Citation Nr: 21077558 Decision Date: 12/30/21 Archive Date: 12/30/21 DOCKET NO. 20-03 872 DATE: December 30, 2021 ORDER A 10 percent rating, but no more, for migraine headaches is granted subject to the payment of monetary benefits. Service connection for a low back disorder is denied. FINDINGS OF FACT 1. The Veteran served on active duty from June 2000 to April 2008. 2. Migraine headaches have been characterized by prostrating attacks that occur, on average, once every two months. 3. A low back disorder was not shown in service and is not etiologically related to service. CONCLUSIONS OF LAW 1. The criteria for a 10 percent rating, but no more, for migraine headaches have been met. 38 U.S.C. § 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 4.124a, Diagnostic Code (DC) 8100 (2021). 2. A low back disorder was not incurred in service. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303 (2021). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran testified at a January 2021 hearing before the undersigned Veterans Law Judge. A transcript of that hearing has been associated with the claims file. At the January 2021 hearing, he waived Regional Office (RO) review of evidence added to the file since the last RO review of the file. Increased Rating Claim for Migraine Headaches Turning to the relevant laws and regulations, disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. The Veteran has been in receipt of a noncompensable rating for migraine headaches under DC 8100. He asserts that the migraines are worse than contemplated by the currently-assigned noncompensable rating. In order to warrant a higher rating, the medical evidence must show: headaches with characteristic prostrating attacks averaging one in two months, over the last several months (10%); headaches with characteristic prostrating attacks occurring on an average of once a month of the last several months (30%); or headaches with very frequent, completely prostrating and prolonged attacks that are productive of severe economic inadaptability (50%). Prostration has not been defined by the rating criteria, or by the Veterans Claims Court. According to Webster's New World Dictionary of American English (p.1080, 3rd College Ed. (1986)), "prostration" is defined as "utter physical exhaustion or helplessness." A very similar definition is found in Dorland's Illustrated Medical Dictionary (p 1554, 31st Ed. (2007)), in which "prostration" is defined as "extreme exhaustion or powerlessness." Turning to the medical evidence, in a March 2017 VA treatment record, the Veteran reported that since the 2002 traumatic brain injury (TBI), he experienced headaches 1-2x per month that were not necessarily debilitating ("I've powered through them before"), though it was noted that he would rest if he could ("I'll just chill out for a little bit"). He endorsed possible phonophobia stating ("I guess so"). The Veteran was diagnosed with migraine headaches at the May 2018 VA examination. He reported symptoms of pulsating or throbbing head pain and pain behind eyes. The examiner found that there were no characteristic prostrating attacks of migraine headache pain. At an October 2018 VA examination, the Veteran complained of headaches occurring 10 times a month and lasting 24 hours. He reported symptoms of constant head pain, pain on both sides of the head. Additionally, it was noted that he experiences non-headache symptoms associated with headaches including sensitivity to light and the duration of typical head pain was noted to be one to two days and the typical head pain location was on both sides of his head. He continued to take medication regularly. The examiner found that there were no characteristic prostrating attacks of migraine headache pain. The examiner also noted that the Veteran did not have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed. The examiner found the Veteran's headache condition impacted his ability to work as he needed some time off of work as a fireman during headaches. During the January 2021 Board hearing, the Veteran testified that he had headaches which effected his ability to work. He indicated that his headaches lasted one or two days, with an aura before a migraine, with sensitivity to light, pain on both sides of the head and that he had to go lay down in a dark room. He stated that he was not able to participate in daily activities or be with his family due to them. Further, he testified that he experienced prostrating headaches one or two times a month where he had to separate himself and go and lay down in a dark room. In this case, the evidence of record reflects that the severity of the Veteran's headaches approximates a level contemplated by a 10 percent rating for the period on appeal. The Board recognizes that the May 2018 and October 2018 VA examinations found that he does not have characteristic prostrating attacks; however, he credibly testified that he has headaches which effected his ability to work. Resolving doubt in the Veteran's favor, the evidence supports a 10 percent rating throughout the appeal period. However, there have been no findings of prostrating attacks on a more frequent basis as is required to warrant a higher rating. Specifically, the VA treatment records are largely silent to any treatment for or complaints of frequent prostrating attacks. Additionally, even in consideration of the Veteran's January 2021 statement, he does not specifically assert, nor does the record show, more frequent prostrating attacks as would warrant a higher rating. In granting a higher rating, the Board has also considered the Veteran's lay statements regarding his symptoms as well as the evidence provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. In sum, after a careful review of the evidence of record, a 10 percent rating, but no more, for a migraine headache disability is granted. Service Connection Claim The Veteran asserts that service connection is warranted for a back disorder because he injured it in a motorcycle accident during service and has had ongoing pain ever since. Turning to the medical evidence, a June 2018 VA examiner indicated that the Veteran has been diagnosed with lumbar strain. A January 2020 private DBQ diagnosed mechanical back pain and degenerative disc disease (DDD) of the lumbar spine. As such, the first element of service connection is met. As to in-service incurrence, the service treatment records (STRs) reflect that the Veteran was involved in a motorcycle accident in March 2001. X-rays revealed no acute fracture or subluxation of the thoracic spine. There are no further STR entries related to the back. Further, on the February 2008 separation Report of Medical History, he denied any recurrent back pain or any back pain. Nonetheless, given the evidence of record and his statements, the second element of service connection is met. As to medical nexus, the evidence does not support a nexus between his current low back disorder and the injuries the Veteran sustained in service. In a June 2018 VA examination, the Veteran reported that he began having low back issues in 2003 but he could not recall a particular injury. He indicated that the low back pain was constant but not debilitating and he was never seen for this in service, and the pain would come and go in service. The examiner, after conducting a physical examination of the Veteran and reviewing the claims file, opined that the low back disorder was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event or illness. The examiner indicated that the Veteran had no documentation of ongoing back issues that connected his current intermittent "flareups" of back strain to back symptoms in service. A January private DBQ received from the Veteran discussed current diagnoses and medical history as relevant to a low back disorder but did not provide a nexus between the disorder and service. In a February 2021 letter, Dr. T.T., D. C., stated that the Veteran had been seen at his office for low back pain since 2010. He indicated that the Veteran suffered a low back injury from a motorcycle accident while on duty in the military in 2003. He noted that the Veteran had chronic low back pain which varied in intensity and occasionally had episodes that were moderate to severe nature and he was seen on an as needed basis for his acute episodes as well as controlling his chronic low back pain. However, he did not provide a nexus between the disorder and service. Therefore, the opinion does not provide a sufficient basis for a grant of service connection. The Board finds that the June 2018 VA medical opinion is highly probative on the issue of whether the Veteran's currently-diagnosed lumbar spine disorder is related to service. The examiner reviewed and discussed the medical evidence and the Veteran's history in detail. Further, the medical opinion was supported by a well-reasoned rationale, which was consistent with the medical evidence of record. The Board has considered the Veteran's lay statements that his disorder was caused by service. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his current disorder due to the medical complexity of the matter involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claim for service connection and there is no doubt to be otherwise resolved. As such, the appeals are denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Grzeczkowicz 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.