MIGRAINE

CYNTHIA M. BRUCE · 2026 · Case ID: A26023528

DENIED

Summary

The veteran, who served in the United States Marine Corps from January 2003 to September 2008, appeals the denial of service connection for a migraine disability secondary to a cervical strain and for a right shoulder disability secondary to a left shoulder disability. The Board found that while the veteran has a current migraine disability and a service-connected cervical strain, the evidence does not establish a causal relationship between the two. A VA examiner concluded it was less likely than not that the migraines were related to the cervical strain, citing a lack of medical literature supporting such a link. The Board found this opinion dispositive. For the right shoulder claim, the Board found no evidence of a current right shoulder disability, noting the VA examiner could not provide a diagnosis and the veteran reported no flare-ups, pain, or functional impairment. The Board cited the lack of a current disability and insufficient evidence of impairment as grounds for denial. In both instances, the Board found the evidence persuasively against the claims, rendering the doctrine of reasonable doubt inapplicable.

Rationale

No known medical literature supports a causal relationship between migraines and cervical strain.; VA examiner's opinion found dispositive.; Evidence persuasively against the claim.

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210419-153643

Full Decision Text

Citation Nr: A26023528
Decision Date: 03/16/26 Archive Date: 03/16/26

DOCKET NO. 210419-153643
DATE: March 16, 2026

ORDER

Entitlement to service connection for a migraine disability, secondary to a cervical strain disability, is denied.

Entitlement to service connection for a right shoulder disability, secondary to a left shoulder disability, is denied.

FINDINGS OF FACT

1. The most probative evidence does not support a finding that the Veteran's migraine disability is secondary to the service-connected cervical strain, and is not otherwise related to an in-service injury or disease.

2. The most probative evidence does not support a finding that the Veteran's right shoulder disability is secondary to the service-connected left shoulder strain, and is not otherwise related to an in-service injury or disease.

CONCLUSIONS OF LAW

1. The criteria for service connection for a migraine disability due to service or the currently service connected cervical strain are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

2. The criteria for service connection for a right shoulder disability due to service or the currently service connected left shoulder strain are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty with the United States Marine Corps from January 2003, until September 2008.

The rating decision on appeal was issued in February 2021, and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the April 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. On October 21, 2024, the Veteran withdrew the hearing request.

Therefore, the Board may only consider the evidence of record at the time of the February 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim(s), considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Service Connection

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; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran 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 - the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

Service connection may also be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a disorder which is aggravated by a service-connected disability; compensation may be provided for the degree of the
Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

Service connection may also be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a disorder which is aggravated by a service-connected disability; compensation may be provided for the degree of the disability (but only that degree) over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b) (2017); Allen v. Brown, 8 Vet. App. 374 (1995).

In Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023), the Federal Circuit Court of Appeals held 38 U.S.C. § 1110 employs only "but-for" causation in direct and secondary service connection claims. Therefore, a service-connected disability need only be a contributing cause, not the contributing cause, to establish secondary service connection.

1. Entitlement to service connection for a migraine disability, secondary to a cervical strain disability, is denied.

The Veteran asserts that his migraine disability is related to his currently service-connected cervical strain disability.

First, the Board finds that there is evidence of a current disability. See Wallin, 11 Vet. App. 509 at 512; see also Allen, supra. The February 2021, rating decision issued by the AOJ provided a favorable finding that the January 2021 VA medical examination shows a currently diagnosed migraine disability. The Board is bound by the favorable findings of the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c). The Board therefore finds that the Veteran has met the first element of service connection, a current disability.

Second, the Board finds that there is evidence of a service-connected disability. See Wallin, 11 Vet. App. 509 at 512. It is undisputed that the Veteran has a current cervical strain disability. Therefore, this element of service connection has been previously conceded by the AOJ.

However, the Board finds that the evidence of record does not support a finding that the current migraine disability is related to the service-connected cervical strain disability.

The Veteran was afforded a VA examination in January 2021, wherein the examiner concluded that it is less likely than not that the Veteran's current migraine disability is related to his current service connected cervical strain. The examiner reasoned that although the Veteran reported having difficulty moving his neck when he experienced severe migraines, it is not medically related to his cervical strain. The examiner stated that there is no known medical literature to support a causal relationship between migraine headaches and a cervical strain.

The probative value of medical opinion evidence is based on the medical expert's personal examination of the patient, the physician's knowledge and skill in analyzing the data, and the medical conclusion that the physician reaches. Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). Whether a physician provides a basis for a medical opinion goes to the weight or credibility of the evidence in the adjudication of the merits. See Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). Other factors for assessing the probative value of a medical opinion are the physician's access to the claims folder and the thoroughness and detail of the opinion. See Prejean v. West, 13 Vet. App. 444, 448-9 (2000); Nieves-Rodriguez, 22 Vet. App. 295 (2008); Prejean v. West, 13 Vet. App. 444, 448-9 (2000).

Here, the January 2021, opinion was provided by a VA medical professional who possesses the necessary education, training, and expertise to provide the requested opinions. Additionally, the opinion is also shown to have been based on a review of the Veteran's record and is accompanied by a sufficient explanation as to why the Veteran's current migraine disability is not related to his service-connected cervical strain disability. Furthermore, there is no competing medical opinion of record. The Board thus finds that the January 2021, medical opinion is dispositive of the issue at hand.

Accordingly, entitlement to service connection for a migraine disability is denied.

In reaching this decision the Board considered the doctrine
App. 444, 448-9 (2000).

Accordingly, entitlement to service connection for a migraine disability is denied.

In reaching this decision the Board considered the doctrine of reasonable doubt. This rule provides that a veteran will prevail in a case where the positive evidence is in a relative balance with the negative evidence. Therefore, the Veteran prevails in a claim when: (1) the weight of the evidence supports the claim, or (2) when the evidence is in approximate balance. It is only when the weight of the evidence is against the claim that the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990); Lynch v. McDonough, 21 F.4th 776 (2021). Here, however, as the evidence is persuasively against the claim and the positive and negative evidence is not in approximate balance, the doctrine is not for application. Lynch, 21 F.4th 776.

2. Entitlement to service connection for a right shoulder disability, secondary to a left shoulder disability, is denied.

The Veteran asserts that his right shoulder disability is related to his currently service-connected left shoulder strain disability.

The Board finds that there is no evidence of a current disability of a right shoulder disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998); see also Allen v. Brown, 8 Vet. App. 374 (1995). The Veteran was afforded a VA examination in January 2021. The January 2021, VA examiner could not provide a diagnosis for a right shoulder disability. The examiner notes that the Veteran did not report flare-ups, pain, functional impairment, or show limited range of motion in testing.

In the absence of a disability during the pendency of the claim, service connection cannot be established. See Brammer v. Derwinski, 2 Vet. App. 223 (1992). There is also insufficient evidence of a disability at any point during the claim period or shortly before. See McClain v. Nicholson, 21 Vet. App. 219 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013).

At the core of service connection is functional impairment, which can be a disability even if there is no underlying diagnosis. Consideration should be given to the impact of functional limitation. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir., 2018). Here there is no assertion of functional limitation due to a right shoulder disability.

Accordingly, entitlement to service connection for a right shoulder disability is denied.

Cynthia M. Bruce

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board R. Liggitt, 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.

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