MIGRAINE

Summary

The Veteran served on active duty from September 1988 to September 2014. This case comes before the Board of Veterans' Appeals (Board) on appeal from March and April 2025 rating decisions. The Veteran elected the Direct Review docket, limiting the Board's review to evidence of record at the time of the AOJ decisions. The Veteran sought service connection for vertigo, chronic allergic conjunctivitis, and recurrent acute maxillary and ethmoidal sinusitis with underlying chronic allergic rhinitis. The Board found that the Veteran has a current diagnosis for all three conditions, and service treatment records indicated an in-service onset or symptoms consistent with the conditions. For vertigo, the Board relied on a VA examiner's opinion that noted evidence of vertigo as a symptom of migraines during service, finding a nexus warranted. For chronic allergic conjunctivitis, the Board found clear in-service onset and continuity of symptoms, resolving doubt in the Veteran's favor. For sinusitis, despite an unfavorable VA opinion, the Board noted extensive service treatment record notations for sinusitis and allergies, along with ongoing post-service symptoms, resolving doubt in the Veteran's favor due to the evidence being in equipoise. Service connection for all three conditions was granted.

Rationale

Current diagnosis of vertigo; In-service reports of vertigo as symptom of migraines; Vestibular migraine noted on exam, indicating chronicity; VA examiner found nexus warranted for vestibular migraine with vertigo

Full Decision Text

Citation Nr: A26036151
Decision Date: 04/17/26	Archive Date: 04/17/26

DOCKET NO. 250818-576110
DATE: April 17, 2026

ORDER

Entitlement to service connection for vertigo is granted.

Entitlement to service connection for chronic allergic conjunctivitis is granted.

Entitlement to service connection for recurrent acute maxillary and ethmoidal sinusitis with underlying chronic allergic rhinitis is granted.

FINDINGS OF FACT

1. The Veteran's vertigo had its onset during service. 

2. Resolving reasonable doubt in the Veteran's favor, her chronic allergic conjunctivitis had its onset during active service.

3. Resolving reasonable doubt in the Veteran's favor, her recurrent acute maxillary and ethmoidal sinusitis with underlying chronic allergic rhinitis had its onset during active service.

CONCLUSIONS OF LAW

1. The criteria for service connection for vertigo have been met.  38 U.S.C. 

§§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for chronic allergic conjunctivitis have been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for acute recurrent max sinusitis and allergic rhinitis have been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from September 1988 to September 2014.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from March and April 2025 rating decisions issued by a Department of Veterans Affairs (VA) Regional Office.

In the August 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the March and April 2025 agency of original jurisdiction (AOJ) decisions on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decisions on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303.  The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

Service connection may also be granted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

Service connection also may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury.  38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc).  

1. Entitlement to service connection for vertigo, to include as secondary to service-connected disability.

Initially, the Board notes the AOJ's favorable findings that the Veteran has a current diagnosis of vertigo, her service treatment records contain reports of vertigo, and that the primary disability, namely migraines, are service connected. 

As to a nexus, the August 2023 VA examiner found there was evidence of vertigo as a symptom of migraine headaches during active duty.  Specifically, vestibular headache was diagnosed and treated during active duty with associated vertigo, and a chronicity was present with "vestibular migraine" noted on examination in April 2020.  Therefore, a nexus was warranted for vestibular migraine with associated vertigo. While
itlement to service connection for vertigo, to include as secondary to service-connected disability.

Initially, the Board notes the AOJ's favorable findings that the Veteran has a current diagnosis of vertigo, her service treatment records contain reports of vertigo, and that the primary disability, namely migraines, are service connected. 

As to a nexus, the August 2023 VA examiner found there was evidence of vertigo as a symptom of migraine headaches during active duty.  Specifically, vestibular headache was diagnosed and treated during active duty with associated vertigo, and a chronicity was present with "vestibular migraine" noted on examination in April 2020.  Therefore, a nexus was warranted for vestibular migraine with associated vertigo. While there are unfavorable opinions with respect to service connection due to exposure to toxins and on a secondary basis, the aforementioned is the only competent opinion addressing direct service connection. 

As such, the Board finds the evidence of record weighs persuasively in favor of the claim for direct service connection for vertigo, and therefore, service connection is warranted. 

2. Entitlement to service connection for chronic allergic conjunctivitis.

Initially, the Board notes the AOJ's favorable findings that the Veteran has a current diagnosis of chronic allergic conjunctivitis, as well as notations of the condition having incurred during service. As such, the Veteran's claim meets the first two elements for service connection, and the Board's analysis pivots to that of a medical nexus. 

Here, the Veteran was afforded a March 2025 VA medical opinion, wherein the VA examiner opined that while the timing of its onset coincides with service, there is no further evidence to support a causative link. As previously noted, service connection is warranted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. Here, the Board finds the Veteran's service treatment records clearly indicate an in-service onset and that the Veteran continues to suffer from the very same condition, namely chronic allergic conjunctivitis, at present. 

Resolving all doubt in favor of the Veteran, the Board finds her chronic allergic conjunctivitis had its onset during service.  As a result, service connection for chronic allergic conjunctivitis is warranted. 

3. Entitlement to service connection for sinusitis.

Per the rating decision on appeal, the AOJ made favorable findings that the Veteran has a current diagnosis of "acute recurrent max sinusitis" and that a qualifying event, injury, or disease had its onset during service. Additionally, the AOJ conceded participation in a toxic exposure risk activity.

A January 2025 VA examination report reflects diagnoses of allergic rhinitis, central perforation of right tympanic membrane, and acute recurrent maxillary sinusitis.  The VA examiner explained that the Veteran has a "classic case" of recurrent acute maxillary and ethmoidal sinusitis with underlying chronic allergic rhinitis.  

Although the January 2025 VA examiner opined that there was no objective evidence of sinus disease and that the claimed condition was less likely than not incurred in or caused by an in-service injury, event, or illness, the Veteran's service treatment records reveal 17 instances or notations referable to sinusitis and/or allergies. The January 2025 VA examiner also indicated in the same report that the Veteran's symptoms progress into sinusitis about three times a year. 

Thus, as the Veteran's service treatment records reveal an extensive history of both sinusitis and allergic rhinitis, and those symptoms are still present post-service, the Board resolves all reasonable doubt in favor of the Veteran and finds the evidence of record to be at least in equipoise as to whether the currently diagnosed condition had its onset during service.  Consequently, service connection for recurrent acute maxillary and ethmoidal sinusitis with underlying chronic allergic rhinitis is warranted.

 

 

M. M. Celli

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S.R. Fey, 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.