Citation Nr: A24061663 Decision Date: 09/27/24 Archive Date: 09/27/24 DOCKET NO. 220525-246578 DATE: September 27, 2024 ORDER Entitlement to service connection for migraine headaches is granted. FINDING OF FACT The Veteran's migraine headaches are proximately due to his service-connected tinnitus. CONCLUSION OF LAW The criteria for entitlement to service connection for migraine headaches have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1987 to August 1999 and from October 2001 to August 2002. He appeals a March 2022 rating decision denying entitlement to service connection for tinnitus. He opted for direct review of the evidence by this Board. Service Connection Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. §§ 3.303(a), 3.304, 3.307, 3.309, 3.310. Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). A disability may also be found service connected on a secondary basis by demonstrating that the disability is either (1) proximately due to or the result of an already service-connected disease or injury or (2) aggravated by an already service-connected disease or injury. See Allen v. Brown, 7 Vet. App. 439, 448 (1995); 38 C.F.R. § 3.310 (2017). 1. Entitlement to service connection for migraine headaches. The Veteran contends that his tinnitus brings on migraine headaches. After review of the evidence, the Board finds that service connection is warranted on a secondary basis. As an initial matter, the Board observes that the Veteran has never asserted that his migraines began during service. A review of his service treatment records confirms an absence of diagnosis, treatment, or complaints of migraines. Moreover, the Veteran reported the onset of migraines in 2016, many years after separation from service. Hence, as the evidence does not show an in-service incident or a continuity of symptoms since service, service connection on a direct basis is not warranted. As to service connection on a secondary basis, the Veteran was afforded a VA examination in January 2022. The examiner opined that a nexus had not been established because, "technically," the Veteran's tinnitus isn't the exact cause of headaches. However, the examiner conceded that it's possible that an underlying condition such as migraine could be a unifying diagnosis for tinnitus and headaches. Experiencing bothersome tinnitus may be the stage for a headache to occur. As the standard of proof is only that it be as likely as not that the Veteran's headaches are caused or worsened by his tinnitus, the Board finds the examiner's opinion to essentially concede a positive nexus. In summation, the evidence supports the Veteran's contention that his tinnitus brings on migraine headaches. Accordingly, service connection is warranted and the claim is granted. 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. B.T. KNOPE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board DB