Citation Nr: 21000616 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 19-11 536 DATE: January 5, 2021 ORDER Service connection for headaches is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran’s headaches began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for headaches are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from July 1960 to August 1960. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in June 2016 by a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously remanded by the Board in June 2019 for additional development, which has since been completed. See Stegall v. West, 11 Vet. App. 268, 271 (1998). It is now before the Board for further appellate review. 1. Entitlement to service connection for headaches. The Veteran asserts that he is entitled to direct service connection for his headaches. The Board will limit its analysis accordingly. Generally, to establish direct service connection there must be competent evidence showing: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the in-service injury incurred or aggravated during service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303; Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). 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; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Here, the Veteran’s current headache disorder is well-documented throughout the record, to include in a February 2019 VA examination and January 2020 Disability Benefits Questionnaire (DBQ). He has also offered competent testimony as to the nature of his headaches during the pendency of this appeal. Historically, the Veteran’s service treatment records (STRs) document an isolated incident of treatment for headaches in August 1960. That same day, the Veteran was examined for discharge and did not report a history of headaches. Rather, his remaining STRs are silent for diagnoses or treatment of a headache disorder. VA treatment records spanning November 2015 to December 2018 document the Veteran’s repeated denial of headaches. He appeared for a VA examination in February 2019 to determine the nature and etiology of his headaches. During the examination, the Veteran reported that he could not recall when his headaches first started and that he takes Tylenol when they occur. He also confirmed that he has never complained of headaches to his VA treating physicians. The examiner opined that the Veteran’s headaches were less likely than not related to his military service. The examiner explained that the Veteran did not have any workup for headaches or neurological evaluation to diagnose migraines. The Veteran subsequently asserted that his headaches began in service and that he self-medicated to manage his symptoms. In a June 2019 Board decision, it was found that the February 2019 VA medical opinion was inadequate, as it did not address the Veteran’s lay statements and lacked overall clarity. Pursuant to the June 2019 Board remand, the Veteran appeared for a VA contract examination in January 2020. During the examination, the Veteran testified that his headaches began in approximately 1965. He reported that he has had headaches for years but was unsure of their actual onset. He reported treating his headaches with Tylenol. Upon this testimony, the examining physician asserted that the Veteran’s headaches were less likely than not related to his military service. The examiner noted that the Veteran complained of a headache in 1960 with no sequelae. The examiner then stated that the Veteran has been treated at the VA Medical Center (VAMC) in Marion, IL with no entries, complaints, or treatment of a headache. Thus, a nexus was not established. The Board finds that the January 2020 VA examiner's opinion is adequate as such considered all of the pertinent evidence of record and provided a complete rationale, relying on and citing to the records reviewed and the Veteran’s own reporting. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A] medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). Upon reviewing all of the pertinent evidence of record, the Board finds that the preponderance of the evidence weighs against the Veteran’s claim. Although the Veteran sought treatment for headaches during service, this was an insolated incident without any evidence of sequelae. There are no medical records corroborating any type of chronicity in the Veteran’s headaches. Further, although the Veteran is competent to report when his headaches began, his reporting as to their onset has been inconsistent throughout the record. Layno v. Brown, 6 Vet. App. 465, 469 (1994); but see Miller v. Wilkie, 32 Vet. App. 249 (2020). Thus, his testimony regarding onset is not sufficiently credible in this limited instance. As such, a nexus has not been established and entitlement to service connection for headaches is not warranted. In reaching such decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, the preponderance of the evidence is against the Veteran's claim for service connection for headaches. As such, that doctrine is not applicable in the instant appeal, and his claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. Of final note, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). Kate E. Kovarovic Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. K. Hall, 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.