Citation Nr: 20044910 Decision Date: 07/06/20 Archive Date: 07/06/20 DOCKET NO. 17-62 215A DATE: July 6, 2020 REMANDED Service connection for migraine headaches, to include as secondary to hypertension, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 2006 to May 2006. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2017 rating decision by the Department of Veterans Affairs (VA). This case was remanded in April 2019 for further development; it has since been re-assigned to the undersigned. The Board finds that further development is needed before it can proceed with adjudication. As stated above, the Board remanded this matter in April 2019 for further development. However, remand is again needed to comply with the April 2019 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). In particular, the Board notes that the prior remand requested that an examiner provide an opinion whether the Veteran’s migraine headaches were caused or aggravated by his service-connected hypertension. The remand order requested that the examiner address a June 2017 letter from the Veteran’s treating doctor regarding his headaches and hypertension, as well as a December 2017 lay statement from the Veteran’s wife regarding his headaches and hypertension. The Veteran underwent a new VA examination in December 2019. The VA examiner’s opinion did not address either the June 2017 letter or the December 2017 lay statement. In correspondence received in May 2020, the Veteran stated concerns with qualifications of the examiner who conducted the December 2019 examination. The Veteran asserted that the examiner specialized in OB/GYN medicine. Based on Further, the Veteran submitted correspondence received in May 2020 contending that his migraines are a side effect of his hypertension medication, including a relevant medical article. In addition, a VA treatment notes from May 2019 and December 2019 indicate that the Veteran receives his migraine headache medication from his non-VA primary care physician. However, the claims file does not reflect records from this provider. Therefore, the Board finds that remand is appropriate to obtain the necessary private treatment records and to obtain an addendum opinion. In addition, the Board finds it necessary for the AOJ to provide documentation (including curriculum vitae (CV)) to address the qualifications of the examiner who have evaluated the Veteran’s migraine headaches in December 2019. The matters are REMANDED for the following action: 1. Please obtain updated VA treatment and non-VA treatment records, including the private treatment records from the Veteran’s non-VA primary care physician. 2. Obtain a CV for the examiner who conducted the December 2019 examination and then provide documentation supporting the examiner’s ability to address hypertension and migraine headache issues in light of the fact that the examiner’s specialty appears to be in OB/GYN according to the documentation provided by the Veteran in May 2020. 3. Obtain an addendum opinion from a clinician in the appropriate specialty, other than the December 2019 examiner, to determine the nature and likely cause of the Veteran’s migraine headaches. The examiner should review the claims file (including this remand) and note such review was conducted. In addition, provide a copy of the examiner’s CV. Based on review of the record, the examiner should provide an opinion with detailed rationale that responds to the following: (a) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s migraine headaches were caused by the Veteran’s service-connected hypertension? Please explain why. The following evidence must be discussed: (1) The June 2017 letter from the Veteran’s treating doctor regarding his headaches and hypertension; (2) The December 2017 lay statement from the Veteran’s wife regarding his headaches and hypertension; and (3) The medical article submitted by the Veteran in May 2020 regarding his headaches and hypertension medication. The examiner should provide detailed rationale as to whether these records indicate potential causation of the Veteran’s migraine headaches by his service-connected hypertension. (b) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s migraine headaches were aggravated by the Veteran’s service-connected hypertension? Please explain why. The opinion must address whether the disability increased in severity (i.e., was aggravated). If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation. The following evidence must be discussed: (1) The June 2017 letter from the Veteran’s treating doctor regarding his headaches and hypertension; (2) The December 2017 lay statement from the Veteran’s wife regarding his headaches and hypertension; and (3) The medical article submitted by the Veteran in May 2020 regarding his headaches and hypertension medication. The examiner should provide detailed rationale as to whether these records indicate potential aggravation of the Veteran’s migraine headaches by his service-connected hypertension. Tiffany Dawson Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board I. Kerner, 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.