Citation Nr: 21014585 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 16-49 049 DATE: March 15, 2021 ORDER Entitlement to service connection for tension headaches, to include as due to service-connected PTSD, is denied. FINDING OF FACT The Veteran’s tension headaches are not secondary to service-connected PTSD and is not otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for tension headaches due to service or service-connected PTSD are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran contends his current headache disability is caused or aggravated by service-connected PTSD. Service connection may be granted for a disability which is proximately due to or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310; Allen v. Brown, 1 Vet. App. 439 (1995). To establish secondary service connection, there must be (1) evidence of a current disability, (2) evidence of a service-connected disability, and (3) nexus evidence establishing a connection between a service-connected disability and the current disability. Wallin v. West, 11 Vet. App. 509 (1998). The question for the Board is whether the Veteran has a current disability that is caused or aggravated by service-connected PTSD. The Board concludes that, while the Veteran has a current disability, the preponderance of the evidence is against finding that the Veteran’s tension headaches are proximately due to or the result of, or aggravated beyond its natural progression by service-connected PTSD. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). The May 2020 VA examiner opined that the Veteran’s tension headaches are not at least as likely as not proximately due to or the result of service-connected PTSD. Additionally, the examiner opined that there was no evidence of aggravation of his headache condition due to his psychiatric condition. The rationale was it is not accepted in the general medical community that mental conditions including depression, psychosis, PTSD or mood disorders are directly responsible for causing the pathophysiology underlying headache conditions. Additionally, it was observed that there was no study in medical literature that definitively establishes a causal relationship. The examiner noted that it was possible to have comorbid headache and psychiatric conditions where one may exacerbate the other. However, the examiner concluded that there was no evidence of aggravation of his headache condition and commented that the records do not indicate that his psychiatric conditions are associated with worsened headache symptoms or that headaches are triggered by his psychiatric conditions. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Veteran believes his tension headache disability is related to service-connected PTSD, but he is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of the interaction between multiple systems in the body and interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the May 2020 VA examination. In light of the above, the weight of the evidence is against finding that tension headaches are proximately caused or aggravated by service-connected PTSD. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. See Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). (Continued on the next page)   Here, the Veteran has not asserted that his symptoms or disability began in service or is related to an in-service event or injury. Additionally, service treatment records do not document any complaints, treatment, or diagnosis of headaches. The April 1978 separation examination was normal. In the April 1978 separation report of medical history, the Veteran denied frequent or severe headaches. Further, VA and private treatment records do not show that the Veteran as diagnosed with tension headaches until the May 2020 VA examination, decades after his separation from service. In light of the above, the Board concludes that the preponderance of the evidence weighs against finding that there was an in-service injury or event and against finding that the current diagnosis of tension headaches began during service or is otherwise related to an in-service injury, event, or disease. In conclusion, the Board finds that the evidence does not establish entitlement to service connection for a headache disability, to include as due to service-connected PTSD. In denying the claim, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Vang, Stephanie 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.