Citation Nr: 1318993 Decision Date: 06/11/13 Archive Date: 06/21/13 DOCKET NO. 06-26 082 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUE Entitlement to service connection for migraine headaches. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD K. Gielow, Counsel INTRODUCTION The Veteran served in the Army Reserves from 1998, with a period of active duty from October 2001 to October 2003. The Veteran served in Afghanistan from November 2002 to April 2003 and in Iraq from April 2003 to June 2003. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2004 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. Jurisdiction over this matter was subsequently transferred to the Atlanta, Georgia, RO. A Decision Review Officer (DRO) hearing was held regarding this matter in August 2006. A transcript of this hearing has been associated with the claims file. The appeal is REMANDED to the RO via the Appeals Management Center (AMC) in Washington, DC. VA will notify the appellant if further action is required. REMAND Although the Board regrets the additional delay, a remand is necessary for additional development. The Veteran's service treatment records reflect that she reported headaches during her deployments to Iraq and Afghanistan. See Post-Deployment Health Assessments of February 2003, June 2003, and August 2003. Although the Veteran was provided with a VA examination in August 2004 that provided a diagnosis of migraine headaches, VA treatment reports noted "no headaches" in October 2003, April 2007, August 2007, and April 2008 review of systems. Here, there is evidence of headaches in service, a post-service diagnosis of migraine headaches, but insufficient medical evidence to decide the claim. Therefore, a remand for a VA medical opinion is necessary. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 C.F.R. § 3.159(c)(4) (2012); see also Barr v. Nicholson, 21 Vet. App. 303, 311-12 (2007) (finding that when the VA undertakes to either provide an examination or to obtain an opinion, it must ensure that the examination or opinion is adequate). Finally, to the extent that the Veteran may have received any additional treatment for headaches, recent treatment records should also be obtained on remand. Accordingly, the case is REMANDED for the following actions: 1. The RO/AMC should ask the Veteran to identify all sources of evaluation and/or treatment she has received for her headaches since separation from service (and to provide releases for records from any private providers). If the Veteran identifies pertinent evidence which is not already associated with the claims file, VA should make appropriate attempts to obtain such information pursuant to 38 C.F.R. § 3.156 (2012). If such records are unavailable, the claims file should be clearly documented to that effect and the Veteran should be notified. 2. After the development requested in item (1) is completed, schedule the Veteran for an examination to determine the nature and etiology of the Veteran's claimed migraine headaches. The examiner must be provided with the claims file for review in conjunction with the examination. After conducting all appropriate testing, the examiner is directed to offer an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the disorder was incurred in or is otherwise related to service. The examiner is requested specifically to address the previous 2004 diagnosis of migraine headaches, as well as the documented in-service complaints made during the Veteran's deployments to Iraq and Afghanistan. A thorough rationale must be provided for all opinions rendered. If the reviewing clinician cannot provide the requested opinion without resorting to speculation, he or she should expressly indicate this and provide a supporting rationale as to why an opinion cannot be made without resorting to speculation. 3. The RO/AMC must notify the Veteran that it is her responsibility to report for the scheduled VA examination and to cooperate in the development of the claim. The consequences for failure to report for a VA examination without good cause may result in her claim being decided, and possibly denied, based on the evidence of record. 38 C.F.R. § 3.655(b) (2012). In the event that the Veteran does not report for the examination, documentation should be obtained which shows that notice scheduling the examination was sent to the last known address. It should also be indicated whether any notice that was sent was returned as undeliverable. 4. Thereafter, and after undertaking any additional development deemed necessary, readjudicate the issue on appeal. If the benefit sought remains denied, the Veteran and her representative should be provided with a Supplemental Statement of the Case and afforded a reasonable opportunity to respond. The case should then be returned to the Board for further appellate review, if otherwise in order. The appellant has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ MICHAEL MARTIN Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand 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) (2012).