Citation Nr: 20071902 Decision Date: 11/06/20 Archive Date: 11/06/20 DOCKET NO. 17-28 419 DATE: November 6, 2020 ORDER Entitlement to an evaluation higher than 30 percent for cluster headaches is denied. FINDING OF FACT The Veteran’s cluster headaches were manifested by no worse than prostrating attacks averaging once a month or more over the last several months. CONCLUSION OF LAW The criteria for an evaluation higher than 30 percent for cluster headaches are not met. 38 U.S.C. § §§ 1155, 5107; 38 C.F.R. § §§ 3.102, 3.159, 4.1, 4.7, 4.124a, Diagnostic Code 8100. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1952 to September 1956. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). However, in October 2015, the Veteran died while the matter was on remand. The appellant is the Veteran’s surviving spouse and was substituted as the claimant in February 2017. See January 31, 2017 Appeal Notification Letter. In June 2020, the appellant testified before the undersigned Veterans Law Judge (VLJ); a transcript of which is attached to the claims file. The appellant, as the substitute claimant, seeks a higher rating for the service-connected cluster headaches, which is rated at 30 percent disabling under 38 C.F.R. § 4.124a, Diagnostic Code 8100. The Board finds, however, that a higher rating is not warranted. Headaches with characteristic prostrating attacks occurring on an average of once a month over the last several months shall be evaluated as 30 percent disabling, and very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability shall be evaluated as 50 percent disabling. 38 C.F.R. § § 4.124a, Diagnostic Code 8100. The January 2013 VA examination report shows symptoms of cluster headaches, including severe headache pain localized to the left side of the head (precipitated with weather changes and hot sun), nausea, left eye tearing and left nostril congestion. The Veteran reported that he had experienced the “same [headaches]” for the “past 40 years,” as they were nightly. He used Gabapentin, Tylenol and oxygen for pain relief. The Veteran’s headaches occurred more frequently than once a month and lasted 30- to 90-minutes without oxygen. The January 2013 examiner indicated that the Veteran did not have characteristic prostrating attacks of headache pain, and that the headaches were not very frequent prostrating and prolonged attacks of migraine or non-migraine headache pain. In terms of functional impact, the Veteran reported he had worked as a police officer for 21 years and his retirement was not “due to headaches.” VA medical records show recurring complaints and treatment of cluster headaches, along with emergency room visits for treatment. In February 2013, the Veteran was hospitalized for cluster headaches. See e.g., May 8, 2017 CAPRI and June 21, 2017 Medical Treatment Record-Non-Government Facility. A series of lay statements from the appellant and the Veteran’s family and friends (two of which are medical providers) outline the extent of the Veteran’s cluster headaches, particularly noting that the headaches were frequent, debilitating and resulted in loss of consciousness and hospitalizations, for which oxygen and medications provided little to no pain relief. See August 20, 2012 and June 21, 2017 Buddy/Lay Statements. Here, the evidence reflects longstanding symptoms of cluster headache pain, which had persisted in frequency over time. The overall evidence shows headaches with prostrating attacks occurring on an at least frequent basis. However, at no time, does the evidence show that the Veteran had completely prostrating and prolonged attacks productive of severe economic inadaptability, to warrant a disability rating greater than 30 percent. The Board has considered the findings of the January 2013 examiner and the Veteran’s own lay assertions, indicating that his headaches had been the same for 40 years and no resultant functional impact from the headaches, regarding severity and finds that they support no more than the currently assigned 30 percent disability evaluation. 38 U.S.C. § § 5107(b); 38 C.F.R. § §§ 4.7, 4.21. Regarding extraschedular consideration, the Board finds that it is not warranted in this case. Diagnostic Code 8100 indicates headaches should be rated according to the frequency of prostrating attacks, which incorporates pain and nausea. The regular schedular criteria thus contemplate both the symptoms and the level of disability suffered by the Veteran - less than completely prostrating attacks. The Board recognizes that the Veteran’s sleep was significantly affected due to pain associated with his headaches at night, but finds that this is contemplated by the schedule when determining whether the headaches are completely prostrating and   “productive of severe economic inadaptability.” The effects of the Veteran’s disability have been fully considered and are contemplated in the rating schedule. M. H. HAWLEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Norwood, 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.