Citation Nr: 0718110 Decision Date: 06/15/07 Archive Date: 06/26/07 DOCKET NO. 05-33 290 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in No. Little Rock, Arkansas THE ISSUE Entitlement to service connection for vertigo with staggering. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Steven D. Reiss, Counsel INTRODUCTION The veteran served on active duty from June 1968 to June 1970, including combat service in the Republic of Vietnam, and his decorations include the Bronze Star Medal with "V" device, the Combat Infantryman Badge and the Purple Heart Medal. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2004 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in No. Little Rock, Arkansas, that denied the veteran's claim of service connection for vertigo with staggering. In August 2006, the veteran testified by video conference at a hearing held before the undersigned Veterans Law Judge. During the August 2006 hearing, the veteran reported that he suffered from chronic ear infections as a consequence of his in-service acoustic trauma. To date, VA has not adjudicated this claim and it is referred to the RO for appropriate action. FINDINGS OF FACT Resolving all reasonable doubt in the veteran's favor, the evidence indicates that he has dysequilibrium that is due to combat-related trauma to the tympanic membrane. CONCLUSION OF LAW The veteran's dysequilibrium was incurred in service. 38 U.S.C.A. §§ 1110, 1154(b), 5107(b) (West 2002); 38 C.F.R. §§ 3.102, 3.303, 3.304(d) (2006). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS In this decision, the Board grants service connection for dysequilibrium, which represents a complete grant of the benefit sought on appeal. Thus, no discussion of VA's duties to notify and assist is required. In his statements and testimony, the veteran asserts that service connection is warranted for dizziness and staggering because he has this condition due to his combat-incurred ear trauma. In support, he points out that the service medical records document his in-service ear trauma. He also highlights that VA has established service connection for tinnitus, bilateral hearing loss and perforation of his left tympanic membrane due to that in-service trauma. In addition, the veteran cites his numerous combat citations and he reports that he had no post-service ear trauma. Finally, he notes that a VA examiner diagnosed him as having dysequilibrium of unclear etiology, and urges VA to resolve doubt in his favor and grant service connection for this condition. Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a pre-existing injury suffered or disease contracted in line of duty. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303. The law also provides that service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Generally, to establish service connection, there must be (1) medical evidence of a current disability, (2) medical evidence, or in certain circumstances lay testimony, of in- service incurrence or aggravation of an injury or disease, and (3) medical evidence of a nexus between the current disability and the in-service disease or injury. See Hickson v. West, 12 Vet. App. 247, 253 (1999). In addition, in cases where a veteran asserts service connection for injuries or disease incurred or aggravated in combat, 38 U.S.C.A. § 1154(b) and its implementing regulation, 38 C.F.R. § 3.304(d), are applicable. This statute and regulation ease the evidentiary burden of a combat veteran by permitting the use, under certain circumstances, of lay evidence. If the veteran was engaged in combat with the enemy, VA shall accept as sufficient proof of service connection satisfactory lay or other evidence of service incurrence, if the lay or other evidence is consistent with the circumstances, conditions, or hardships of such service. 38 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(d). To establish service connection, however, there must be medical evidence of a nexus between the current disability and the combat injury. Dalton v. Nicholson, 21 Vet. App. 23, 36-37 (2007); Libertine v. Brown, 9 Vet. App. 521, 523-24 (1996). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C.A. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). As noted above, the veteran has been awarded numerous combat citations. Further, the award certificate for his Bronze Star Medal with "V" device reflects that he suffered punctured ear drums during combat. In addition, the service medical records confirm that he sustained ear trauma due to a combat injury while serving in Vietnam and document that the veteran received significant treatment for ear problems during service. Indeed, as the veteran points out, as a consequence of his combat ear injuries, service connection has been established for tinnitus, bilateral hearing loss and the residuals of the perforation of the left tympanic membrane. In denying this claim, the RO pointed out that the service medical records are negative for complaint or treatment of vertigo and that there was no medical evidence linking the condition to his service-connected ear disabilities. As the veteran has emphasized, however, in March 2003 a VA physician diagnosed him as having dysequilibrium. Further, although he indicated that the etiology of the disorder was unclear, the examiner stated that because of the condition of the tympanic membrane, which was perforated in service, it was possible that its hypercompliace touched the stapes, which might explain the cause of the veteran's dizziness. The March 2003 VA examiner's opinion constitutes the only competent medical evidence addressing whether the veteran's dysequilibrium is related to service. The Board interprets that examiner's assessment, particularly given his explanation, as essentially providing a nexus between this condition and the veteran's combat service in Vietnam. Thus, the veteran has satisfied his burden of showing that he suffers from a chronic disability as a result of an in- service injury. See Dalton; Libertine. Thus, with resolution of all reasonable doubt in the veteran's favor, the Board finds that service connection is warranted. ORDER Service connection for dysequilibrium is granted. ____________________________________________ MICHAEL E. KILCOYNE Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs