Citation Nr: 18154205
Decision Date: 11/29/18	Archive Date: 11/29/18

DOCKET NO. 14-41 360A
DATE:	November 29, 2018
Service connection for migraine headaches, to include as secondary to service-connected tinnitus is remanded.
The Veteran served on active duty from August 1959 to May 1963.  
This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a December 2012 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).  This claim was remanded by the Board in September 2017.  
This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900 (c) (2017).  38 U.S.C. § 7107 (a)(2) (2012).  
Service connection for migraine headaches, to include as secondary to service-connected tinnitus is remanded.
Although VA obtained an examination and opinion in November 2017, another opinion is necessary.  Specifically, the examiner failed to provide an adequate rationale for his opinions.  
The Veteran asserts that his migraine condition is related to exposure to non-ionizing radiation by way of proximity the radars on B-47 aircrafts.  See  March 2015 Correspondence.  Although the Board, in its prior Remand, requested the VA examiner take into account the Veteran’s report of radar wave exposure, the November 2017 opinion and rationale does not reflect consideration of this contention.  Further, the very brief opinion for direct service connection was based on a lack of documented complaints in-service and post-service treatment records.  As the examiner’s rationale is based solely on the absence of documented medical treatment it is rendered inadequate. See Dalton v. Peake, 21 Vet. App. 23 (2007). Notably, the opinion and rationale do not reflect review and/or consideration of the relevant private (neurology) medical records.  As such, a new opinion is required.
Moreover, the November 2017 opinion does not include an adequate rationale as to whether the Veteran’s migraines are proximately caused or aggravated by his service-connected tinnitus.  Part of the rationale for the unfavorable opinion was that the separation examination was normal.  Again, this reflects failure to adequately consider the Veteran’s competent lay statements about his migraine symptoms.  The Veteran reports that his migraine headache intensity is linked to tinnitus symptoms.  See March 2015 correspondence.  Finally, the examiner seems to suggest that he did not have the necessary expertise to answer the questions posed- as part of his rationale was that ‘there are no audiologic or neurologic opinion supporting a correlation.’  As such, a new opinion is required.  
The matter is REMANDED for the following action:
Return the file to the VA examiner who provided the November 2017 opinion.  If he is unavailable, obtain an addendum opinion from an appropriate examiner regarding the nature and etiology of the Veteran’s migraine headaches.   The claims file AND A COPY OF THE COMPLETE REMAND, must be reviewed by the examiner.
a)	The examiner is asked to state whether the Veteran’s migraine headaches are at least as likely as not related to an in-service event, illness or injury, to include the Veteran’s asserted exposure to non-ionizing radar waves.  
In doing so, the examiner must review the scientific literature provided by the Veteran and his private neurology records, and the opinion and rationale should reflect such review and consideration.
b)	The examiner is also asked to opine as to whether the Veteran’s migraine headaches are proximately due to, or aggravated beyond their natural progression by service-connected tinnitus.  
In doing so, the examiner should review the Veteran’s lay statements regarding a link between the intensity of migraines and tinnitus.  See, for example, his March 2015 correspondence.
A complete rationale for each of the requested opinions must be provided.  The Veteran is competent to report his symptoms, and his lay statements must be considered.
If the examiner is unable to provide any required opinion, or cannot provide an opinion without resorting to mere speculation, a full explanation as to why this is so must be provided. If the inability to provide the requested opinions is due to a need for additional information or additional expertise- such as from an audiologist and/or neurologist- this should be clearly indicated.  
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The RO is advised that if the examiner indicates further expertise is required, then appropriate action should be taken to secure the opinions from the necessary specialist(s).
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Vuong, Associate Counsel

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