Citation Nr: 21001334 Decision Date: 01/07/21 Archive Date: 01/07/21 DOCKET NO. 16-35 698A DATE: January 7, 2021 ORDER Entitlement to service connection for a headache disorder is granted. INTRODUCTION The Veteran served on active duty from May 1989 to November 1994. In December 2020, the Veteran testified before the undersigned Veterans Law Judge at a virtual hearing. FINDING OF FACT The Veteran’s migraine headaches first manifest in service. CONCLUSION OF LAW The criteria for service connection for migraine headaches have been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION Legal Criteria Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be granted for any disease initially diagnosed after service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Burden of Proof Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. 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 (2012); 38 C.F.R. §§ 3.102, 4.3 (2020); 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. Factual Background and Analysis The Veteran seeks service connection for a migraine headache disorder, which she contends originated in service. The medical evidence confirms the Veteran currently has migraine headaches. The central issue that must be resolved at this time is whether the Veteran’s current disability originated during service or is otherwise related to service. Initially, the Board notes that the Veteran’s service treatment records (STRs) show she was treated for headaches in service. The Veteran has since reported chronic ongoing headaches since her initial headache disorder onset in service. During her January 2011 VA examination, the examiner diagnosed the Veteran with both a premenstrual headache disorder and a more severe headache disorder. The examiner initially found the Veteran’s premenstrual headaches were incurred in service; however, the examiner determined the Veteran’s more severe headache disorder was less likely than not related to her military service, as the condition developed 4-5 years after service. The examiner wholly failed to explain how or why he concluded the Veteran’s in-service headaches were premenstrual type headaches, rather than a progressively worsening headache disorder. To be considered adequate, a medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Notwithstanding the determinations provided by the January 2011 VA examiner, the Veteran has continuously reported she initially experienced headaches during her period of active duty. The Board notes there is no indication the Veteran experienced a chronic headache disorder prior to entrance into active duty. In this case, the Board must determine the value of all evidence submitted, including lay and medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). The evaluation of evidence generally involves a 3-step inquiry. First, the Board must determine whether the evidence comes from a “competent” source. The Board must then determine if the evidence is credible, or worthy of belief. Barr v. Nicholson, 21 Vet. App. 303 (2007) (Observing that once evidence is determined to be competent, the Board must determine whether such evidence is also credible). The third step of this inquiry requires the Board to weigh the probative value of the proffered evidence in light of the entirety of the record. The Board also notes that under certain circumstances, lay evidence may be sufficient to establish a nexus. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); see also Layno v. Brown, 6 Vet. App. 465, 469 (1994). Lay evidence has been found to be competent with regard to a disease that has “unique and readily identifiable features” that are “capable of lay observation.” See Barr v. Nicholson, 21 Vet. App. 303, 308-09 (2007). In this case, the Veteran has reported that she initially experienced headaches in service, which have persisted ever since. The Board finds the Veteran competent to report the quality and onset of her headaches. It is generally within the competence of a lay person to identify and observe the effect of a disability under the ordinary conditions of daily life. Many symptoms are readily observable by a lay person. Accordingly, the lay evidence provided by the Veteran is unquestionably competent evidence. In this respect, the Board finds the Veteran’s own reports of experiencing headaches to be at least as probative as the above-noted VA examiners’ findings. As previously noted, this appeal turns on whether there is a nexus between the Veteran’s current headache disorder and her headaches experienced in service. The Veteran has competently and credibly reported that she initially experienced her headaches during service. Accordingly, a nexus to service is established. To the extent the VA examiner found the Veteran’s current headaches were less likely incurred in service, the Board finds this conclusion to be of limited probative value as the examiner failed to fully explain his findings. In sum, the Board is satisfied that the Veteran’s current headache disorder initially manifest in service. Therefore, the Veteran is entitled to service connection for her migraine headache disorder. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Fraser, 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.