Citation Nr: 21007403 Decision Date: 02/09/21 Archive Date: 02/09/21 DOCKET NO. 95-29 187 DATE: February 9, 2021 REMANDED Entitlement to service connection for headaches with dizziness and nausea is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1968 to April 1984. A January 1986 Administrative Decision found that the period of service from October 18, 1979 to April 13, 1984 was terminated under conditions which preclude the payment of Department of Veterans Affairs (VA) benefits. The Board notes that the Veteran is represented by an attorney on other issues before the Board. However, that representation is limited in scope and does not extend to the current appeal before the Board. See VA Form 21-22a, Box 23, received October 2019; December 15, 2020 Attorney Statement. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision of the Department of Veterans’ Affairs (VA) Regional Office (RO). This appeal was previously before the Board in June 2020, at which time it was remanded for further evidentiary development. Specifically, the Board instructed the RO to obtain a nexus opinion regarding whether the Veteran’s headaches were either caused by service or alternatively caused or aggravated by his service-connected disabilities. In September 2020, the VA examiner opined that the Veteran’s headaches were neither caused by service nor caused or aggravated by his service-connected conditions. However, the examiner’s opinion essentially relied on the absence of records showing such a causal connection but the absence of such an evaluation does not address the issue of whether such a medical causation can or cannot be made. The examination report must be returned as inadequate for rating purposes. The Board also observes that the Veteran appear to raise multiple theories for the cause of his headaches such as exposure to jet fuel, burn pits, herbicides, etc. VA’s duty to assist is triggered when there is competent evidence of record suggesting such a correlation. McLendon v. Nicholson, 20 Vet. App. 79 (2006). He did report an onset after direct exposure to jet fuels and herbicides, but there is no competent evidence suggesting an association with any further exposure. The Veteran may submit such evidence, for example medical opinion, medical studies, etc., would suggests such an association. See Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010) (holding that a conclusory generalized statement that a service illness caused his present medical problems was insufficient to trigger duty to provide medical examination as this theory would eliminate the carefully drafted statutory standards governing the provision of medical examinations and require the Secretary to provide such examinations as a matter of course in virtually every veteran’s disability case). The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate medical professional to determine whether the Veteran’s headaches are due to service or proximately due to service-connected disability. If the Veteran is permitted to attend a VA examination, schedule an appropriate examination for the Veteran’s headaches. The examiner must review the entire claims file and the examination report should note that review. The examiner should then address the following: (a) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s headaches were incurred in service or are otherwise etiologically related to any incidents of the Veteran’s period of active service from February 1968 to October 1979 including exposure to jet fuels and herbicides? The examiner should discuss whether there is any medical reason to accept or reject the Veteran’s contention that he has manifested a chronic headache disorder incurred during the period of service from February 1968 to October 1979. (b) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s headaches are either caused by a service-connected disability, to include TMJ, residuals of a fractured nose, orthostatic hypotension, and/or PTSD; OR (c) Is it at least as likely as not (50 percent probability or greater) that a service-connected disability, to include TMJ, residuals of a fractured nose, orthostatic hypotension, and/or PTSD results in any additional functional impairment associated with his headache disorder (e.g., a medically discernible increase in frequency, duration and/or severity, even if temporary, above the degree associated with that expected from his baseline headache disorder alone). (continued on the next page) The examiner is requested to discuss whether the underlying service-connected disorders are medically capable of causing or aggravating a headache disorder and, if so, whether the Veteran’s headache disorder has been caused or aggravated based on the particular facts of this case. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Orie, 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.