Citation Nr: 21076169 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 12-26 170 DATE: December 22, 2021 ORDER Service connection for a groin disorder manifested as femoral nerve radiculopathy is granted. REMANDED Entitlement to service connection for migraine headaches is remanded. FINDING OF FACT The evidence is at least in equipoise as to whether the Veteran has a groin disorder manifested as femoral nerve radiculopathy secondary to service-connected lumbar disorder. CONCLUSION OF LAW The criteria for service connection for a groin disorder have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. § 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1983 to December 1986. In a November 2010 rating decision, the Regional Office (RO) denied service connection for groin pain and migraines. The Veteran appealed those denials to the Board of Veterans' Appeals (Board). In April 2017, March 2019, and May 2021, the Board remanded those issues to the RO for additional action. Entitlement to service connection for a groin disorder. The Veteran contends that his groin pain is related to his service-connected lumbar DDD. In a September 2021 rating decision, the RO granted service connection, effective April 26, 2010, for the Veteran's lumbar DDD. The RO also granted service connection for radiculopathy (sciatic nerve) in the Veteran's left and right legs secondary to his lumbar DDD. Service connection may be established on a direct basis for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Service connection may also be granted for any disease diagnosed after service when all the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In general, service connection requires (1) evidence of a current disability; (2) medical evidence, or in certain circumstances lay evidence, of in-service incurrence or aggravation of a disease or injury; and (3) evidence of 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). Service connection may be granted on a secondary basis for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Aggravation of a non-service-connected disease or injury by a service-connected disability may also be service-connected. 38 C.F.R. § 3.310(b). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a claim, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107. After a thorough review of the evidence of record and based on the legal criteria above, the Board finds that service connection for a groin disorder manifested as femoral nerve radiculopathy is warranted. In that regard, at an August 2020, VA examination to evaluate the current severity of the service-connected lumbar spine disorder, the examiner diagnosed the Veteran with bilateral radiculopathy of the lower extremities with both femoral nerve and sciatic nerve involvement. In a corresponding VA medical opinion, the examiner indicate that the Veteran's groin disorder was at least as likely as not caused by his low back disorder and explained that such symptom was radiculopathy. Accordingly, the Board finds that service connection for a groin disorder manifested as femoral nerve radiculopathy as secondary to service-connected lumbar spine disorder is warranted. REASONS FOR REMAND Entitlement to service connection for migraine headaches The Board is remanding this issue for an additional VA medical opinion. The Veteran contends that his headaches began in service, are attributable to head traumas in service, or are secondary to his service-connected Meniere's syndrome with benign paroxysmal positional vertigo (BPPV). In the September 2021 rating decision, the RO granted service connection for the Veteran's Meniere's syndrome with BPPV, effective April 26, 2010. In VA treatment in May 1987, the Veteran reported intermittent dizzy spells. The clinician's impression was positional vertigo. In October 1987, the Veteran reported intermittent headaches. In later treatment, on numerous occasions, he related having both dizzy spells and headaches. The Veteran has reported that he sustained head traumas in service. In remands the Board instructed the RO to obtain VA medical examinations and opinions addressing the likely etiology of the Veteran's headaches. The Board sought opinions addressing the contentions of incurrence in service, relationship to claimed head traumas in service, and relationship to a claimed disorder manifested by dizzy spells. VA examinations and opinions in 2017 through 2021 did not address whether the Veteran's headaches were secondary to his Meniere's syndrome with BPPV. The Board is remanding the issue for a VA file review and medical opinion addressing that question. The matter is REMANDED for the following action: Provide the Veteran's expanded claims file to an appropriate VA examiner for review and opinion regarding the history and etiology of his current headaches, including any migraine headaches. Ask the reviewer to review the claims file thoroughly, with particular focus on information about the Veteran's headaches and his service-connected Meniere's syndrome with benign paroxysmal positional vertigo (BPPV). The examiner must provide an opinion as to whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran's headaches are: (a) proximately due to or the result of his Meniere's syndrome with BPPV, or (b) aggravated by his Meniere's syndrome with BPPV. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. PAUL E. METZNER Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. J. Kunz, 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.