Citation Nr: 21008504 Decision Date: 02/17/21 Archive Date: 02/17/21 DOCKET NO. 190304-10532 DATE: February 17, 2021 ORDER Entitlement to an initial rating of 10 percent, but not higher, for migraines for the relevant appeal period is granted. FINDING OF FACT For the relevant period on appeal, the Veteran’s migraines were manifested by characteristic prostrating attacks occurring on an average of one in two months over the last several months. CONCLUSION OF LAW The criteria for an initial rating of 10 percent, but not higher, for migraines for the relevant period on appeal have been met. 38 U.S.C. § 1155 (2018); 38 C.F.R. §§ 4.7, 4.124a, Diagnostic Code 8100 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active air service from June 2012 to September 2014. This case comes before the Board of Veterans’ Appeals (Board) on appeal of a September 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). Originally, an August 2016 rating decision by the VA RO granted service connection for migraine headaches and assigned a noncompensable (0 percent) rating, effective March 29, 2016. The Veteran submitted a notice of disagreement and disagreed with the rating assigned for her headache disability in November 2016. In June 2018, the Veteran opted to take part in VA’s AMA test program RAMP, the Rapid Appeals Modernization Program. She selected the Higher-Level Review of the issue of entitlement to an initial compensable rating for migraine headaches. A September 2018 RAMP decision continued the noncompensable rating. In March 2019, the Veteran opted into the Board’s RAMP program and elected the evidence submission review option. In November 2019, the Board denied the Veteran’s claim for an initial increased rating for migraine headaches. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In an August 2020 Order, the Court granted a Joint Motion of the parties, vacated the Board’s decision, and remanded the case to the Board for action consistent with the Joint Motion. Increased Rating – Migraine Headaches The Veteran has asserted that she should have a higher rating for her migraines as her symptoms are worse than those contemplated by the currently assigned rating. At the outset, the Board notes that as this case is an initial increased rating claim under the modernized review system, the relevant rating period on appeal will be from the date of the claim to the date the RAMP opt-in was received in June 2018. As the Veteran elected the evidence submission review option, the Board will consider the evidence of record at the time of the June 2018 opt-in, and the evidence submitted for the 90-day period beginning the date VA received the Veteran’s appeal to the Board in March 2019. However, any evidence submitted in the 90-day evidence submission period must pertain to the relevant rating period to be considered relevant to the issue on appeal. 38 C.F.R. §§ 3.240 (c)(1), 20.303 (2019). The Veteran has asserted that her migraines are worse than that accounted for by the currently assigned noncompensable initial rating. In the November 2016 notice of disagreement, the Veteran’s representative indicated that the July 2016 VA examination results are tantamount to one headache every two months which warrants a 10 percent rating. Service treatment records documented that the Veteran had an established diagnosis of migraine headaches. In August 2014, the Veteran’s migraines were reported to be well-controlled with Sumatriptan. The Veteran’s VA treatment records do not include findings relevant to rating the Veteran’s migraine headaches. The Veteran underwent a VA headaches examination in July 2016. The VA examiner reviewed the record, interviewed the Veteran, and conducted an in-person examination. The Veteran reported stress related headaches with scotoma, photo and phonophobia, and nausea/vomiting. She further reported headaches every two to three months that were relieved with Sumatriptan. The Veteran also reported that she had missed three days of work over the past year due to her headache condition and was currently asymptomatic. Upon examination, the Veteran reported pulsating headache pain. She further reported experiencing non-headache symptoms including nausea, vomiting, sensitivity to light, sensitivity to sound, and changes in vision. They typically lasted less than one day. The VA examiner indicated that the Veteran did not have characteristic prostrating attacks of migraine/non-migraine headache pain. In March 2019, the Veteran submitted a VA Disability Benefits Questionnaire (DBQ) completed by R.F., P.A. While that VA DBQ does address the Veteran’s headaches, it was completed in February 2019. As discussed above, the relevant rating period before the Board ends the date the RAMP opt-in was received in June 2018. As such, a medical report created in February 2019 does not address the Veteran’s symptoms prior to June 2018. As such, it is not relevant to the rating period on appeal and is of no probative value in the current appeal. The Board finds that an initial rating of 10 percent, but not higher, is warranted for the relevant period on appeal. In this regard, the medical and lay evidence of record support that the Veteran had characteristic prostrating headaches. However, there is no indication from the record that the Veteran experienced characteristic prostrating attacks on average once a month. The Board acknowledges that the Veteran has had to leave work on occasion. However, there is no indication from the record that such episodes happen regularly. Accordingly, the Board finds that an initial rating of 10 percent, but not higher, for migraines is warranted. 38 C.F.R. § 4.124a, Diagnostic Code 8100. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Cryan, 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.