This matter is before the Board of Veterans' Appeals (Board) on appeal of a March 2026 Appeals Modernization Act (AMA) rating decision which denied an increased rating for the claim of tinnitus with vertigo by the Department of Veterans Affairs (VA) Regional Office (RO). 

Later in March 2026, the Veteran submitted a VA Form 10182 Decision Review Request form opting into AMA and selecting the Direct Review lane. In his appeal, the Veteran identified the issue as a rating for vertigo.  The Board interprets this as seeking a separate rating for vertigo, but to ensure the Veteran's interests are addressed in full, the Board also adjudicated the separate issue of an extraschedular rating for tinnitus.

As explained in the VA Form 10182, "direct review" means that the Board's decision must be based upon the evidence of record at the time of the prior decision, with no evidence submission or hearing request.  As such, the Board has considered only the evidence of record at the time of the March 2026 decision. 

Under 38 C.F.R. § 20.202(c)(2), an appellant selecting the direct review docket has one year to change to the evidence submission or hearing docket. While that period has not yet lapsed, the Board nevertheless proceeded with adjudication of this appeal after determining that no realistic risk of prejudice to the Veteran is presented by granting the maximum schedular rating for vertigo and denying an extraschedular rating for tinnitus. 

1. Entitlement to a separate rating of 30 percent for vertigo is granted.

2. Entitlement to an initial rating in excess of 10 percent for tinnitus is denied.

The Veteran is currently assigned a 10 percent disability rating under Diagnostic Code 6204-6260 for tinnitus with vertigo.  He contends he should be provided a separate rating for his vertigo, which manifests as dizziness and staggering, and that his tinnitus rating should be increased.

Disability Rating Background

The rating for a service-connected disability is generally determined by applying the criteria in the diagnostic code (DC) associated with that disability, as set forth in the VA rating schedule codified in the Code of Federal Regulations (C.F.R.). See 38 C.F.R. § 4.27; Copeland v. McDonald, 27 Vet. App. 333, 336-37 (2015). 

The starting point for assigning a rating is the "limitation of activity imposed by the disabling condition," and the veteran's ability "to function under the ordinary conditions of daily life including employment [and] self-support." 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1, 4.10. The evidence pertaining to a veteran's impairment must be evaluated "from the point of view of the veteran working or seeking work." 38 C.F.R. § 4.2. 

The VA then combines the evaluations for each separate disability to create a single combined rating, which sets the veteran's level of compensation. 38 C.F.R. § 4.25.

Diagnostic Code 6204 evaluates peripheral vestibular disorders.  Peripheral vestibular disorders manifesting occasional dizziness are rated at 10 percent disabling.  Peripheral vestibular disorders manifesting dizziness and occasional staggering are rated at 30 percent disabling.  

Diagnostic Code 6260 evaluates tinnitus. A 10 percent rating is assigned regardless
1, 4.10. The evidence pertaining to a veteran's impairment must be evaluated "from the point of view of the veteran working or seeking work." 38 C.F.R. § 4.2. 

The VA then combines the evaluations for each separate disability to create a single combined rating, which sets the veteran's level of compensation. 38 C.F.R. § 4.25.

Diagnostic Code 6204 evaluates peripheral vestibular disorders.  Peripheral vestibular disorders manifesting occasional dizziness are rated at 10 percent disabling.  Peripheral vestibular disorders manifesting dizziness and occasional staggering are rated at 30 percent disabling.  

Diagnostic Code 6260 evaluates tinnitus. A 10 percent rating is assigned regardless of whether the sound is perceived in one ear, both ears, or the head

Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the specific basis for the evaluation assigned.  38 C.F.R. § 4.27.  

When the Board finds a rating higher than the maximum available in the rating schedule may be warranted, the Board remands the appeal to the AOJ with directions to refer to it to the Director of Compensation Service for consideration of an extraschedular disability rating. 38 C.F.R. § 3.321(b). 

Based on Thun v. Peake, 22 Vet. App. 111, 114-116 (2008), Board applies a two-element test to determine whether an issue warrants referral. 

First, the Board must determine whether the veteran's disability is exceptional-i.e., it manifests as symptoms or impairments not contemplated by the regular schedular rating criteria. Id. See also, Long v. Wilkie, 33 Vet. App. 167, 174 (2020) (a disability is "exceptional" only if it cannot be evaluated by "conventional rating means"). 

If so, the Board then must determine whether the effects of the veteran's symptoms or impairments include "related factors" such as "marked interference with employment" or "frequent periods of hospitalization" justifying compensation beyond what is contemplated in the established rating criteria. The issue of entitlement to an extraschedular rating will be referred only if both elements are met. Thun 22 Vet. App. at 115; Yancy v. McDonald, 27 Vet. App. 484, 494 (2016).

Providing multiple separate ratings under different diagnostic codes for what is in fact a single disability, symptom or impairment is known as "pyramiding." Pyramiding is prohibited under 38 C.F.R. § 4.14. See also, Brady v. Brown, 4 Vet. App. 203, 206 (1993) (pyramiding is prohibited because it compensates a veteran beyond the actual degree of impairment suffered). 

However, if two disabilities are manifestations of a single pathology or arise from a single incident but present distinguishable symptoms or impairments, this prohibition does not apply.

Evidence and Analysis

In an August 2018 rating decision, the RO granted a separate and compensable disability rating, 10 percent, for the Veteran's vertigo disability, under Diagnostic Code 6204.  The Veteran was already service-connected for tinnitus, under Diagnostic Code 6260, with an assigned evaluation of 10 percent.

Then, in an April 2025 rating decision, the Veteran's evaluation for vertigo was combined with the evaluation for tinnitus, and rated together as a single disability.  A 10 percent disability was assigned under Diagnostic Code 6204-6260 to be "tinnitus with vertigo."  

The August 2024 VA ear conditions examination report shows that the Veteran reported experiencing dizziness and a loss of balance due to his condition. Upon examination, the Veteran's dizziness occurred at a frequency of 1 to 4 times per month, for less than an hour.  The Veteran's gait was unsteady, slow and limping.  The limb coordination test found that the Veteran was not aiming correctly on the nose with each finger.  

The March 2026 VA examination report shows a diagnosis of vertigo and indicating that the Veteran has a peripheral vestibular condition resulting in dizziness occurring more than once weekly and a finding of staggering occurring more than once weekly.  

Therefore, based on the objective evidence outlined above, the maximum 30 percent rating is warranted under Diagnostic Code 6204 for vertigo for the entire period on appeal. 

Once the symptomatology associated with vertigo is detached from the Veteran's tinnitus disability, there is no basis for assigning a higher rating for tinnitus alone under Diagnostic Code 6260. 

The Veteran is currently in receipt of the highest rating for his service-connected tinnitus, and there is no aspect of his tinnitus per
 finger.  

The March 2026 VA examination report shows a diagnosis of vertigo and indicating that the Veteran has a peripheral vestibular condition resulting in dizziness occurring more than once weekly and a finding of staggering occurring more than once weekly.  

Therefore, based on the objective evidence outlined above, the maximum 30 percent rating is warranted under Diagnostic Code 6204 for vertigo for the entire period on appeal. 

Once the symptomatology associated with vertigo is detached from the Veteran's tinnitus disability, there is no basis for assigning a higher rating for tinnitus alone under Diagnostic Code 6260. 

The Veteran is currently in receipt of the highest rating for his service-connected tinnitus, and there is no aspect of his tinnitus per se that is not contemplated by the diagnostic criteria, nor does his tinnitus require hospitalization or create marked interference with employment.  Thus, an extraschedular rating for tinnitus is not appropriate.  

Conclusion

Resolving all reasonable doubt in the Veteran's favor, a separate rating of 30 percent for vertigo under Diagnostic Code 6204 is warranted. To that extent, this appeal is granted. However, no increase in the Veteran's disability rating for tinnitus is warranted, and to that extent, this appeal must be denied.

Other Considerations

The Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record.  See Doucette v. Shulkin, 28 Vet. App. 366 (2017).

As a final matter, the Board acknowledges that in Rice v. Shinseki, 22 Vet. App. 447 (2009), it was held that a claim for a total disability rating based on individual unemployability (TDIU) is part of an increased rating claim when such is raised by the record.  The August 2024 VA examiner noted that the Veteran was unable to focus or concentrate on and or complete tasks when vertigo symptoms set in.  The March 2026 VA examination report shows that the VA examiner noted that the Veteran's intermittent nausea and staggering, when dizzy, would interfere with task completion.  

While limitations due to the Veteran's disability are noted, there is no evidence to suggest that he is unable to secure or follow a substantially gainful occupation due to the synergistic effects of his service-connected disabilities at this juncture.  Accordingly, a TDIU claim has not been raised, and no action pursuant to Rice is necessary.

 

 

Timothy Cothrel

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Evans, A-L

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.