Citation Nr: 21009021 Decision Date: 03/18/21 Archive Date: 02/18/21 DOCKET NO. 17-18 627 DATE: March 18, 2021 REMANDED Service connection for migraine headaches is remanded. REASONS FOR REMAND The Veteran, who is the Appellant, served on active duty from October 2002 to October 2008. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2016 rating decision from the Regional Office (RO), which, in pertinent part, denied service connection for migraine headaches and a left sided hernia. In a September 2019 rating decision, the RO granted service connection for a left sided inguinal hernia, which is a full grant of the benefit sought on appeal, so is no longer in appellate status before the Board. In April 2020, the Veteran testified at a Board virtual hearing before the undersigned Veterans Law Judge. The hearing transcript has been associated with the record. Although the Veteran provided testimony regarding a higher (compensable) initial rating for the now service-connected left sided inguinal hernia, a review of the record shows that the Veteran did not submit a Notice of Disagreement (NOD) with the initial rating assigned for the left sided inguinal hernia within one year of the August 2019 rating decision. In the absence of a NOD, the Board does not have jurisdiction over an issue of a higher initial rating for the left sided inguinal hernia. See Roy v. Brown, 5 Vet. App. 554, 555 (1993) (“appellate review of an RO decision is initiated by an NOD”); see also See Manlincon v. West, 12 Vet. App. 238 (1999) (where there is a NOD, the Board has jurisdiction, and next step is SOC). If the Veteran would like to pursue an increase rating for the left sided inguinal hernia, the Veteran must file a claim on the appropriate form. Service connection for migraine headache is REMANDED for additional development. The Veteran asserts that service connection for migraine headaches is warranted due to trauma to the head. At the April 2020 Board hearing, the Veteran testified that he fell off a truck and hit his head in approximately 1982. The Veteran testified that he has had problems with headaches since that head injury. He testified that he was prescribed migraine medications years ago, but he stopped using them because they were not effective. The Veteran asserts that his migraine headaches are a distinct and separate disorder from his sinus headaches, as his sinus headaches manifest as pressure in the sinuses below and above the eyes and are associates with other sinusitis symptoms such as runny or stuffy nose. Additionally, the sinus headaches or pressure resolved when he flushes his sinuses. In contrast, the Veteran testified that his migraine headaches start on the left side of the top of his head and sometimes radiate to the other side of the head and to the back of the head. The Veteran reports that his migraine headaches occur almost daily and are not triggered by anything in particular. He keeps journal of his migraines headaches and manages them with Ibuprofen. The service treatment records show that in June 1982 the Veteran fell off the back of a truck causing a laceration above the left eye. The Veteran endorsed headaches following the head injury. There are also reports of headaches associated with reading. See June 1982, April 1989, February 1993 service treatment records. Post-service records from 1997 to 2005 also show symptoms and treatment for headaches, some of which were side effects of certain medications, others which had no indicates trigger at all and were not indicated as a symptoms of sinusitis. Migraine medications were prescribed for the headache syndromes. See October 2000, January 2002, January 2005, June 2005 government treatment records. Thereafter, the record is silent for any additional symptoms, treatment, or diagnosis of headaches. The record indicates that the Veteran denied headaches on multiple occasions. See November 2006, October 2008, February 2012, June 2017, March 2018 VA and government treatment records. However, as noted above, the Veteran testified that he continues to have daily headaches that are distinguishable from the head/sinus pain he experiences during episodes of sinusitis. It does not appear that the Veteran has been provide a VA examination and opinion as to the etiology of the current headaches. Given the in-service head injury and report of headaches, post-service records noting symptoms and treatment for headaches, and the Veteran’s testimony that he has had migraine headaches since service that he manages with ibuprofen, a VA examination and medical opinion would be helpful to assess if the Veteran has a current headache disability and the etiology of any such disability. Service connection for migraine headaches is REMANDED for the following action: Schedule the appropriate VA headache examination to assess the relationship, if any, between any current headache disorder and active service. The relevant documents in the record should be reviewed by the examiner and a detailed history of relevant symptoms should be obtained from the Veteran. All indicated studies should be performed. A rationale for all opinions and a discussion of the facts and medical principles involved should be provided. The following opinion is requested: a) Does the Veteran have a current disability of headaches that is distinct and separate from the headache symptoms associated with the service-connected sinusitis? b) Is it at least as likely as not (50 percent or higher degree of probability) that any currently diagnosed headache disorder was caused by or etiologically related to active service, to include the during service the June 1982 head injury and other reports of headaches associated with reading? J. PARKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Moore 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.