Citation Nr: 21077357 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 17-22 282A DATE: December 29, 2021 ORDER The claim of entitlement to service connection for migraine headaches (hereinafter migraines) is granted. FINDING OF FACT The competent and credible evidence of record indicates that the Veteran's migraines are related to his active-duty service. CONCLUSION OF LAW Resolving any doubt in the Veteran's favor, the criteria for service connection for migraines have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had honorable active-duty service with the United States Army from January 1993 to May 1993, January 1994 to April 1994, August 1999 to April 2000 and with additional Army National Guard service. This matter is before the Board of Veteran's Appeals (Board) from the rating decisions of November 2014, May 2016, and June 2016 of the Department of Veterans Affairs (VA) Regional Office (RO) that denied service connection for migraines. The appellant's representative has not provided an informal hearing presentation (IHP). However, as this represents a full grant of benefits there is no prejudice to the Veteran in proceeding with issuing a decision in the absence of the IHP. The Board notes the Board decision from September 2021 reopened the Veteran's claim for service connection for migraines and then remanded the claim for a new VA examination. The requested action has been undertaken. Accordingly, there has been substantial compliance with the prior remand instructions. See D'Aries v. Peake, 22 Vet. App. 97 (2008) (holding that only substantial, and not strict, compliance with the terms of a Board remand is required pursuant to Stegall v. West, 11 Vet. App. 268 (1998)). Entitlement to service connection for migraines The Veteran contends he is entitled to service connection for migraines. Specifically, the Veteran contends his migraines developed after a fall in service and have continued since then. Generally, to establish service connection there must be competent evidence showing: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the in-service injury incurred or aggravated during service. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303. VA must consider all favorable lay evidence of record. 38 U.S.C. § 5107. Lay testimony is competent to establish the presence of observable symptomatology, where the determination is not medical in nature and is capable of lay observation. Barr v. Nicholson, 21. Vet. App. 303 (2007). The Secretary shall consider all information and lay and medical evidence of record in a case and make appropriate determinations as to competence, credibility, and weight. 38 U.S.C. § 5107; 38 C.F.R. § 3.303; Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience, if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. 38 C.F.R. § 3.159. Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, the extensive evidence of record. Indeed, the Federal Circuit has held that the Board must review the entire record but does not have to discuss each piece of evidence. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). Therefore, the Board will summarize the relevant evidence where appropriate, and the Board's analysis below will focus specifically on what the evidence shows, or fails to show, as to the claim on appeal. When there is an approximate balance between positive and negative evidence, equipoise, the benefit of the doubt doctrine must apply in favor of the Veteran. But when the preponderance of the evidence weighs against the claims of the Veteran the claim will be denied on its merits, and when the preponderance of the evidence weighs for the claims of the Veteran the claim will be granted on its merits. In those cases, the benefit of the doubt doctrine is inapplicable. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Veteran has met the first element of service connection with a current diagnosis of migraines. The Veteran's service treatment records during active duty are silent as to any reports, complaints, or treatment of migraines. The records do note a fall in October 1999. Thus, the Veteran has met the second element of service connection of an inservice event or injury. The remaining question before the Board is whether the Veteran's migraines were due to, caused by, or result of active-duty service. The Veteran's VA treatment records reflect treatment and medications for migraines starting shortly after discharge from active service. VA treatment records noted in December 2000 a diagnosis of migraine headaches that frequently occurred behind one eye and happened 2 to 3 times per week. Additionally, the Veteran's National Guard service treatment records noted complaints of migraines in July and August 2001. The Veteran received a VA examination in January 2015 that noted a diagnosis of migraine variants diagnosed in 2000. The Veteran reported he developed severe headaches after his fall in service when he lost consciousness. The Veteran reported his symptoms and was found not to have characteristic prostrating attacks of migraine pain or non-migraine headache pain. The examiner provided no opinion as to the etiology or origin of the Veteran's migraines. VA treatment records also contain positive nexus opinion from the Veteran's neurologist, Dr. A.M., dated February 2020. The doctor noted they were the Veteran's neurology provider and had consistently treated him for the past two years. The doctor noted the Veteran developed migraines within a few months of his in-service fall. The doctor opined that the Veteran "appears to suffer from post traumatic migraine headaches since his initial injury while in active duty." This opinion is well-reasoned and based on treatment of the Veteran and consideration of the lay evidence of record. The Board finds the opinion highly probative. As directed by the September 2021 Board remand, the Veteran submitted to another VA examination for his migraines in October 2021. The Veteran gave a history of onset due to a fall in 1999 and worsening since that time. The Veteran's migraines were noted lasting less than 1 day with no prostrating attacks. The examiner found the Veteran's migraines were not incurred in or caused by his service. The examiner found the Veteran's service treatment records had no mention of any headaches or head injuries and the Veteran did not mention any additional falls or injuries in service. The examiner also commented on the February 2020 neurologist opinion and found, "there is no documentation in the reviewed notes to concur with the information." The examiner concluded that based on all of the above, the headaches of the Veteran were not incurred in or caused by his service to include his reports of headaches in October 1999. The Board finds the VA opinion has no probative value as the examiner fails to note the diagnosis of migraines in VA treatment records in December 2000. Medical opinions have no probative value when they are based on an inaccurate factual premise. See Reonal v. Brown, 5 Vet. App. 548 (1993). The Veteran submitted statements and indicated consistently throughout the record that his migraines began after his fall in service and continued thereafter. The Board finds the Veteran's statements as to his experiences, symptoms, and onset to be competent, credible, and with significant probative weight. Therefore, reading the evidence in a way most favorable to the Veteran, and resolving any doubt in the Veteran's favor, the Board finds that the Veteran has satisfied the third element of service connection. The Veteran's claim for service connection for migraines is granted. Rebecca N. Poulson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C.A. Teich, Associate 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.