Citation Nr: 21066599 Decision Date: 11/01/21 Archive Date: 11/01/21 DOCKET NO. 16-19 893 DATE: November 1, 2021 ORDER Service connection for ocular migraines is granted. FINDINGS OF FACT 1. The Veteran has a current diagnosis of ocular migraines. 2. Symptoms of ocular migraines began during active service and have been present since service separation. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for ocular migraines have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran, who is the Appellant, served on active duty from January 2008 to October 2009, and from May 2010 to June 2011. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2015 rating decision from the Regional Office (RO), which, in pertinent part, denied service connection for ocular migraines. In November 2019, the Veteran testified at a Board videoconference hearing from the RO in Detroit, Michigan, before the undersigned Veterans Law Judge in Washington, DC. The hearing transcript has been associated with the record. Service Connection for Ocular Migraines is Granted. The Veteran contends the condition is the result of active duty in Iraq. Alternatively, she testified that the ocular headaches are secondary to the service-connected conjunctivitis or skin disability. See April 2016 VA Form 9, November 2019 Board Hearing Transcript. Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, service connection for a disability requires evidence of: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. The evidence shows a current diagnosis of ocular migraines, as noted in the October 2014 VA examination. See also September 2014, March 2021 VA treatment records. After a review of all the lay and medical evidence of record, the Board finds that the evidence is at least in equipoise on the question of whether there were symptoms of severe head pain, in service and since service separation, that were later diagnosed as ocular migraines, i.e., whether ocular migraines were directly "incurred in" service. Post-service treatment records are silent for symptoms of treatment of headaches; however, a July 2011 private treatment record shows that the Veteran reported that she was prescribed antibiotics by the Army two months prior, that is, in May 2011 during active service, and she developed headaches within a week of treatment, placing the onset of head pain symptoms during service. Upon examination, the treating physician noted that the Veteran was experiencing headaches, as well as eye swelling and inflammation. The diagnosis was headaches and eye swelling and erythema. During the October 2011 VA examination, the Veteran endorsed an onset of symptoms and treatment for ocular migraines and the service-connected conjunctivitis in 2011. She endorsed symptoms of bitemporal head pain with visual phenomena that occur about twice a year, though are less frequent than when the condition began. VA treatment records also show intermittent episodes of ocular headaches over the years. September 2014, May 2016, March 2021 VA treatment records. The Board has found the evidence at least in equipoise on the question of whether the Veteran had symptoms of head pain that began during service and continued since service separation, which symptoms were later diagnosed as ocular migraines, thus tending to show direct service incurrence. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a), (d). The Board is granting the service connection claim based on evidence, including that pertinent to service, which establishes that symptoms of an ocular migraine disability began in service, so was "incurred in" service. This obviates the need for any secondary service connection nexus opinions (June 2020 and August 2021). For these reasons, and resolving reasonable doubt in the Veteran's favor, the Board finds that the criteria for direct service connection for ocular migraines have been met. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moore, Shanna 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.