Citation Nr: 21007316 Decision Date: 02/09/21 Archive Date: 02/09/21 DOCKET NO. 17-48 744 DATE: February 9, 2021 REMANDED Entitlement to service connection for migraine headaches, claimed as secondary to service-connected posttraumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1984 to May 1988 and from August 1988 to January 1992. This appeal to the Board of Veterans’ Appeals arose from a November 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the case in March 2020 for further development. In January 2020, the Veteran testified during a Board videoconference hearing before a Veterans Law Judge (VLJ). A transcript of that hearing has been associated with the claims file. The law requires the Veterans Law Judge who conducts a hearing to participate in any decision made on the appeal. 38 U.S.C. § 7107 (c); 38 C.F.R. § 20.707. The Veteran was notified that the VLJ that conducted her hearing is no longer employed by the Board by way of a January 2021 letter. She was offered the opportunity to have a new hearing and was notified that if she did not respond within 30 days, the Board would assume that she does not desire an additional hearing and would proceed with adjudication of the issue. The Veteran has not responded to this letter. Thus, the Board will proceed to consider the Veteran’s claim without additional hearing testimony. 1. Entitlement to service connection for migraine headaches, claimed as secondary to service-connected PTSD, is remanded. The Veteran contends that her migraine headaches are caused or aggravated by her service-connected PTSD. The Board remanded the case in March 2020 for a VA examination and opinion addressing these questions. The June 2020 VA examiner provided a negative nexus opinion for secondary service connection based on causation. However, while the examiner checked the “no” box with respect to whether or not the Veteran’s PTSD aggravated her migraine condition, the examiner’s listed rationale for that opinion was the same as for causation. The rationale does not adequately support the examiner’s stated opinion that the Veteran’s current migraine headache disability was not aggravated (increased beyond the natural progression of the disability) by her service-connected PTSD. When VA undertakes to provide a VA examination or medical opinion, it must ensure that the examination is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Based on the above, the Board finds that a remand is required for an addendum opinion that adequately addresses the aggravation aspect of the claim. The matters are REMANDED for the following action: Obtain an addendum VA opinion from the VA examiner who authored the June 2020 opinion addressing migraine headaches, or another appropriately qualified examiner. Only if deemed necessary to provide an opinion, should the Veteran be afforded a new VA examination for her migraine headache disability. Provide the claims file, including a copy of this REMAND, to the examiner for review. After reviewing the claims file, the examiner should respond to the following: Is it at least as likely as not (50 percent probability or more) that the Veteran’s migraine headache disability was aggravated (increased beyond the natural progression of the disability) by her service-connected PTSD? A complete rationale for any opinion expressed must be provided, and the rationale provided for the opinion must specifically address aggravation rather than direct causation. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. G. Mazzucchelli, 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.