Citation Nr: 18160337
Decision Date: 12/26/18	Archive Date: 12/26/18

DOCKET NO. 16-51 790
DATE:	December 26, 2018
ORDER
Entitlement to service connection for migraine headaches is granted.
FINDING OF FACT
Resolving reasonable doubt in the Veteran’s favor, his current migraine headaches were incurred in active service.
CONCLUSION OF LAW
The criteria for service connection for migraine headaches have been met.  38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. § 3.303 (2017).
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty from October 1994 to October 2003 and from October 2004 to November 2005.
Service Connection for Migraine Headaches
The Veteran contends that his migraine headaches first developed in service.  For the following reasons, the Board finds that service connection is warranted.
Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service.  38 U.S.C. § 1110; 38 C.F.R. § 3.303(a).  Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a link between the claimed in-service disease or injury and the present disability.  
Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service.  38 C.F.R. § 3.303(d).
The Veteran’s VA treatment notes reflect that he has been diagnosed with migraine headaches during the pendency of the appeal.  Thus, the “current disability” element of his claim has been met.  The “in-service incurrence” element has been met as well; the Veteran’s service treatment records document multiple headache complaints, including reports of recurrent or severe headaches on examination in May 1997, May 1998, and October 2003.  The crucial question on appeal is whether there is a causal link between the Veteran’s in-service complaints and his current diagnosis.
To that end, the Veteran has repeatedly asserted that his headaches began during active service and have persisted continuously thereafter.  As noted above, his assertions are supported by several service treatment records, to include a May 1997 report of medical history (in which an examiner reported that the Veteran experienced headaches one to two times per month); a May 1998 report of medical history (in which the Veteran reported a history of recurrent or severe headaches); and an October 2003 clinical note in which the Veteran reported headaches lasting three days.  (The Board notes that the RO decisions on appeal have cited the fact that the Veteran denied experiencing headaches on multiple occasions in service.  While this appears to be true, insofar as there are several in-service examination reports of record reflecting no reports of headaches, the Veteran has explained that his headaches occurred only intermittently, and therefore he did not feel compelled to report having headaches during all such examinations.  The Board finds this explanation compelling.)  
Notably, the Veteran underwent a VA spine examination in February 2006, just three months after his discharge, during which a history of migraine headaches was noted.  Thereafter, his VA and private medical records show continuous treatment for headache-related symptoms.
On VA examination in November 2013, the Veteran reported that his headaches started around 1998, and that he had taken over-the-counter medications until 2005, when he was treated for headache pain.  He suggested that the cause of his headaches may have been an incident in service when he struck his head on a refrigerator and lost consciousness.  In a January 2014 addendum, the VA physician opined (with little in the way of supporting rationale) that the Veteran’s current headaches were not as likely as not related to the in-service head injury.  On review, the Board finds that this opinion is entitled to no probative weight, as the physician was not able to review the claims folder.  See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that the Board may reject a medical opinion based on an inaccurate factual basis).  Moreover, the physician failed to address the Veteran’s reports of recurrent headaches in service, instead merely considering the theory that his headaches resulted from the in-service head injury.
After careful review, the Board finds that the evidence of record is in equipoise as to whether the Veteran’s current migraine headaches began in active service.  As noted above, there is both objective and lay evidence that the Veteran experienced recurrent headaches during active service, as well as a post-service confirmation of a diagnosis of migraine headaches just three months after the Veteran’s discharge.  There is no convincing evidence of record that calls into question the Veteran’s claim.  The Board acknowledges that an additional examination might be helpful in providing clarification as to the etiology of the Veteran’s headache disorder.  Nonetheless, the Board finds that the positive evidence discussed above is sufficient to decide the claim, particularly given the extremely lengthy duration of this appeal.
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In sum, the Board finds that the evidence of record is evenly balanced with respect to whether the Veteran’s migraine headaches were incurred in active service.  Consequently, service connection is warranted.
 
A. S. CARACCIOLO
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	T. Minot, Associate Counsel 

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