Citation Nr: 20049933 Decision Date: 07/27/20 Archive Date: 07/27/20 DOCKET NO. 15-08 870A DATE: July 27, 2020 ORDER Entitlement to service connection for headaches (described also as migraine headaches and tension headaches), to include as secondary to hypertension, is granted. FINDING OF FACT Resolving all reasonable doubt in favor of the Veteran, the Board finds that the Veteran’s headaches were proximally related to or aggravated beyond its natural progression by the Veteran’s service-connected hypertension. CONCLUSION OF LAW The criteria for service connection for headaches, as secondary to hypertension, have been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had honorable active service with the United States Army from January 1984 to August 1991. The Board of Veterans’ Appeals (Board) previously remanded this entitlement claim back to the Department of Veterans Affairs (VA) Regional Office (RO) in July 2018 for further development. See BVA Decision dated July 2018. The claim was originally on appeal from a November 2013 rating decision. In April 2020, after development by the RO, a supplemental statement of the case (SSOC) denied entitlement to service connection for migraine headaches. After the SSOC, the claim of entitlement to service connection for migraine headaches was returned to the Board. See Form 8 dated May 2020. The Form 8 noted both prior issues before the Board in July 2018, but at this time, the issue before the Board is only the entitlement to service connection for headaches. The other entitlement claim before the Board in July 2018 was granted in an April 2020 rating decision. Generally, service connection will be granted for a disability resulting from an injury or disease caused or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). A grant for service connection for a disability requires: (1) a present disability or persistent or recurrent symptoms of a disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (“nexus”) between the present disability and the in-service event, injury, or disease. 38 U.S.C. § 1110; 38 C.F.R. § 3.303; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). A disability, with no causal relationship (“nexus”) to an in-service event can be considered service-connected by being proximately due to or aggravated by a service-connected disease or injury. 38 § C.F.R §3.310(a)-(b). To establish secondary service connection there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) competent evidence establishing a link (“nexus”) between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). The Board notes that a non-service-connected disability proximally caused by a service-connected disability is considered part of the original condition. See 38 § C.F.R §3.310(a). A disability which is aggravated by a service-connected disease or injury, is compensated to the degree of the increase of severity. See 38 C.F.R. § 3.310(b); and see Allen v. Brown, 7 Vet. App. 439 (1995). In this case, the Board has reviewed all the evidence of record, with an emphasis on the evidence relevant to this appeal. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that VA must review the entire record but does not have to discuss each piece of evidence). Hence, the Board will summarize the relevant evidence where appropriate and the Board’s analysis below will focus specifically on what the evidence shows, or fails to show, as to the claim on appeal. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. The Veteran contends that his headaches are caused by or aggravated by his hypertension. See Hearing Transcript received April 2018. The Board noted that the Veteran called his headaches, migraine headaches, and the VA examiner diagnosed these headaches as acute intermittent tension headaches. However, the Veteran consistently described headaches related to and exacerbated by uncontrolled hypertension. First, the Veteran has a current disability. The March 2015 statement of the case (SOC) stated that the Veteran had private treatment for headaches since 2012. The VA examiner in July 2019 found that the Veteran had acute or intermittent tension headaches. See C&P Exam received in July 2019. As such, the Veteran has a current disability, which is reasonably within the scope of his claim, and the first prong of secondary service connection is established. Next, the Veteran has a service-connected disability. The Veteran is service connected for hypertension and this establishes the second prong of the test for secondary service connection. Last, there is competent evidence establishing a link between the service-connected disability and the current disability. Specifically, the July 2019 VA examiner opined that the claimed condition is at least as likely as not (50 percent or greater probability) proximately due to or the result of the Veteran’s service-connected condition. See C&P Exam received July 2019; see also Third-Party Correspondence received July 2013, and Hearing Transcript received April 2018. Considering the evidence of record and the opinions of the VA examiner the last prong of secondary service connection is established. Accordingly, resolving the benefits of the doubt in the Veteran’s favor, the Board finds that the Veteran’s headaches are related to his service-connected hypertension. Therefore, service connection for headaches is warranted. B. Mullins Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Associate Counsel, C. Parnell 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.