Citation Nr: 21066123 Decision Date: 10/28/21 Archive Date: 10/28/21 DOCKET NO. 15-18 843 DATE: October 28, 2021 REMANDED Entitlement to service connection for migraine headaches, claimed as a residual of a head injury, and including as secondary to a service-connected psychiatric disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1988 to February 1990. This matter is before the Board of Veterans' Appeals (Board) on appeal from a February 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). A Board hearing was held before the undersigned in July 2018. A transcript of the hearing is of record. This matter was previously before the Board in October 2018, May 2020, September 2020, and January 2021 when it was remanded for further development. Entitlement to service connection for migraine headaches, claimed as a residual of a head injury, and including as secondary to a service-connected psychiatric disorder, is remanded. Although the additional delay is regrettable, the Board finds an additional remand is required as there has not been substantial compliance with the January 2021 Board remand. See Stegall v. West, 11 Vet. App. 268 (1998) (holding that where the remand orders of the Board are not substantially complied with, the Board errs as a matter of law when it fails to ensure substantial compliance). In the January 2021 Board remand order, the Board directed the Agency of Original Jurisdiction to obtain an addendum opinion addressing the etiology of the Veteran's migraine headache condition. A VA examiner was asked to specifically provide an opinion as to whether the Veteran's migraine headache condition was caused or aggravated by her service-connected unspecified anxiety disorder and unspecified bipolar disorder. In providing the opinion, the examiner was asked to address the Veteran's statement that she experiences headaches whenever she gets anxious or has panic attacks, as noted in a July 2013 treatment record. In March 2021, a VA examiner opined that the Veteran's migraine headache condition was not caused by her unspecified anxiety disorder and unspecified bipolar disorder. The examiner noted that, while the Veteran reported onset of headaches during service due to trauma, there was no evidence of the trauma found in the record. The examiner then opined that the Veteran's headaches were not aggravated by her unspecified anxiety disorder and unspecified bipolar disorder, noting that there was no evidence headaches are aggravated by psychiatric disorders. However, the examiner did not address the Veteran's statement that she experiences headaches when she gets anxious and has panic attacks. Furthermore, the Board notes the opinions are also inadequate as the examiner failed to provide an adequate rationale to support the opinions. Therefore, remand for a new medical opinion is required. The matters are REMANDED for the following action: 1. Obtain any updated VA treatment records for the period from July 2021 to the present. 2. After obtaining any additional records, obtain an addendum medical opinion from an examiner other than the March 2021 examiner regarding the Veteran's current migraine headache condition. An examination should only be scheduled if the clinician determines that an examination is necessary in order to provide the requested opinion. Following a review of the Veteran's claims file, the examiner is asked to provide an opinion on whether it is at least as likely as not (a 50 percent or greater probability) the Veteran's migraine headache condition was caused or aggravated (i.e., any worsening beyond natural progression) by her service-connected unspecified anxiety disorder and unspecified bipolar disorder. In providing the requested opinions, the examiner should address the Veteran's statement that she experiences headaches whenever she gets anxious or has panic attacks, as noted in a July 2013 treatment record. The examiner is also advised that there is no temporal requirement for a claim seeking service connection as caused or aggravated by an already service-connected condition, and that if an opinion continues to be based on a finding that migraine headaches were not caused or aggravated by a psychiatric disorder due to them having an onset many years after the diagnosis of the psychiatric disorder, further rationale is required to explain the basis for that conclusion. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Jiggetts 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.