Question:

Hi Jim, I currently receive 20% service connected disability for tinnitus and hearing loss as a result of extended exposure to sustained loud noises. I have been wearing VA supplied hearing aids. I have also been diagnosed with bilateral Meniere's, for which I am currently being treated, and Benign paroxysmal positional vertigo (BPPV), which I do physical therapy at home after completing balance classes from my neurologist.
 

I have a nexus letter from my ENT stating that the Meniere's disease caused my hearing loss and tinnitus. Prior to rotating home from in-country, I was diagnosed with and treated for herpes simplex on both arms. Then, Hepatitis, which I was also treated for. It's my understanding that Meniere's disease is caused by a virus. Additionally, I have been diagnosed by the VA for Major depressive disorder, anxiety and stress from trauma, and lastly, I was diagnosed with sleep apnea. I've been on CPAP for several years. I have a 60% rating for back injuries sustained while serving in the Marine Corps for a total of 80% VA compensation. In your opinion can I file a secondary claim for sleep apnea or should I file for depression, or anxiety, or Meniere's disease? Thanks for your help.

Jim's Reply:

You ask a pretty popular question. Just how does one go about getting an increase in a disability rating when the rated condition has measurably worsened over time?
 

First up: Make a plan. What is the #1 problem and the place where you have a seriously worsening disabling condition? To my eye and from what you tell me, your hearing has gone downhill. The 10% for tinnitus is the max for that condition. But if you're wearing hearing aids your hearing is likely to deserve a higher rating. From the hearing problem may flow some of the anxiety and stress.
 

People who haven't experienced hearing loss don't understand how it can have such a negative effect on your life when you can't hear a TV (garbled) or a movie in a theater (garbled) and so on. Significant depression and anger and even suicidal ideation may result. That goes for tinnitus too. Many folks get used to it and don't notice it, it can drive some vets over the edge. If tinnitus is affecting your mental health, speak up.
 

You can pursue having the Meniere's Disease service connected and rated but that's often a steep uphill climb. You'll need an IMO in support of your claim. In fact, you probably should consider an IMO from the start because you have significant but fairly complex claims. A well written IMO will be a huge help to you https://www.vawatchdog.org/imo-ime-medical-opinions-exams.html   

In fact, having read your email a couple more times, I think you should seriously consider an IMO or "Nexus Letter" written by a professional who does this every day. The IMO doctor will be able to tie your conditions together as to cause and effect as well as to define secondary conditions and how and why they are just that. 
 

If you aren't able to work you're eligible to file for the TDIU benefit and that may be a quicker route for you to consider. https://www.vawatchdog.org/tdiu-unemployability.html  TDIU provides you with exactly the same 100% benefits as a schedular 100% rating does other than you can't work. It's a sort of shortcut to the 100% rating for certain eligible vets.
 

I'm also sensing that you may be more seriously injured and permanently disabled than you want to confess. It's my thought that you are probably going to find yourself eligible for SMC now or in the near future. I don't want to sound all doom and gloom but you know you have a lot going on. 
 

If you need some help sorting this out and filing claims you're welcome to contact me via my VAWatchdog.org site and we'll see what we can do. Semper Fi.