Citation Nr: 20028868 Decision Date: 04/24/20 Archive Date: 04/24/20 DOCKET NO. 16-13 028 DATE: April 24, 2020 REMANDED Entitlement to an initial rating in excess of 30 percent for migraine headaches is remanded. REASONS FOR REMAND In a November 2018 decision, the Board denied the Veteran’s claim for a rating greater than 30 percent for his headache disability. He appealed that decision to the higher U. S. Court of Appeal for Veterans Claims (Court/CAVC) – which, in an October 2019 Order, vacated the Board’s decision denying this claim and remanded it to the Board for further development and readjudication pursuant to agreement in a Joint Motion for Partial Remand (JMPR). Since that October 2019 JMPR, the Veteran has undergone another examination for his headaches in December 2019. Still more development of his claim is required, however, so, to comply with the Court’s Order granting the JMPR, the Board is remanding the claim to the agency of original jurisdiction (AOJ). Entitlement to a rating in excess of 30 percent for migraines is remanded. A March 2011 private Novi Neurology report indicates the Veteran has cervicogenic headaches. July 2012 correspondence from Novi Neurology indicates he has migraine headaches, for which he has been prescribed Relpax. In May 2013, the Veteran completed a Bio-esthetics Questionnaire wherein he indicated that he experienced headaches that were seldom, but intense (8 on a scale of 0-10). He also reported frequent (weekly) parietal and occipital head pain, and pain behind his ears, lasting for hours. In January 2017, the Veteran submitted a copy of his “migraine log” which covered a period of several months in 2016. The log shows multiple headaches per month lasting anywhere from 30 minutes to 8 hours and treated with medications. The notes indicate that, on a few occasions, he had to cancel a meeting, a show, and visits with his grandchildren. At a May 2018 VA examination, the Veteran reported getting three headaches a week – reportedly, some were bad and some were not so bad, and 15 headaches a month. He further reported that the pain gets worse with physical activity and that he experienced nausea, sensitivity to light, sensitivity to sound, changes in vision, and rare vomiting halos in his visual field without and without the headaches with a duration of less than one day. Regarding functional impairment, he said the headaches impacted his ability to work as he “goes home a couple times a month.” The examiner concluded that the Veteran experienced “characteristic prostrating attacks” “once every month,” but found that his headaches were not very prostrating and prolonged attacks of migraines/non-migraine pain productive of severe economic inadaptability. The October 2019 JMPR agrees that the May 2018 examiner’s opinion lacks sufficient rationale because the examiner failed to reconcile her opinion that the Veteran’s headaches were not very prostrating, prolonged, and productive of severe economic inadaptability with the Veteran’s statements as to experiencing three headaches a week, 15 headaches a month, and that his headaches impact his work. The JMPR also agreed that an addendum opinion consequently was needed to rectify this opinion inadequacy. A December 2019 Disability Benefits Questionnaire (DBQ) since submitted in support of the claim reflects that the Veteran reported headaches and nausea, but that he did not have vomiting, sensitivity to light, sensitivity to sound, or changes in vision. The typical headache had a duration of less than one day, and they were not prostrating. To reconcile these inconsistencies in the evidence, this claim is REMANDED for the following action: 1. Request the Veteran to provide evidence, if any, of missed work due to his headaches from January 2011 to the present (e.g., sick leave forms, doctor’s notes, clinical records, etc.). 2. Obtain an addendum to the May 2018 VA examination report. The examiner should especially reconcile her opinion that the Veteran’s headaches were not very prostrating, prolonged, and productive of severe economic inadaptability with the Veteran’s statements that he has three headaches a week, 15 headaches a month, and that his headaches impact his work. The examiner should also consider: a) the May 2013 Bio-esthetics Questionnaire completed by the Veteran, b) the 2016 log of headaches submitted by the Veteran in January 2017, and c) the December 2019 DBQ. KEITH W. ALLEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Wishard 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.