Citation Nr: 21023030 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 16-23 385 DATE: April 19, 2021 REMANDED The issue of service connection for migraine headaches, including as secondary to service-connected posttraumatic stress disorder (PTSD), is remanded. The issue of an effective date for a total disability evaluation based on individual unemployability (TDIU) before April 11, 2017 is remanded. REASONS FOR REMAND The Veteran had active service from May 1969 to February 1971. In May 2020, the Board of Veterans’ Appeals (Board) remanded this matter for a VA medical examination and opinion, which were completed in August 2020. In June 2020, the Veteran withdrew his appeal of the May 2020 denial of service connection for hepatitis C and an increased rating for a right finger injury. As outlined below, another remand is necessary to obtain an addendum opinion addressing the Veteran’s contentions that his headaches are related to his service-connected PTSD. The claim for an earlier effective date for a TDIU is intertwined with the remanded claim and will be deferred until service connection for headaches is adjudicated. 1. The issue of service connection for migraine headaches, including as secondary to service-connected PTSD, is remanded. 2. The issue of an effective date for a TDIU before April 11, 2017 is remanded. The matters are REMANDED for the following action: 1. BACKGROUND FOR THE RO ADJUDICATOR: In a January 2021 statement and appellate brief, the Veteran contends his migraine headaches are caused or worsened by his service-connected PTSD. While the August 2020 VA examiner provided an opinion on direct service connection, he did not address secondary service connection. Remand is necessary for an addendum opinion addressing secondary service connection. 2. REMAND DIRECTIVES: Return the claims file to the August 2020 VA examiner and request he provide an addendum opinion responding to the questions below. If the examiner unavailable, obtain an opinion from an appropriately qualified PHYSICIAN. All relevant medical records must be made available to the examiner for review of pertinent documents. The report should specifically state that such a review was conducted. The examiner must give a comprehensive explanation for all opinions provided. The examiner is requested to give the following opinion(s): (a.) Whether the Veteran’s migraine headache disorder was caused or aggravated (worsened beyond its normal progression) by his service-connected PTSD and related psychiatric symptoms? (b.) Given the medical evidence in this case, your experience and knowledge and the state of medical science, is the Veteran’s account of the development of his headache disorder consistent with the clinical findings? Please fully explain your opinion. In addition to reviewing the entire file, the examiner is requested to review the following: *March 2017 non-VA PTSD DBQ where headaches are not listed among PTSD symptoms. See “BVA-General,” received May 7, 2018, at pages 10-18. *December 2019, April 2017, and July 2014 VA psychiatric examination reports where headaches are not listed among PTSD symptoms. See “C&P Exam,” received December 12, 2019; “VA Examination,” received April 11, 2017; “C&P Exam,” received July 22, 2014. *January 2021 statement where the Veteran reported his headaches have been severe “since at least 2015,” and are triggered by stress, anger, negative interactions with others, and/or loud noise. He also reported his headaches can trigger and aggravate his anxiety. See “Correspondence,” received January 5, 2021. Following the review and any additional development deemed necessary, readjudicate the claims. If the claims are not granted in their entirety, issue a supplemental statement of the case (SSOC) and forward the claims to the Board for adjudication. The Veteran has the right to submit additional evidence and argument on the matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims remanded by the Board or by the United States Court of Appeals for Veterans Claims (Court) for additional development or other appropriate action be handled in an expeditious manner. See 38 U.S.C. §§ 5109B, 7112. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Hiaasen 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.