PERIPHERAL VESTIBULAR DISORDERS

COLLEEN M. GLASER-ALLEN · 2026 · Case ID: A26039529

MIXED

Summary

The Veteran, who served in the U.S. Navy from March 1988 to February 1998, appeals the denial of service connection for vertigo and erectile dysfunction. The Board found that the Veteran's service treatment records contained contemporaneous complaints of vertigo, dizziness, and lightheadedness during service, and the Veteran provided credible lay testimony describing these symptoms and their continuity since service, believing they were related to aircraft noise exposure. The Board also noted the Veteran's service connection for hearing loss and tinnitus. However, the VA medical examiner's opinion was deemed inadequate because it failed to address the Veteran's lay reports of symptom onset during service and the potential secondary connection to service-connected hearing loss and tinnitus, and it misstated the criteria for service connection by requiring chronicity. The Board found the evidence in approximate balance regarding vertigo, resolving doubt in the Veteran's favor due to his credible lay testimony and service treatment record notations, and granted service connection for vertigo. For erectile dysfunction, the Veteran claimed it was caused by Antabuse prescribed during service for alcohol abuse. While the Veteran reported symptoms and believed they were related to the medication, the Board found no diagnosis of erectile dysfunction in the record, noting only a single prescription for Viagra in 2007 and the Veteran's own reports of "never" having erectile dysfunction. The Board concluded the evidence persuasively weighed against the claim, denying service connection for erectile dysfunction.

Rationale

Service treatment records show contemporaneous complaints of vertigo during service.; Veteran provided credible lay testimony describing symptoms and continuity since service.; Evidence found in approximate balance, resolving doubt in Veteran's favor.

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210614-165958

Full Decision Text

Citation Nr: A26039529
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 210614-165958
DATE: April 28, 2026

ORDER

Entitlement to service connection for vertigo is granted.

Entitlement to service connection for erectile dysfunction is denied.

FINDINGS OF FACT

1. The evidence is in approximate balance that the Veteran's vertigo was incurred in and is related to military service.

2. The weight of the evidence does not show that the Veteran had a diagnosis for erectile dysfunction.

CONCLUSIONS OF LAW

1. After affording the benefit of the doubt, the criteria for entitlement to service connection for vertigo have been met. 38 U.S.C.§§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.3.

2. The criteria for entitlement to service connection for erectile dysfunction have not been met. 38 U.S.C.§§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.3.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Navy from March 1988 through February 1998. His awards and decorations include the Navy Achievement Medal and National Defense Service Medal, among others.

Introduction

This matter comes before the Board of Veterans' Appeals (Board) on the Veteran's appeal of a January 2021 rating decision issued by the Department of Veterans Affairs (VA) Regional Office, which is the Agency of Original Jurisdiction (AOJ). The January 2021 rating decision denied entitlement to service connection for vertigo and for erectile dysfunction. In June 2021, the Veteran submitted a VA Form 10182: Decision Review Request: Board Appeal (Notice of Disagreement), appealing the AOJ's denial of entitlement to those conditions. The Veteran elected the Hearing docket. A hearing was held before the undersigned member of the Board in October 2024; the transcript of that hearing is included in record. See October 2024 Hearing Transcript.

Evidentiary Windows

Because the Veteran elected the Hearing docket, the Board may only consider the evidence of record at the time of the rating decision on appeal, as well as any evidence submitted by the Veteran at his Board hearing or within the 90 days following that hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the January 2021 rating decision and prior to the Board hearing, or (2) more than 90 days following the hearing, the evidence could not be considered in this decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. Here, the Veteran submitted evidence that could not be considered by the Board.

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.

Legal Criteria

Evidence Assessment

The Board interprets the evidence, determining the weight and credibility as well as making reasonable inferences from it. Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001); Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15 Vet. App. 362, 367 (2001); Evans v. McDonald, 27 Vet. App. 180, 187 (2014); 38 U.S.C. § 7104(a). The Board has wide latitude and discretion in its evaluation of the evidence; its assignment of probative weight, its credibility determinations, interpretations, and conclusions are all subject to review under the deferential clearly erroneous standard. 38 U.S.C. § 7261(a)(4).

When making its determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on matters which they have personal knowledge of,
1998); Wensch v. Principi, 15 Vet. App. 362, 367 (2001); Evans v. McDonald, 27 Vet. App. 180, 187 (2014); 38 U.S.C. § 7104(a). The Board has wide latitude and discretion in its evaluation of the evidence; its assignment of probative weight, its credibility determinations, interpretations, and conclusions are all subject to review under the deferential clearly erroneous standard. 38 U.S.C. § 7261(a)(4).

When making its determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on matters which they have personal knowledge of, such as the onset and continuity of symptomatology. Layno v. Brown, 6 Vet. App. 465, 470 (1994). Lay evidence can also be competent and sufficient evidence of a diagnosis or to establish etiology if (1) the layperson is competent to identify the medical condition, (2) the layperson is reporting on a contemporaneous medical diagnosis made by a medical professional, or (3) the lay testimony describing symptoms supports the later diagnosis of a condition by a medical professional. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007).

The benefit of the doubt doctrine, codified at 38 U.S.C. § 5107(b), is a unique standard of proof in the American jurisprudence; "the nation, 'in recognition of our debt to our veterans' has 'taken upon itself the risk of error . . .' in awarding such benefits." Wise v. Shinseki, 26 Vet. App. 517, 531 (2014). Therefore, when there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of a matter before VA, the benefit of the doubt in resolving each such issue shall be afforded to a veteran. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102, 4.3. The benefit-of-the-doubt doctrine does not apply when the evidence persuasively favors one side. Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021).

Service Connection

Generally, service connection (which is a prerequisite to entitlement to disability compensation) will be granted if it is shown that a veteran suffers from a disability resulting from an injury suffered or disease contracted in the line of duty, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty, during active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303.

When an injury or disease is diagnosed after discharge from service, service connection may also be granted when the evidence establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). The veteran ultimately bears the burden of presenting and supporting a claim for benefits. 38 U.S.C. § 5107; Fagan v. Shinseki, 573 F.3d 1282 (Fed. Cir. 2009); Cromer v. Nicholson, 455 F.3d 1346 (Fed. Cir. 2006).

In order to establish service connection on a direct basis, the record must contain competent evidence of: (1) the existence of a current disability; (2) the in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Establishing service connection on a secondary basis requires sufficient evidence 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 disability 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 aggrav
2004).

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.

1. Service Connection for Vertigo

The Veteran claimed entitlement to service connection for vertigo, a condition which he believed was caused or aggravated by his service-connected hearing impairment (and presumably his related noise-induced, service-connected tinnitus as well). See, e.g., September 2020 VA Form 21-526EZ: Application for Disability Compensation and Related Compensation Benefits; June 2021 VA Form 10182: Decision Review Request: Board Appeal (Notice of Disagreement).

Evidence

The AOJ made favorable findings that: (1) the Veteran suffered from vertigo; and (2) his service treatment records show an event, injury, and disease in service, specifically, complaints of vertigo, nausea, and lightheadedness. See January 2021 Rating Decision Narrative. Favorable findings are binding on the Board, absent clear and unmistakable error. 38 C.F.R. 3.104. As there was no indication of error, the first two elements of service connection are met. Further, for purposes of its consideration of secondary service connection, the Board notes that the Veteran was previously service-connected for tension headaches, bilateral hearing loss, and tinnitus. See, e.g., January 2021 Rating Decision Codesheet.

The questions left for the Board are whether the Veteran's current vertigo disability is etiologically related to his in-service vertigo symptoms or whether a service-connected condition or conditions (such as his headaches, tinnitus, or bilateral hearing loss) caused or aggravated his vertigo symptoms.

As noted above, the Veteran's contemporaneous complaints of vertigo symptoms are recorded in his service treatment records. See, e.g., January 2014 Service Treatment Records (notations for dizziness and lightheadedness). Next, at his Board hearing, the Veteran reported vertigo symptoms such as dizziness, nausea, and a need to rest after an episode. He explained that he believed his condition was caused by exposure to jet aircraft flight lines while serving in the Navy. Lastly, the Veteran provided some confusing testimony regarding what medical providers told him about his condition; he appeared to state that a medical provider told him that he may have a structural ear condition which contributed to his vertigo, and also that his vertigo "could be from tinnitus." The Veteran continued that the provider told him that his hearing loss, tinnitus, and vertigo were "all related."

There is also VA medical examination report and medical opinion of record. See December 2020 Ear Conditions (including Vestibular and Infectious Conditions) Disability Benefits Questionnaire; January 2021 Medical Opinion Disability Benefits Questionnaire. The medical examination report confirmed the Veteran's diagnosis for benign paroxysmal positional vertigo. There, the Veteran reported to the examiner that he experiences intermittent dizziness, and his symptoms began in approximately 1990. The Veteran stated that he experiences episodes of vertigo three to four times per week, and the episodes last for up to an hour.

In the associated medical opinion, the VA examiner acknowledged that the Veteran suffered from vertigo symptoms during and since service but opined that his claims file did not support "chronic" vertigo symptomology, and without documentation of chronic symptomology there was no nexus between the Veteran's in-service symptoms and his current disability. The medical opinion did not offer any opinion on secondary service connection or consider or discuss the Veteran's lay report that his symptoms began in 1990 (during service) as was notated on the examination report.

Lastly, for the sake of completeness, the Board notes that there are intermittent reports of dizziness contained in the Veteran's VA CAPRI medical records, supporting his reports of symptomology continuity since service. See March 2013 VA CAP
, the VA examiner acknowledged that the Veteran suffered from vertigo symptoms during and since service but opined that his claims file did not support "chronic" vertigo symptomology, and without documentation of chronic symptomology there was no nexus between the Veteran's in-service symptoms and his current disability. The medical opinion did not offer any opinion on secondary service connection or consider or discuss the Veteran's lay report that his symptoms began in 1990 (during service) as was notated on the examination report.

Analysis and Conclusion

Given the nature of the Veteran's claim, the Board has considered the theories of direct and secondary service connection.

Unfortunately, the only medical examination report and opinion of record discussing or opining on the Veteran's vertigo is inadequate. The examination is inadequate for several reasons. First, the examiner did not consider or discuss the Veteran's lay report that his vertigo symptoms began in service and continued since. Second, the examiner appeared to state that there could be no nexus between the Veteran's condition and service without chronicity, which is a misstatement of the criteria for service connection. Lastly, despite the Veteran claiming that he believed his service-connected bilateral hearing loss caused his vertigo, the AOJ did not obtain any opinion on secondary service connection, and the opinion of record did not consider or discuss whether any service-connected condition caused or aggravated the Veteran's vertigo.

Due to the nature of the Veteran's claim and the lack of an adequate opinion, the Board strongly considered remanding this claim for supplemental medical opinions considering the Veteran's reports of symptomology since 1990 and addressing his claim that his condition should be service connected as secondary to his service-connected hearing loss and tinnitus.

The Board recognizes this appeal originates from a January 2021 rating decision and that the Veteran's hearing was held in October 2024. Further, though certainly not its intent, the Board is also aware that a remand could be construed as attempting to impermissibly develop negative evidence to deny the Veteran's claim. 38 C.F.R. § 3.304(c); Andrews v. McDonough, 34 34 Vet. App. 216, 225 (2021) (remand is 'inappropriate where the predominant purpose is not to allow the Board to make a fully informed decision unencumbered by error but to allow VA to obtain more evidence so that it can properly deny the claim').

Here, the Veteran was formally diagnosed with vertigo by a medical provider. Unlike conditions with more complicated diagnosis requirements, the Veteran is competent to identify and describe dizziness and related vertigo symptoms; he provided competent lay evidence describing those which he stated first manifested during service when after being exposed to aircraft noise (which also damaged his hearing and caused tinnitus). The undersigned had the opportunity to observe the Veteran during his Board testimony and found no reason to doubt his credibility. Further, while perhaps providing less detail than ideal, he provided testimony that his medical provider indicated there was a medical relationship between his vertigo and his service-connected hearing loss and tinnitus.

With those factors in mind and especially given the Veteran's credible lay reports of his vertigo symptoms beginning in service and the corroboration from his service treatment records, rather than remand, the Board finds that the evidence in this instance is in approximate balance that the Veteran's vertigo is etiologically related to service.

To the extent that this grant of service connection is primarily based on the Veteran's lay testimony, if the Board concludes that "the lay evidence presented by a veteran is credible and ultimately competent, the lack of contemporaneous medical evidence should not be an absolute bar to the veteran's ability to prove [their] claim . . . based on that competent lay evidence." Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006).

Therefore, the Board resolves doubt in the Veteran's favor and finds entitlement to service connection for vertigo is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990) ("a [V]eteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail"); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) ("When the evidence is in approximate balance in the Veteran's favor or nearly equal regarding any issue material to
. Cir. 2006).

2. Service Connection for Erectile Dysfunction

The Veteran claimed that he suffered from erectile dysfunction caused by a medication prescribed during service to treat alcohol abuse. See, e.g., September 2020 VA Form 21-526EZ: Application for Disability Compensation and Related Compensation Benefits; October 2024 Hearing Transcript.

The Board notes that the Veteran was prescribed "Antabuse" while undergoing Navy alcohol abuse treatment in 1990. See July 2014 Service Treatment Records.

However, as discussed above, the first element of service connection is a diagnosis for a current disability. The Veteran had two children, the first in 1993 and the second in 1994, relatively soon after being treated with Antabuse and while still serving in the Navy. See March 1998 Certificate of Live Birth; March 1998 Certificate of Live Birth. When asked about how he had fathered children with erectile dysfunction at his hearing, the Veteran acknowledged his children but explained that he would have wanted to have more but for his erectile issues. Specifically, the Veteran reported that his erections "didn't last . . ." and he had trouble getting and maintaining erections. The Veteran continued that although the doctors did not make entries for erectile issues in his medical files, they told him they were a side effect of Antabuse.

The Board reviewed the entire claims file, including the Veteran's VA, military, and private medical records. The Board did not find any medical diagnosis for erectile dysfunction, reports of impotence, or the like. In fact, the medical evidence of record contained only one prescription for Viagra in 2007, as well as the Veteran's contemporaneous reports of "never" having erectile dysfunction. See, e.g., October 2019 VA CAPRI Records.

Even if the Board construed the one-time prescription for Viagra as sufficient evidence of erectile dysfunction, beyond his claim and hearing testimony, there were no other indications of erectile dysfunction noted in the record. As there is no showing of a current erectile dysfunction diagnosis, the claim must be denied. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) ('Congress specifically limits entitlement . . . to cases where such incidents have resulted in a disability. In the absence of proof of a present disability there can be no valid claim').

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Therefore, service connection for erectile dysfunction is not warranted. In reaching this conclusion, the Board finds the weight of the evidence is persuasively against the claim, therefore, no reasonable doubt exists to resolve in the Veteran's favor. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 C.F.R. § 3.102. Accordingly, the appeal is denied.

Colleen M. Glaser-Allen

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board M. Stanley

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.

.1303.

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