MIGRAINE

R. CASADEI · 2026 · Case ID: A26032668

GRANTED

Summary

The veteran, who served from December 2006 to August 2007 and April 2008 to March 2016, appeals the denial of service connection for migraines. The veteran contends that migraines began in service and are caused by service-connected sinusitis. The Board reviewed service treatment records, which showed isolated headache complaints in service, and VA examination opinions from February and March 2021. These VA examiners concluded it was less likely than not that the migraines were related to service, citing a lack of service treatment records and only isolated headache complaints. However, the Board found these VA opinions lacked probative value due to inconsistencies with the service treatment records, which did show multiple headache complaints. The Board also gave substantial weight to the veteran's lay statements, finding them credible and competent to establish the onset and continuity of migraines since service. The Board acknowledged the contrary VA opinions but found the veteran's lay evidence persuasive, particularly given the lack of contemporaneous medical records did not preclude service connection. The Board found the evidence in approximate balance and resolved reasonable doubt in the veteran's favor. Consequently, service connection for migraines was granted.

Rationale

Veteran's lay statements found credible and competent; VA examiner opinions lacked probative value due to inconsistencies; Evidence in approximate balance, doubt resolved in veteran's favor

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210701-169869

Full Decision Text

Citation Nr: A26032668
Decision Date: 04/08/26 Archive Date: 04/08/26

DOCKET NO. 210701-169869
DATE: April 8, 2026

ORDER

Service connection for migraines is granted.

FINDING OF FACT

The Veteran's migraines first manifested in service and have persisted since that time.

CONCLUSION OF LAW

The criteria to establish service connection for migraines are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from December 2006 to August 2007 and April 2008 to March 2016.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2021 rating decision by the Department of Veterans Affairs (VA) Veterans Benefits Administration Regional Office (RO), which is the Agency of Original Jurisdiction (AOJ).

In July 2021, the Veteran requested a hearing docket review of the appeal by the Board on a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement). A hearing was scheduled for April 15, 2025. However, in March 2025, the Veteran, through the representative, requested to cancel the hearing. Therefore, the Veteran's request for a Board hearing is considered withdrawn. 38 C.F.R. § 20.704(e).

Under the hearing review election, when the request for a hearing is withdrawn, the Board may consider evidence submitted to VA at the time of the April 2021 rating decision and any evidence submitted within 90 days after receipt of the withdrawal. 38 C.F.R. § 20.302(b). VA will not seek additional evidence on behalf of the Veteran as part of the review. 38 C.F.R. § 20.303.

1. Entitlement to service connection for migraines.

Service connection may be established for a disease or injury incurred in or aggravated by service, resulting in a current disability. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.304.

To establish service connection for a disability, a veteran must show (1) the existence of a present disability; (2) incurrence or aggravation of a disease or injury in service; 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 (Fed. Cir. 2004).

To prevail on the issue of service connection there must be medical evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of occurrence or aggravation of a disease or injury in service; and medical evidence of an etiological relationship between an injury or disease in service and the current disability. Hickson v. West, 12 Vet. App. 247 (1999).

Diseases diagnosed after discharge may be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

The Board must assess the competence and credibility of evidence. A Veteran is competent to testify to factual matters of which he or she has first-hand knowledge. Lay testimony is competent if it is limited to matters that the witness has actually observed and is within the realm of the personal knowledge of the witness. Barr v. Nicholson, 21 Vet. App. 303 (2007); Washington v. Nicholson, 19 Vet. App. 362 (2005); Layno v. Brown, 6 Vet. App. 465 (1994); 38 C.F.R. § 3.159(a)(2).

Medical evidence is required to demonstrate a relationship between a current disability and the continuity of symptomatology demonstrated if the condition is not one where a lay person's observations would be competent. Clyburn v. West, 12 Vet. App. 296 (1999). Whether lay evidence is competent and sufficient in a particular case is an issue of fact and lay evidence can be competent and sufficient to establish a diagnosis when (1) a layperson is competent to identify the medical condition, sometimes the layperson will be competent to identify the condition where the condition is simple, for example, a broken leg, and sometimes not, for example, a form of cancer; (2) the layperson is reporting a contemporaneous medical diagnosis; or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional.
if the condition is not one where a lay person's observations would be competent. Clyburn v. West, 12 Vet. App. 296 (1999). Whether lay evidence is competent and sufficient in a particular case is an issue of fact and lay evidence can be competent and sufficient to establish a diagnosis when (1) a layperson is competent to identify the medical condition, sometimes the layperson will be competent to identify the condition where the condition is simple, for example, a broken leg, and sometimes not, for example, a form of cancer; (2) the layperson is reporting a contemporaneous medical diagnosis; or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).

Lay evidence presented by a Veteran concerning continuity of symptoms after service may generally be considered credible and ultimately competent, regardless of a lack of contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (2006). The Board has the authority to discount the weight and probity of evidence in light of its own inherent characteristics and its relationship to other evidence. Madden v. Gober, 125 F.3d 1477 (Fed. Cir. 1997).

The Board acknowledges that lay evidence concerning continuity of symptoms after service, if credible, can be competent, despite the lack of contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). In making a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which the Board finds to be persuasive or unpersuasive, and provide the reasons for the rejection of any material evidence favorable to the claimant. Gabrielson v. Brown, 7 Vet. App. 36 (1994); Gilbert v. Derwinski, 1 Vet. App. 49 (1990).

The Veteran contends that a migraine headache disability is caused by active service. Specifically, the Veteran asserts that he began having headaches in service. Additionally, the Veteran states that his migraine headaches are caused by service-connected sinusitis.

An April 2021 rating decision found that the Veteran was diagnosed with a migraine disability including migraine variants. The Board is bound by that favorable finding.

During an August 2006 service entrance examination, the Veteran reported that he did not have frequent or severe headaches.

The service medical records show that the Veteran sought treatment for a headache in January 2007.

In March 2008, the Veteran reported that he did not have frequent or severe headaches that caused him to miss work or school.

The Veteran sought treatment for headaches several additional times in service. Specifically, the Veteran sought medical treatment for a headache in May 2008, June 2008, September 2008, September 2009, September 2011, January 2012, and May 2012.

Notably, however, the Veteran reported on a September 2010 post-deployment health assessment that he did not have a bad headache nor did headaches begin or get worse.

During a September 2019 medical appointment, the Veteran stated that he experienced monthly headaches.

During a December 2019 neurology medical appointment, the Veteran asserted that he began having headaches at least weekly and that he got headaches 2 to 3 times a week about a year prior. The Veteran explained that his headaches were made worse by light and sound, that he occasionally saw spots, and would get nauseous.

In March 2020, the Veteran reported that he had been having headaches twice a week before he was prescribed Topamax.

The Veteran again sought treatment for his migraine by a neurologist in April 2020.

Following a February 2021 VA examination, the examiner noted that the Veteran's migraines began in 2013. The Veteran reported that when his migraines started, they were mild but light and noise increased his pain. The Veteran reported that he would have to lay down for hours when he had a migraine. He stated that he had 2 to 3 migraines a week without his medication, and had 1 to 2 a week with his medication. The VA examiner noted that the Veteran had a prostrating headache once every month. The February 2021 VA examiner concluded that it was less likely than not that the Veteran's migraine disability incurred in or was caused by service. The examiner stated that the Veteran was only seen once for a headache during service and that the headache was an isolated occurrence in 2008.

A March 2021 VA examiner diagnosed the Veteran with migraines including migraine variants. During the examination, the Veteran reported that
that he would have to lay down for hours when he had a migraine. He stated that he had 2 to 3 migraines a week without his medication, and had 1 to 2 a week with his medication. The VA examiner noted that the Veteran had a prostrating headache once every month. The February 2021 VA examiner concluded that it was less likely than not that the Veteran's migraine disability incurred in or was caused by service. The examiner stated that the Veteran was only seen once for a headache during service and that the headache was an isolated occurrence in 2008.

A March 2021 VA examiner diagnosed the Veteran with migraines including migraine variants. During the examination, the Veteran reported that his migraines began in 2013 and that he experienced constant head pain which pulsed and throbbed. The Veteran explained that he was sensitive to light and sound, and that he experienced vision changes when he had a migraine. The March 2021 VA examiner determined that the Veteran's migraine disability was less likely than not due to his service in Southwest Asia because there was no record of the Veteran having a headache when he was in Southwest Asia.

In August 2021, the Veteran sought treatment at a VA Medical Center for recurrent headaches that had become more frequent in the recent months. The Veteran reported that his headaches began over 10 years prior and that he had headaches more than 3 times a week.

In May 2025, the Veteran, through his representative, stated that the Veteran had migraines continuously since service. Additionally, the Veteran stated that his migraines were caused by his military duties and his service-connected sinusitis.

Also in May 2025, the Veteran's representative submitted a medical study titled "Assessing the relationship between migraine and sino-nasal symptoms and diseases among Syrian Private University students: a case-control study." The 2025 medical study determined that there was a significant statistical relationship and association between diseases and symptoms of the nose and sinuses and migraines.

The evaluation and weighing of evidence and the drawing of appropriate inferences from it are determinations committed to the discretion of the Board.

Additionally, the Board notes that the Veteran is competent to testify to factual matters of which he has first-hand knowledge, such as injuries or events which occurred during service, and that he has consistently reported his symptoms. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). The Board finds that the Veteran, as a lay person, is both credible and competent to provide evidence of the existence of his migraines, as it comes to him through his sense of pain in his head, sensitivity to light and sound, and nausea, and the fact that it has been continuous since active service. The Veteran may also competently state when that condition started and if it has continued to the present.

A review of the competent evidence of record shows the Veteran has credibly reported symptoms of migraines and headaches both during service and persistently since service. The Board also finds the Veteran's lay statements regarding the persistent symptoms of migraines to be credible.

The Board acknowledges that there may be medical evidence of record contrary to the Board's findings and that the service medical records do not show complaints of migraines during service. Specially, the February 2021 and March 2021 VA examiners opined that the Veteran's migraine disability was less likely than not related to active service. However, the Board finds the February 2021 VA examination to lack probative value. The examiner stated that the Veteran only reported having a headache one time in service, but the record includes multiple service medical records indicating that the Veteran sought treatment for headaches multiple times during service. Additionally, the Board notes that a lack of medical evidence in service medical records does not preclude service connection. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (lack of contemporaneous medical records does not serve as an absolute bar to the service connection claim).

The Board assigns substantial probative weight to the Veteran's lay statements of record because the Veteran, as a layperson, may competently state that he perceives migraine pain and when that disability began. The Board finds that the evidence is in approximate balance as the favorable and unfavorable evidence has nearly equal evidentiary weight.

Accordingly, based on the evidence and arguments presented, the Board finds that the Veteran's migraine disability was at least as likely as not present during service and has persisted since service. Resolving reasonable doubt in favor of the Veteran, the claim for service connection for a migraines is granted. 38 U.S.C. § 5107; 38 C.F.R. §§
to the service connection claim).

R. Casadei

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board M.H., 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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