Citation Nr: 21031284 Decision Date: 05/21/21 Archive Date: 05/21/21 DOCKET NO. 16-49 001 DATE: May 21, 2021 REMANDED Entitlement to a compensable disability rating for musculoskeletal tension headaches is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1976 to May 1995. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a virtual hearing before the undersigned in December 2020. A transcript is of record. The Board remanded this case in December 2020 for further development. 1. Entitlement to a compensable disability rating for musculoskeletal tension headaches is remanded. In its December 2020 remand directives, the Board instructed the examiner to reconcile the August 2014 VA examiner's finding that the Veteran's headaches did not result in characteristic prostrating attacks with the evidence of record, to include (1) the August 2014 VA examiner's findings that the Veteran experienced head pain, sensitivity to light, sensitivity to sound, changes in vision, and sensory changes due to his headaches; (2) the Veteran's lay statements regarding his headaches; and (3) evidence showing that the Veteran had to miss work due, in part, to his headaches. Review of the record shows that the March 2021 VA examiner did provide this opinion. Additionally, the VA examiner was to opine as to the frequency and severity of the Veteran's headaches, and, in doing so, discuss the Veteran's lay statement regarding his headache symptoms and their effects. While the examiner referred to the first four pages of the Veteran's hearing testimony, it does not appear he addressed the symptoms described in the latter part of the testimony, to include reports of feeling tired, powerless, weak, nauseous, faint, dizzy, a lack of energy, and sensitivity to light. It also does not appear the examiner considered the Veteran's statement that he had to stay in bed between six to twelve hours due to his headaches. As such, the RO's development of the Veteran's claim did not substantially comply with the December 2020 remand instructions. Hence, another remand is required. See Stegall v. West, 11 Vet. App. 268 (1998). The matters are REMANDED for the following action: Schedule a VA examination to assess the current nature and severity of the Veteran's musculoskeletal tension headaches by an examiner who has not yet seen the Veteran. The examiner must review the claims file and should note that review in the report. The examiner should opine regarding the frequency and severity of the Veteran's headaches, to include whether there are prostrating attacks and the frequency and severity of any prostrating attacks of headaches. In doing so, the examiner must discuss the Veteran's lay statements regarding his headache symptoms and their effects, to include missing work. The Veteran's lay statements should include the entirety of his hearing testimony and the April 2021 lay statement. Additionally, the examiner must reconcile the August 2014 VA examiner's finding that the Veteran's headaches did not result in characteristic prostrating attacks with the evidence of record, to include (1) the August 2014 VA examiner's findings that the Veteran experienced head pain, sensitivity to light, sensitivity to sound, changes in vision, and sensory changes due to his headaches; (2) the Veteran's lay statements regarding his headaches; and (3) evidence showing that the Veteran had to miss work due, in part, to his headaches. All opinions are to be supported with explanatory rationale. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Ko, Associate 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.