Citation Nr: 18154543
Decision Date: 11/30/18	Archive Date: 11/30/18

DOCKET NO. 16-41 571
DATE:	November 30, 2018
ORDER
Service connection for a headache disability, to include as proximately due to service-connected ankylosing spondylitis, is granted.
FINDING OF FACT
Resolving all doubt in the Veteran’s favor, his headache disability is proximately due to service-connected ankylosing spondylitis.
CONCLUSION OF LAW
The criteria for service connection for a headache disability is proximately due to service-connected ankylosing spondylitis have been met.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.102, 3.310(a).
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty from September 1996 to September 2000 and from September 2001 to September 2003.  
The Veteran withdrew his request for a Board hearing in a December 2016 statement.  
1. Entitlement to service connection for a headache disability, to include as proximately due to service-connected ankylosing spondylitis
The Veteran contends that he incurred a headache disability due to his service-connected ankylosing spondylitis.  
VA treatment records show the Veteran has a current diagnosis of a chronic headache disability and a January 2015 and April 2016 VA treatment provider opined that the Veteran’s headache disability is proximately caused and exacerbated by his service-connected ankylosing spondylitis in the spine.  The VA physician stated that the neck pain and spasm symptoms of the service-connected disability resulted in the headache disability.  
The Board acknowledges that a July 2015 VA examiner provided a negative opinion regarding a proximate connection, but the opinion was not supported by a clear rationale that is responsive to the Veteran’s contentions. In addition, a July 2016 VA opinion ultimately was against a finding of a proximate connection; however, the opinion stated that the cause for migraines is “not much understood” and that the pathogenesis of tension-type headaches is probably multifactorial and vary from on individual to another and even to one attack to another in the same individual.  The Board finds that the 2016 VA examiner’s rationale not only does not definitively support the negative opinion, but in fact could be read as supporting a possible proximate connection.  The examiner essentially stated that the causes of each type of headache are not understood and could include a varying range of causes that can differ from person to person.  
Given the positive opinions from the Veteran’s treating physician in favor of a proximate connection between the current headache disability and service-connected disability and the fact that the VA opinions do not adequately and definitively support a negative finding in this case, the Board concludes, resolving all doubt in the Veteran’s favor, that service connection for his headache disability is warranted.
 
B.T. KNOPE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A.B., Counsel