Citation Nr: 21062616 Decision Date: 10/08/21 Archive Date: 10/08/21 DOCKET NO. 20-25 598 DATE: October 8, 2021 ORDER Service connection for a migraine disability, to include as secondary to a service-connected right shoulder disability is denied. FINDING OF FACT The Appellant's migraines are not secondary to a service-connected right shoulder disability, and are not otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for migraines are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Appellant served on active duty for training (ACDUTRA) from March 1976 to June 1976 followed by additional periods of ACDUTRA and inactive duty for training (INACDUTRA). This matter comes to the Board of Veterans' Appeals (Board) on appeal from a March 2018 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA). This matter was remanded in September 2020 and June 2021 for further development, which has been completed. The Board also remanded the issues of entitlement to service connection for a left shoulder disability and a neck disability. The RO issued an August 2021 rating decision in which it granted service connection for a left shoulder strain and cervical spine degenerative arthritis. The granting of service connection constitutes a complete grant as to these claims. Consequently, the are no longer before the Board. Service connection for a migraine disability, to include as secondary to a service-connected right shoulder disability is denied. The Appellant contends that her migraines are due to either ACTDUTRA or INACTURA service. Alternatively, she contends that they are secondary to her service connected right shoulder disability. Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated in active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). In general, service connection requires competent and credible evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Active military service includes any period of active duty for training during which the individual concerned was disabled or died from a disease or injury incurred in or aggravated in line of duty, or any period of inactive duty training during which the individual concerned was disabled or died from injury incurred in or aggravated in line of duty. 38 U.S.C. § 101 (21) and (24); 38 C.F.R. § 3.6 (a) and (d). It follows that service connection may be granted for disability resulting from disease or injury incurred or aggravated while performing active duty for training, or from injury incurred or aggravated while performing inactive duty for training. 38 U.S.C. §§ 101 (24), 106, 1131. ACDUTRA is, among other things, full-time duty in the Armed Forces performed by Reserves for training purposes or by members of the National Guard of any state. 38 U.S.C. § 101 (22); 38 C.F.R. § 3.6 (c)(1). INACDUTRA is part-time duty in the Armed Forces performed by Reserves for training purposes or by members of the National Guard of any state. 38 U.S.C. § 101 (22); 38 C.F.R. § 3.6 (c)(1). Active service also includes authorized travel to or from such duty or service. 38 U.S.C. § 106 (d); 38 C.F.R. § 3.6 (e). In summary, when a claim for service connection is based only on a period of ACDUTRA or INACDUTRA, there must be evidence that the appellant became disabled as a result of a disease or injury incurred or aggravated in the line of duty during that period of ACDUTRA or INACDUTRA. See 38 U.S.C. §§ 101 (2), (22), (24); 38 C.F.R. § 3.6 (a); Donnellan v. Shinseki, 24 Vet. App. 167, 172 (2010); Acciola v. Peake, 22 Vet. App. 320, 324 (2008) (citing Mercado-Martinez v. West, 11 Vet. App. 415, 419 (1998); Paulson v. Brown, 7 Vet. App. 466, 470 (1995)). In the absence of such evidence, the period of ACDUTRA or INACDUTRA would not qualify as "active military, naval, or air service," and the appellant would not qualify as a "veteran" for that period of ACDUTRA or INACDUTRA service alone. 38 U.S.C. § 101 (2), (24); see Acciola, 22 Vet. App. at 324. The question for the Board is whether the Appellant has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Appellant has a current diagnosis of migraines, and evidence shows that she reported a 4 day history of headaches in April 1991, the preponderance of the evidence weighs against finding that the Appellant's current diagnosis began during service or is otherwise related to an in-service injury, event, or disease. Service treatment records refect that the Appellant reported a 4 day history of headaches in April 1991. She was assessed with "[rule out] Headache Probable muscle contraction." The Appellant was instructed to follow up as needed. Numerous treatment records over the course of the next two decades fails to reflect any follow up treatment. She completed a September 1994 Report of Medical History in which she denied frequent or severe headaches. She completed a September 1999 Report of Medical History in which she once again denied frequent or severe headaches. The Appellant underwent a VA examination in August 2021. The Appellant reported that her migraines began during service (in 1979). The examiner noted a diagnosis of migraines in July 2021. The examiner opined that it was less likely than not that the Appellant's current headaches began during or were caused by an in-service event. In a separate opinion, he pointed out that there is no evidence in the service treatment records regarding a chronic or recurrent disability, as there was no follow up treatment. Regarding any contentions that the Appellant's headache pain has been continuous throughout service and/or since service, such contentions are contradicted by the Appellant's own Reports of Medical Histories dated September 1994 and September 1999. Consequently, contentions regarding continuity of symptomatology are deemed to be not credible. Based on the lack of a chronic disability reflected in the service treatment records, and the August 2021 VA opinion which weighed against the Appellant's claim, the Board finds that preponderance of the evidence is against the granting of service connection on a direct basis. Service connection may be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. In this case, the Appellant contends that her migraine headaches are secondary to her service-connected right shoulder disability. The only medical opinion addressing this contention weighs against the claim. The aforementioned August 2021 VA examiner opined that the Appellant's migraines are less likely than not the result of her service-connected right shoulder disability. He explained that there is no direct pathophysiology between the two isolated conditions to support a connection of the right shoulder disorder to the Appellant's claimed headache condition. The examiner also opined that the Appellant's headaches are less likely than not aggravated by a right shoulder injury. He pointed out that it is not possible to establish a baseline from which to determine the degree of aggravation because the only documentation of a headache is dated April 1991, and there was no follow up appointment. The examiner stated that this suggests that the headache was an isolated incident. The examiner also stated that regardless of an established baseline, the Appellant's claimed headache condition is less likely than not aggravated by her right shoulder disability. (Continued on the next page) The Appellant believes that her headaches are related to an in-service injury, event, or disease, or are secondary to a service-connected disability. She is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of pathology. Therefore, it is outside the competence of Appellant in this case because the record does not show that she has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the August 2021 VA examiner. As the preponderance of the evidence is against this claim, the benefit-of-the-doubt doctrine does not apply, and the claim for service connection for a migraine disability must be denied. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). D. JOHNSON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Prem, 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.