Citation Nr: 22012260 Decision Date: 03/03/22 Archive Date: 03/03/22 DOCKET NO. 14-27 663 DATE: March 3, 2022 REMANDED Entitlement to service connection for headaches, to include migraines and/or post-traumatic cluster headaches, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from August 1993 to June 1995 and in the Army National Guard of Louisiana from November 2001 to November 2002. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2012 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO). In August 2017, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In a December 2018 Board decision, service connection for migraines was denied because the evidence of record did not demonstrate the development of migraines during service or within one year of service. The Veteran timely appealed. In August 2019, a Joint Motion for Partial Remand (JMPR) was issued by the United States Court of Appeals for Veterans Claims (CAVC) vacating the Board decision in part, because the Board failed to discuss a private medical record from November 2018. The claim was returned to the Board and denied again in an April 2020 Board decision, because the preponderance of the evidence is against finding that the Veteran has migraine headaches due to a disease or injury in service, to include his described exposure to CS gas and gas training areas. The Veteran appealed again to CAVC which resulted in a March 2021 JMPR. The JMPR stated that the Board failed to address whether Appellant's claim for service connection for migraines reasonably encompassed a claim for service connection for post traumatic cluster headaches. The Board limited its analysis to migraine headaches and did not address the question of entitlement to service connection based upon the cluster headache diagnosis. Moreover, the JMPR noted that the Board stated in the April 2020 decision that in April 2012, the Veteran "wrote that he was prescribed medication for migraines due to constant ringing in his ears which developed when he worked with missiles in service. The Board then reportedly found that the evidence reflects that the Veteran was not routinely exposed to hazardous noise. Contrary to this finding, in a December 2018 decision, the Board found that Veteran's military occupational specialty (MOS) of heavy anti-armor weapons infantryman "carries a high probability of excessive noise exposure, and the Veteran's described exposures are found to be consistent with the circumstances of his military service" and granted service connection for tinnitus based on that noise exposure. Thus, on remand, the Board must provide an adequate statement of reasons or bases, properly addressing the Veteran's headaches as it relates to noise exposure and tinnitus. The adjudication of the Veteran's claim was focused on the theory of entitlement asserted by the Veteran. The Veteran asserted that his migraines developed as a result of his exposure to CS gas and training areas in service. The record contains insufficient evidence to properly adjudicate the claim on a secondary service connection basis. Allday v. Brown, 7 Vet. App. 517, 526 (1995). Therefore, remand is required to obtain a medical opinion to address the Veteran's contention that his migraines is secondary to his service-connected tinnitus. In addition, the Veteran has not been provided a VA examination for his migraines. Remand is required to obtain a medical opinion to determine whether the Veteran's diagnosed migraines is separate from his diagnosed cluster headaches, and whether either is related to service or to a service-connected disability. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination from an appropriate examiner to determine the etiology of any current headache disorder, to include whether the Veteran's migraines is secondary to his service-connected disabilities. A complete copy of the claims file including a copy of this remand must be provided for review. The examiner is asked to review the claims file in its entirety and indicate in the record that he or she has done so. Thereafter, the examiner is asked to render an opinion as to: Whether the Veteran's migraines are separate and apart from his cluster headaches. Whether either disability is etiologically related to noise exposure during service in his military occupational specialty of heavy anti-armor weapons infantryman. Whether the Veteran's migraines are at least as likely as not (50 percent probability or greater) proximately due to or the result of the service-connected disability or aggravated by the service-connected tinnitus. (Continued on the next page) A complete rationale must be provided for any opinion rendered. If the examiner is not able to render an opinion without resorting to mere speculation, he or she must indicate with information is necessary to provide such an opinion. 2. After ensuring compliance with this remand, readjudicate the claim on appeal. MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Harris, Attorney Advisor 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.