Citation Nr: 20021421 Decision Date: 03/25/20 Archive Date: 03/25/20 DOCKET NO. 17-35 897 DATE: March 25, 2020 ORDER Service connection for migraine headaches is granted. FINDINGS OF FACT 1. A migraine headache disability was not “noted” at service entrance. 2. The Veteran’s migraine headache disability was incurred in service, symptoms of which have persisted since service separation. CONCLUSION OF LAW The criteria for service connection for a migraine headache disability are met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from August 2006 to February 2007, and from February 2008 to March 2009. This matter comes on appeal before the Board of Veterans’ Appeals (Board) from the June 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a Board video-conference hearing in February 2020 before the undersigned Veterans Law Judge; a transcript of the hearing is associated with the claims file. Service Connection for Migraine Headaches—Laws and Analysis Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Establishing service connection generally requires (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. The Veteran maintains that he has a migraine headache disability that first manifested in service. Every veteran shall be taken to have been in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance, and enrollment, or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service. 38 U.S.C. §§ 1111 (2012); 38 C.F.R. § 3.304 (b) (2019). Only such conditions as are recorded in examination reports are to be considered as noted. 38 C.F.R. § 3.304 (b). Upon review of the evidence of record, the Board finds that a migraine headache disability was not “noted” at service entrance. The Board acknowledges that medical evidence of record shows that the Veteran was involved in a motor vehicle accident in 2005 (prior to service entrance). Medical evidence shows that the Veteran had a “minor” head injury. See January 2005 Anderson Community Hospital note. A CT scan at that time showed no intracranial pathology and no evidence of a skull fracture or hemorrhage. In a June 2005 Report of Medical Examination, conducted at service entrance, the Veteran had a “normal” clinical evaluation of his head. The physician noted that an MRI of the Veteran’s brain (conducted as a result of the pre-service motor vehicle accident) was negative. Although the physician noted that the Veteran had previously sustained a head injury prior to service in 2005, no specific residuals associated with the head injury, to include headaches or migraines, were “noted.” Moreover, in a June 2005 Report of Medical History, completed by the Veteran at service entrance, the Veteran specifically checked “NO” as to having “frequent or severe headaches.” The Veteran did note that he had taken Excedrin in the morning for a headache, but symptoms had resolved. Moreover, during the February 2020 Board hearing, the Veteran specifically denied having any residual headaches or migraines following the 2005 motor vehicle accident. For these reasons, the Board finds that the record does not demonstrate that a migraine headache disability was noted upon entry into service and does not demonstrate by clear and unmistakable (obvious or manifest) evidence that a migraine headache disability existed before service entrance. Accordingly, the Board finds that the presumption of soundness attached at service entrance has not been rebutted in this case. See 38 C.F.R. § 3.304 (b); see also Odiorne v. Principi, 3 Vet. App. 456, 457 (1992). Next, the Board finds that the preponderance of the evidence of record weighs in favor of a finding that currently diagnosed migraine headache disability was incurred in service. Service records include a February 2009 memorandum from the Department of the Army. This memorandum confirms that the Veteran was exposed to burning landfills and contaminated dust while deployed in Iraq. The Veteran was afforded a VA examination in May 2014. At that time, the examiner confirmed a diagnosis of migraine headaches. During the evaluation, the Veteran stated that he began having headaches in Iraq. He reported continued headaches since that time on an almost daily basis. The examiner stated that the Veteran had a diagnosable, but medically unexplained chronic multi-symptom illness of unknown etiology (migraine headaches) which started after his deployment to Iraq. Without other identifiers of origin, the examiner opined that the Veteran’s migraine headaches were at least as likely as not the result of environmental conditions encountered by the Veteran in Iraq. The Veteran was afforded another VA examination in January 2015. The examiner opined that the Veteran’s headaches were not related to any Gulf War environmental exposure and were more likely due to a pre-existing head injury. The Board finds that this opinion lacks probative value as there is no indication that the Veteran had a pre-existing migraine headache disability at service entrance. As noted above, the Veteran specifically denied having frequent or severe headaches at service entrance. A CT scan in 2005 showed no intracranial pathology and no evidence of a skull fracture or hemorrhage. Moreover, post-service VA treatment records are consistent with the Veteran’s contentions that his migraine headaches began in service. In a January 2013 VA primary care note, the Veteran reported a history of headaches “for the past 4 years,” i. e., approximately 2009. The Veteran also testified that his headaches began during his 2008 deployment to Iraq, which the Board finds to be consistent with reports in his VA treatment records. For these reasons, and resolving reasonable doubt in the Veteran’s favor, the Board finds that the evidence of record shows that the Veteran’s migraine headache disability had its onset during active service and has persisted since that time. Therefore, the Board concludes that the migraine headache disability was incurred in service. Accordingly, and resolving reasonable doubt in the Veteran’s favor, the Board finds that service connection for is warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. JAMES G. REINHART Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Casadei, 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.