Citation Nr: 20032823 Decision Date: 05/11/20 Archive Date: 05/11/20 DOCKET NO. 13-34 229A DATE: May 11, 2020 REMANDED Entitlement to service connection, to include on a secondary basis, for headaches. REASONS FOR REMAND The Veteran served on active duty from February 1961 to January 1965. In February 2017, the Veteran testified via video conference before the undersigned. The issue was remanded by the Board in October 2017. In January 2018, the issue was remanded for a VA opinion regarding service connection secondary to service-connected PTSD. Entitlement to service connection for headaches due to contaminated water at Camp LeJeune and or secondary to service-connected posttraumatic stress disorder (PTSD) is remanded. The Veteran contends that his headaches are due to service, including through exposure to contaminated water at Camp LeJeune. He also contends the headaches are secondary to service-connected PTSD. The Veteran initially submitted a claim for service connection for headaches due to contaminated water at Camp LeJeune. In the October 2017 Board decision, it was determined that the Veteran’s headaches may be a symptom of or secondary to an undiagnosed psychiatric disorder. Once the Veteran was service connected for PTSD the issue of service connection for headaches was remanded for a VA opinion on whether headaches were secondary to service-connected PTSD. An August 2018 VA examination reflects that the Veteran reported his headaches began in 1967-1968, about three years after separation from service. The Veteran stated he had arthritis in the neck and that when he treated his neck with pain medications or cold compresses, it helped the headaches. The examiner opined that the Veteran’s headache condition is not at least as likely as not due to or the result of service-connected PTSD. The rationale provided was that the Veteran reported his headaches began three years after service and the headaches are associated with neck pain. The examiner noted the Veteran’s neck x-ray was consistent with degenerative disc disease capable of causing headache. The examiner stated that under the circumstances it was not possible to ascribe the cause of his headache condition to PTSD. Unfortunately, the August 2018 examiner did not address whether the Veteran’s PTSD aggravated the Veteran’s headaches. Additionally, in August 2019 the Veteran submitted a September 2018 article discussing the link between PTSD and headaches. Given that the August 2018 VA examination is incomplete, and the September 2018 article is relevant to the issue at hand, the Board finds that remand is necessary to determine whether the Veteran’s headaches are caused by or aggravated by his service-connected PTSD disability. The matters are REMANDED for the following action: Forward the Veteran’s claims file, including a copy of this Remand, to an appropriate VA examiner to address the following: a) Opine whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s service-connected PTSD caused the Veteran’s headaches. b) Opine whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s service-connected PTSD aggravated the Veteran’s headaches. The examiner should comment on the September 2018 article discussing the link between PTSD and headaches. A rationale should be given for all opinions and conclusions rendered. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Mitchell, 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.