Citation Nr: 21015095 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 16-40 464 DATE: March 16, 2021 REMANDED Entitlement to service connection for headaches, including as secondary to service-connected disability, is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran had active service from July 1967 to July 1970. This case came to the Board of Veterans’ Appeals (Board) on appeal from an Agency of Original Jurisdiction (AOJ) decision dated in September 2015 and November 2015. In an October 2018 decision, the Board denied entitlement to service connection for headaches and entitlement to a TDIU. The Veteran then appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In a November 2019 memorandum decision, the Court set aside the October 2018 Board decision, and remanded the issues for further development and adjudication. In July 2020, the Board remanded this case to the AOJ for additional development consistent with the memorandum decision. The case was subsequently returned to the Board. 1. Service connection for headaches, including as secondary to service-connected disability is remanded. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives regarding the issue of service connection for headaches. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Court’s November 2019 memorandum decision vacated and remanded the October 2018 Board decision because the record raised the theory that the Veteran’s headaches are secondary to his service-connected facial scars and right eye ectropion, and VA did not obtain a medical opinion as to this theory of entitlement. The Court stated that the failure by the VA examiners to address the theory of aggravation of the Veteran's tension headaches by his service-connected facial scars and right eye ectropion rendered the examinations inadequate. The Board remanded this claim to obtain such a medical opinion. Although a VA examination and medical opinion were obtained in November 2020, the examiner did not provide an opinion as to whether the claimed headaches are aggravated by service-connected disabilities, because the Veteran currently denies headaches. However, since a headache disorder was diagnosed during the pendency of the appeal (tension headaches, on VA examination in November 2015), a current disability has been shown, and a medical opinion must be obtained. The Board cannot make a fully-informed decision on the issue of service connection for headaches because no VA examiner has opined whether tension headaches were aggravated by service-connected disabilities.   2. Entitlement to a TDIU is remanded. The Board finds that the issue of entitlement to a TDIU must also be remanded because the Court’s decision found that this claim was inextricably intertwined with the above service connection claim and this is now the law of the case. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s tension headaches (diagnosed during the pendency of the appeal, on VA examination in November 2015) are at least as likely as not aggravated beyond their natural progression by service-connected facial scars and right eye ectropion. The claims file must be reviewed. S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. L. Wasser, 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.