Citation Nr: 18145004 Decision Date: 10/25/18 Archive Date: 10/25/18 DOCKET NO. 14-26 843 DATE: October 25, 2018 ORDER Entitlement to service connection for chronic headaches is denied. FINDING OF FACT The Veteran’s current headache condition is not related to active service. CONCLUSION OF LAW The criteria for service connection for a chronic headache condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1966 to October 1969. While the Board acknowledges that the Veteran submitted a RAMP opt-in election form, received on December 26, 2017, the appeal had already been activated at the Board on December 6, 2017, and is therefore no longer eligible for the RAMP program. The Board notes that service records and VA treatment records were received since the Agency of Original Jurisdiction (AOJ) last reviewed the record. However, as these records contain evidence duplicative of that already of record regarding the Veteran’s headache condition, they are not pertinent evidence. As such, the Board finds no prejudice to the Veteran in proceeding to adjudicate the claims, as neither waiver of new evidence nor issuance of a supplemental statement of the case is required. See 38 C.F.R. §§ 19.31(b); 20.1304(c). 1. Entitlement to service connection for chronic headaches The Veteran contends that his headache condition is related to service. Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). “To establish a right to compensation for a present disability, a Veteran must show: “(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service”- the so-called “nexus” requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The August 2011 VA examination indicates a diagnosis of chronic headaches. Service treatment records (STRs) indicate that the Veteran complained of headaches when reading. VA treatment records indicate that the Veteran denied headaches on treatment visits on August 18, 2009, February 2, 2010, October 12, 2010, December 21, 2010, and April 26, 2012. Private treatment records do not indicate complaints of or treatment for headaches. The Veteran underwent a VA examination in August 2011. The report indicates that the Veteran reported that severe headaches started in his temple and progressed to his neck during the last year of service. He reported that daily headaches continued and in 1997 he developed a headache with a fever and went to the hospital but eventually began to deal with his headaches by himself. The report indicates that the Veteran now has headaches once a month, lasting 2 days. The report indicates that the Veteran was in combat in Vietnam and was constantly near explosions. The examiner opined that the Veteran’s claimed chronic headaches are less likely as not caused by or a result of headaches while in active service. He explained that he reviewed the Veteran’s file and could find no documentation of chronic headaches, visits to clinic for headaches, and that there is no documentation regarding a purported spinal tap at El Toro base in 1968-1969 which the Veteran asserts took place. He stated that the only documentation found is in the Veteran’s claim indicating chronic headaches in 2010. The Veteran’s contentions indicate that the Veteran has had a history of headaches; however, his statements do not provide a sufficient basis to establish a nexus to relate the Veteran’s headaches in service with his current headache condition. Moreover, the record does not include any evidence of a relationship between any current chronic headache disability and the Veteran’s active service. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(a), (d). Rather, following a VA examination in August 2011, the examiner stated that the Veteran’s diagnosed headaches are less likely than not caused by or a result of headaches while in active service. The examiner could find no documentation of chronic headaches since service until the Veteran’s claim filed in 2010. Consequently, the most probative medical evidence of record is against a finding of a nexus between service and the Veteran’s current headache condition. The Board acknowledges the Veteran’s contentions that he currently suffers from headaches as a result of service. Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), as to the specific issue in this case, etiology of chronic headaches falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007) (lay persons not competent to diagnose cancer).” Accordingly, the Board finds that the statements as to medical causation are not competent evidence to establish service connection for a chronic headache condition. The Veteran first filed a claim for a chronic headache condition in September 2010, almost 41 years after service, despite contending that his headaches began in service. While not dispositive, the passage of so many years between discharge from active service and the objective documentation of a claimed disability is a factor that weighs against a claim for service connection. Additionally, VA treatment records from January 2017 show that the Veteran reported “new onset” of headaches following radiation treatment. These records do not suggest that the Veteran had a chronic headache disability prior to that time. The Board finds that the preponderance of the evidence is against a grant of service connection for a headache condition. The Veteran’s assertions are not supported by the evidence of record, and in fact, they are contradictory to various statements on VA treatment records denying headaches, as noted above. Finally, the Veteran’s assertions that he has suffered from headaches since service is inconsistent with his denial of headaches at the time of separation from service. Accordingly, the Board finds that the August 2011 VA examiner’s opinion outweighs the Veteran’s assertions. The benefit-of-the-doubt doctrine is not applicable, as there is no approximate balance of evidence. Thus, service connection must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Labi, Associate Counsel