Citation Nr: 20006386 Decision Date: 01/27/20 Archive Date: 01/27/20 DOCKET NO. 15-21 555 DATE: January 27, 2020 ORDER Entitlement to service connection for a headache condition is denied. FINDING OF FACT The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a headache condition. CONCLUSION OF LAW The criteria for service connection for a headache condition have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty with the United States Navy from July 1945 to December 1947. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an October 2012 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In November 2018, a videoconference Board hearing was held before the undersigned; a transcript of the hearing is of record. In March 2019, the Board remanded the Veteran’s claim for service connection for an acquired psychiatric condition, to include depressive neurosis with muscle contraction headaches, posttraumatic stress disorder with anxiety, and depressive disorder. The Board’s remand directives instructed the AOJ to obtain an opinion that addressed the etiology of the psychiatric condition and whether the Veteran had a separate diagnosis for a headache condition, or if the headache condition was a symptom of any diagnosed psychiatric condition. Following the examination for his psychiatric condition, the Veteran was awarded service connection for posttraumatic stress disorder (PTSD) in an October 2019 Rating Decision. The AOJ denied a claim for service connection for a headache condition as a separate issue in a December 2019 Supplemental Statement of the Case (SSOC) and returned the case to the Board for adjudication. Accordingly, the decision herein will address the issue of service connection for a headache condition. 1. Entitlement to service connection for a headache condition Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Establishing service connection generally requires evidence of: (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (nexus) between the claimed in-service disease or injury and the present disability. See, e.g., Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may also be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). The question for the Board is whether the Veteran has a separate diagnosis of a headache condition. As noted above, the Board’s March 2019 remand instructed the AOJ to obtain an opinion as to the Veteran’s headaches; noting that the Veteran’s complaint of headaches had been treated as a symptom of his psychiatric condition. The Veteran was afforded a VA examination in July 2019. The examiner noted a diagnosis of migraine including migraine variants in 2012. The examiner opined that that the Veteran’s condition was less likely than not related to service. The examiner added that although the Veteran may refer to chronic headaches, he was unable to describe any other symptom, and there was not a real correlation between his duties and the start of headache symptoms. In an October 2019 correspondence of record, the AOJ determined that the July 2019 VA examination and opinion did not address the Veteran’s claim that he suffered a head injury during service. Therefore, the AOJ determined that the examination was inadequate and scheduled the Veteran for a new examination. The Veteran was afforded a new examination in November 2019. The examiner noted that the Veteran was diagnosed with common headaches in 1973, after reporting a 5-year history of a headache condition in 1978. The examiner further noted that the Veteran reported no longer having headaches at the time of the November 2019 examination. During the examination, the Veteran complained of humming in his ears that sounded like an engine on a ship, instead of headaches. The Veteran further stated that he was confusing the humming in his ears for headaches. The examiner ultimately noted that the Veteran’s headaches had resolved, and that the Veteran now denied having headaches. Additionally, the examiner pointed out that the Veteran’s complaint and diagnosis of headaches in 1973 occurred many years after separation from service. The Board concludes that the Veteran does not have a diagnosis of a headache condition due to disease or injury and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). The July 2019 examiner indicated that while the Veteran may refer to chronic headaches, he was unable to describe any other symptom. Nonetheless, the examiner still pointed out that there was not a real correlation between the Veteran’s service and the start of headache symptoms. Additionally, the November 2019 examiner relied on her own clinical examination of the Veteran, the Veteran’s own reports of confusing the humming in his ears for headaches, and the Veteran’s own statements denying having headaches, to determine that the Veteran did not suffer from any headache condition. Absent a showing of a diagnosis due to disease or injury, service connection for a headache disability cannot be granted. Thus, the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine does not apply, and the claim must be denied. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Marsh II, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.