Citation Nr: 18152553 Decision Date: 11/23/18 Archive Date: 11/23/18 DOCKET NO. 16-43 983 DATE: November 23, 2018 REMANDED Entitlement to an initial compensable rating for service-connected migraines is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1996 through November 2004, from January 2007 through March 2007, and from September 2011 through February 2012. This case is before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision. 1. Entitlement to an initial compensable rating for service-connected headaches is remanded. The Veteran asserts that his service connected migraines warrant a compensable rating. Specifically, the Veteran contends that the VA examiners did not adequately listen to him or correctly understand his symptoms. The Veteran, through his representative, argued in a July 2018 appellant brief that the available evidence is too old to adequately evaluate the state of the Veteran’s condition and that VA must provide a new examination. The Veteran requested a new examination after the RO filed the original statement of the case (SOC), but he was unable to attend the scheduled appointment because of a work conflict, as noted in October 2016. The RO did not reschedule the examination but issued a supplemental statement of the case which led to the Veteran filing a substantive appeal in August 2016. The Veteran was afforded an original VA examination in August 2013 and a second examination during the appeal period in July 2016. Both examiners found that the Veteran’s migraines did not constitute prostrating attacks of pain. However, neither examiner explained the rationale for this, especially considering the Veteran’s assertions, noted in both examinations, that he experiences severe migraines multiples times each month. The Veteran further asserted, and it is noted by both examiners, that the migraines usually last about 30 minutes, that a warm shower helps the migraine subside, and that the Veteran is not taking any medication to treat the migraines. Further, both examiners note that the Veteran experiences pulsating or throbbing head pain, pain on both sides of the head, nausea, and sensitivity to both light and sound. In this case, the Board notes that the Veteran is fully competent to report the symptoms and frequency of his migraines, which are largely measured based on subjective reports, as well as their effect on his work. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Although, the VA examiners indicated that the Veteran did not have characteristic prostrating attacks of migraine pain, the Veteran described having severe migraines requiring him to take a shower to help the pain subside. However, there is no indication from the reports that indicate the Veteran is prevented from going about his activities and the Veteran’s headaches generally only last for 30 minutes. The Veteran and his representative have continued to request another examination, most recently in the appellant brief in July 2018. Considering these requests, the Veteran’s symptoms, and the fact that the examiners did not provide a rationale for finding the Veteran did not experience prostrating attacks of pain, the Board does not have the necessary information to make a fully informed decision on this case. Therefore, the case is remanded for further development and for the Veteran to obtain an additional VA examination. The matter is REMANDED for the following action: 1. Obtain and associate all the Veteran’s recent treatment records with the Veteran’s claims file. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected migraines. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. To the extent possible, the examiner should identify any symptoms and functional impairments and discuss the effect of such on any occupational functioning and activities of daily living. In this regard, the examiner should specifically discuss the Veteran's assertions that he experiences characteristic prostrating attacks of migraine pain. If the examiner finds that the Veteran does not experience prostrating attacks of migraine pain, a full explanation of such a determination shall be provided. L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Shelton, Law Clerk