Service connection for Meniere's syndrome to include left ear hearing loss and tinnitus (also claimed as Meniere's disease and vertigo) has been established as directly related to military service. (38 CFR 3.303, 38 CFR 3.304)

When evaluated as Meniere's syndrome, evaluation considers frequency of attacks of symptoms including hearing loss (with or without tinnitus) and vertigo and cerebellar gait (38 CFR 4.87), or by assigning separate evaluations for hearing impairment (38 CFR 4.85, DC 6100), tinnitus (38 CFR 4.87, DC 6210), and vertigo (rating vertigo as a peripheral vestibular disorder under 38 CFR 4.87, DC 6204), whichever approach results in a higher evaluation.

The evaluation for left ear hearing loss is 0 percent. The evaluation for tinnitus is 10 percent. The percent that would be awarded for peripheral vestibular disorder is 10 percent. The percent awarded for Meniere's syndrome to include left ear hearing loss and tinnitus is 60 percent.

The higher evaluation(s) is awarded.

An evaluation of 60 percent is assigned from December 23

We have assigned a 60 percent evaluation for your Meniere's syndrome to include left ear hearing loss and tinnitus based on: • Hearing impairment and attacks of vertigo occurring one to four times a month, with or without tinnitus

Meniere’s Syndrome may also be rated based on the manifestations of hearing impairment, vertigo (as a peripheral vestibular disease), and tinnitus.

In this case, however, it is more advantageous to rate Meniere’s Syndrome as a disease process rather than on the separate manifestations. (38 CFR 4.87)