Citation Nr: 20047524 Decision Date: 07/16/20 Archive Date: 07/16/20 DOCKET NO. 14-32 215 DATE: July 16, 2020 REMANDED Entitlement to service connection for chronic headaches, to include as secondary to a service-connected bilateral hearing loss disability and/or tinnitus disability is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1956 to November 1960. In March 2018, the Veteran testified under oath before the undersigned Veterans Law Judge at a videoconference hearing. A transcript of the hearing is of record. In May 2018, the Board remanded this matter for additional development. For the reasons outlined below, the Board finds that remand is again needed. Entitlement to service connection for chronic headaches, to include as secondary to a service-connected bilateral hearing loss disability and/or tinnitus disability is remanded. The Board finds that additional development is needed prior to final adjudication of the remaining issue on appeal. Specifically, the Board finds that a new medical opinion is needed to adequately address the Veteran’s contentions. The Veteran was afforded a VA examination in October 2019. The examiner noted a diagnosis of tension headaches. The examiner stated that he “would not be able to determine the etiology of [the Veteran’s] headaches without resorting to speculation.” Nevertheless, the examiner did opine that it is “less likely than not that the [Veteran’s] headaches are caused by the [Veteran’s] active duty service since he denied having headaches during the Discharge Examination on 10/27/1960.” However, this explanation does not adequately address the following: (1) the Veteran’s treatment for headache in service (see STR, October 1958); (2) the conceded noise exposure in service (see VA audio examination, August 2004); (3) the Veteran’s contentions that he experienced headaches in service (see Veteran’s statement, March 2018); and (4) his contentions that they continued to the present day (see Hearing, March 2018). Regarding potential secondary service connection, the examiner did address a potential nexus to the Veteran’s service-connected bilateral hearing loss disability and tinnitus, but again the Board finds that a new opinion is needed. In particular, a new opinion is needed that addresses aggravation. The examiner wrote: “Since the [Veteran’s] headaches are not likely to be related to hearing loss/tinnitus, then it is less likely than not that the [Veteran’s] headaches are aggravated beyond normal progression by the [Veteran’s] sevice [sic] connected bilateral hearing loss and/or tinnitus.” There is no further explanation or evidence offered in support of this conclusion. Nor does the examiner address the Veteran’s contentions that his hearing aids gave him headaches (see Veteran’s statement, March 2018), or that he gets chronic headaches especially in quiet when his tinnitus is more noticeable (see Hearing, March 2018). Accordingly, a new opinion is needed. The matter is REMANDED for the following action: 1. After securing any necessary consent forms from the Veteran, obtain any outstanding treatment records, to include any VA and/or private treatment records, pertaining to the issue on appeal. All efforts should be documented in the claim file. If any records could not be obtained, this should be noted in the claim file. 2. Upon completion of the above, schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) with a new examiner to address the etiology of the claimed headache disability. For each disability diagnosed, the examiner is asked to address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran’s active duty service. The examiner is asked to specifically address: (1) the Veteran’s treatment for headache in service (see STR, October 1958); (2) the conceded noise exposure in service (see VA audio examination, August 2004); (3) the Veteran’s contentions that he experienced headaches in service (see Veteran’s statement, March 2018); and (4) his contentions that they continued to the present day (see Hearing, March 2018). In addition, the examiner should provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that claimed headache disability is proximately due to, or the result of, or aggravated (permanently worsened) beyond normal progression by the Veteran’s service-connected bilateral hearing loss disability and/or tinnitus disability. The examiner is asked to specifically address: the Veteran’s contentions that his hearing aids gave him headaches (see Veteran’s statement, March 2018), and that he gets chronic headaches especially in quiet when his tinnitus is more noticeable (see Hearing, March 2018). The VA examiner should be given access to the claim file. The examiner should state that a review of the claim file was completed. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. A detailed rationale is requested for all opinions provided. 3. If upon completion of the above action the issue is denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Foster, 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.