BVA9508073 DOCKET NO. 93-18 034 ) DATE ) ) On appeal from decisions of the Department of Veterans Affairs Regional Office in Boise, Idaho THE ISSUE Entitlement to an increased evaluation for Meniere's disease, currently rated as 60 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD T. Hal Smith, Counsel INTRODUCTION The veteran served on active duty from February 1948 to February 1954 and from March 1954 to March 1968. This appeal arises from rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in Boise, Idaho. REMAND The VA will assist the veteran in the development of his claim. 38 U.S.C.A. § 5107(a) (West 1991). It is contended by and on behalf of the veteran that he is entitled to an increased evaluation for Meniere's disease in that this disorder has increased in severity. The record shows that service connection for Meniere's disease was established upon rating determination in 1968. A 60 percent evaluation was assigned. This appeal ensued following a RO decision from August 1991 in which the 60 percent rating was confirmed and continued. VA outpatient treatment records show that the veteran was seen in March 1992 for complaints associated with Meniere's disease, to include dizziness, being off balance, nausea and vomiting. He reported that his symptoms had worsened over the last three months. He experienced sharp pain in the right ear and a dull pain in the left ear. Vertigo was especially noticed at bed time. He was unable to travel by car or by plane. In a May 1993 statement, a VA staff physician, Dan Braby, M.D., noted that the veteran had a long-term history of Meniere's disease. This disorder had been present for approximately 28 years. It was bilateral and was described as somewhat progressive. He was status post endolymphatic shunt in September 1987 which decreased the vertiginous episodes for approximately one year and a half, but they had then recurred. Currently, the veteran experienced episodes of nausea, vomiting and rotatory vertigo with slightly increased tinnitus. He had fullness, right greater than the left, but did not have significant hearing fluctuation. He had been refractory to medical treatment of all types, and still remained with viable hearing. The examiner noted that the most recent testing from 1992 showed 84 percent discrimination bilaterally. The physician noted that his diagnosis of Meniere's disease was from history only, as this was the first time that he had seen the veteran. A follow-up visit report from May 1992 indicates that the veteran was seen for hearing aid evaluation. He was issued ear aids on a trial basis although it was noted that he was an experienced user. At a personal hearing in May 1992, the veteran testified that he experienced vertigo at night and had to get up out of bed and focus on something. Sometimes this vertigo was so bad that he had to crawl across the room. This usually happened two or three times per night. If he took a walk, he walked somewhat stiff- legged and often veered to the right. He had fallen quite a bit. In a May 1993 statement, a service representative requested that the veteran be scheduled for an up to date physical examination in that the last treatment records were from 1992. He felt that this was necessary to determine the current severity of the Meniere's disease. The VA has a duty to assist the veteran in the development of facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1994). The Court of Veterans Appeals (Court) has held that the duty to assist in obtaining and developing available facts and evidence to support his claim includes obtaining adequate VA examinations. Littke v. Derwinski, 1 Vet.App. 90 (1990). Under the circumstances of this case, we are also of the opinion that additional assistance is required. The case is REMANDED to the RO for the following: 1. The RO should seek to obtain and associate with the claims folder copies of all treatment records dated from May 1992 to the current date from the Boise, Idaho, VA Medical Center. 2. Thereafter, the veteran should be scheduled for a special VA audiometric examination in order to ascertain the severity of current Meniere's disease. All tests indicated should be performed, and the physician should comment on the severity and frequency of the veteran's episodes of vertigo, the degree of his deafness and as to his cerebellar gait. The claims folder should be made available to the examiner prior to the examination. Following completion of these actions, the RO should review the evidence and determine whether the veteran's claim may now be granted. If not, he and his representative should be provided with an appropriate supplemental statement of the case, and the case should be returned to the Board for further appellate consideration. The veteran need take no action until he is so informed. The purposes of this REMAND are to obtain additional medical evidence and to ensure compliance with due process considerations. Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This action has been taken in accordance with the Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 303, 108 Stat. 4645, ___ (1994), and is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1993).