Back to BVA DecisionsDENIEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 251020-597842
MIGRAINE
RYAN T. KESSEL · 2026 · Case ID: A26037058
Summary
The veteran served from October 1962 to October 1966. The veteran appeals the denial of service connection for headaches, an eye disability, a respiratory disability (allergic rhinitis and bronchitis), and a skin disability (other than facial scars). The veteran contended that his headaches, eye conditions, and respiratory issues were due to exposure to the elements and toxic substances as a mechanic at Camp Lejeune and other duty stations. For headaches, the VA examiner found no service connection, attributing them to tension and acute infections, not in-service stress or TERA. The Board found this opinion persuasive. For eye conditions, the VA examiner attributed the veteran's glaucoma, cataracts, dermatochalasis, and macular degeneration to age, not service or TERA, and this opinion was found adequate. For respiratory conditions, the VA examiner concluded that the veteran's bronchitis was due to acute infections and not related to TERA, and this opinion was also found adequate. For skin conditions, the veteran claimed chloracne due to flightline exposure in Japan and Vietnam. The VA examiner found no chloracne, stating the veteran had acne vulgaris and that chloracne is rare and linked to specific toxic exposures not evidenced in the record. While the Board found a current diagnosis of porphyria cutanea tarda, VA examiners opined it was not related to service, attributing it to age and genetics, and finding insufficient medical literature to support a link to TERA. The Board found the evidence persuasively against all claims, determining insufficient evidence of service connection for any of the conditions.
Rationale
VA examiner opinion found no service connection for headaches.; Examiner cited medical literature supporting conclusion.; Lay statements were considered but given less weight than medical evidence.
Full Decision Text
Citation Nr: A26037058 Decision Date: 04/21/26 Archive Date: 04/21/26 DOCKET NO. 251020-597842 DATE: April 21, 2026 ORDER Service connection for headaches is denied. Service connection for an eye disability is denied. Service connection for a respiratory disability, including allergic rhinitis and bronchitis, is denied. Service connection for a skin disability, other than facial scars, is denied. ? FINDINGS OF FACT 1. The Veteran's headaches are not related to service. 2. The Veteran's eye disabilities are not related to service. 3. The Veteran's respiratory disabilities, including allergic rhinitis and bronchitis, are not related to service. 4. The Veteran's skin disability, other than facial scars, is not related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for headaches have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for an eye disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 3. The criteria for service connection for a respiratory disability, including allergic rhinitis and bronchitis, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for a skin disability, other than facial scars, have not 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 October 1962 to October 1966. The case is on appeal from a September 2025 rating decision. In an October 2025 notice of disagreement (NOD), the Veteran selected the Direct Review option. Therefore, the Board has considered the evidence of record at the time of the September 2025 rating decision. In December 2025, the Veteran waived the right to switch Board review options. Evidence was added to the claims file during a period of time when new evidence was not allowed. As the Board is deciding the claims, it may not consider this evidence in its decision. 38 C.F.R. § 20.300. The Veteran may file a Supplemental Claim 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, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. The Board has limited the discussion below to the relevant evidence required to support its finding of fact and conclusion of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(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." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may also be granted for a disability that is proximately due to, or aggravated by, a service-connected disease or injury. See 38 C.F.R. § 3.310. 1. Service connection for headaches. The Veteran contends that his headaches are the result of "stressful" military duties and exposure to the "elements" while working between the present disability and the disease or injury incurred or aggravated during service." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may also be granted for a disability that is proximately due to, or aggravated by, a service-connected disease or injury. See 38 C.F.R. § 3.310. 1. Service connection for headaches. The Veteran contends that his headaches are the result of "stressful" military duties and exposure to the "elements" while working on the flightline during service. See March 2023 claim. The Veteran was diagnosed with tension headaches during an October 2024 VA examination. Additionally, the Veteran participation in toxic exposure risk activities (TERA) during service, to include exposure to perchloroethylene, trichloroethylene, vinyl chloride, and benzene while stationed at Camp Lejeune and other compounds associated with his military duties as a mechanic, has been confirmed. See March 2023 VA memorandum. Accordingly, a current disability and in-service incurrence have been established. Regarding nexus, in August 2025, a VA examiner reviewed the Veteran's medical records and concluded that the Veteran's tension headaches are not the result of in-service stress or hazardous exposures during service. The examiner emphasized that the Veteran's tension headaches began after service and that the Veteran's in-service headaches were associated with acute upper respiratory symptoms. Likewise, the examiner explained that while some of the compounds to which the Veteran was exposed in-service while stationed at Camp Lejeune and as a mechanic are known to cause acute headaches immediately following exposure, they are not associated with the development of tension headaches. The examiner cited medical literature in support of this conclusion. The Board finds this medical opinion adequate for review. The opinion included an adequate rationale and referenced pertinent medical literature. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008). The Board will thus affords it substantial evidentiary weight. This medical opinion is also notably not substantially controverted by the available treatment records or prior VA medical opinions on this topic. The Board has reviewed the Veteran's lay statements regarding the etiology of his headaches. The Veteran is competent to report the onset and recurrence of symptoms, and the Board will thus assign his statements evidentiary weight. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a veteran is competent to report on that of which he or she has personal knowledge). However, the question of the etiology of the Veteran's condition is medically complex. See Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Thus, the Board will assign the greatest probative weight to the competent medical evidence on this topic. Accordingly, the evidence is persuasively against the claim. There is insufficient evidence that the Veteran's headaches are related to service. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102. Service connection for headaches is not warranted. 2. Service connection for an eye disability. The Veteran contends that his eye disabilities are the result of exposure to the "elements" while working on the flightline during service. See May 2023 claim. The Veteran was diagnosed with bilateral open-angle glaucoma, bilateral cataracts, bilateral upper lid dermatochalasis, and bilateral macular degeneration during an August 2024 VA examination. As previously noted, the Veteran participated in TERA during service, to include exposure to perchloroethylene, trichloroethylene, vinyl chloride, benzene while stationed at Camp Lejeune and other compounds associated with his military duties as a mechanic. See March 2023 VA memorandum. Accordingly, a current disability and in-service incurrence have been established. Regarding nexus, in August 2025, a VA examiner reviewed the Veteran's medical history and concluded that none of his eye disabilities are related to service. The examiner noted that none of the eye conditions began during service. The examiner explained that age is the most likely cause of the Veteran's glaucoma, macular degeneration, dermatochalasis, and cataracts, citing several sources in support of this conclusion. In an August oethylene, trichloroethylene, vinyl chloride, benzene while stationed at Camp Lejeune and other compounds associated with his military duties as a mechanic. See March 2023 VA memorandum. Accordingly, a current disability and in-service incurrence have been established. Regarding nexus, in August 2025, a VA examiner reviewed the Veteran's medical history and concluded that none of his eye disabilities are related to service. The examiner noted that none of the eye conditions began during service. The examiner explained that age is the most likely cause of the Veteran's glaucoma, macular degeneration, dermatochalasis, and cataracts, citing several sources in support of this conclusion. In an August 2025 addendum opinion, a separate VA examiner further explained that the Veteran's conditions would have likely onset earlier had they been the result of in-service TERA, rather than age. The author of the addendum opinion also separately opined that none of the Veteran's eye conditions are caused or aggravated by his service-connected diabetes. The examiner provided a thorough analysis, explaining that diabetic cataracts are generally found in young, Type 1 diabetics and that there is insufficient medical research showing that glaucoma is caused or aggravated by diabetes. The examiner again emphasized age-related factors as the likely cause of the Veteran's eye conditions. Accordingly, as the August 2025 medical opinions included adequate rationales and referenced pertinent medical literature, the Board will afford this evidence substantial evidentiary weight. See Nieves-Rodriguez, 22 Vet. App. at 302. The examiners' findings also comport with earlier VA medical opinions and are not substantively controverted by the available treatment records. The Board has reviewed the Veteran's lay statements regarding the etiology of his eye conditions. The Veteran is competent to report the onset and recurrence of symptoms, and the Board will thus assign his statements evidentiary weight. See Layno, 6 Vet. App. at 470. However, the question of the etiology of the Veteran's condition is medically complex. See Jandreau, 492 F.3d at 1377 n.4. Thus, the Board will assign the greatest probative weight to the competent medical evidence on this topic. Accordingly, the evidence is persuasively against the claim. There is insufficient evidence that any of the Veteran's eye conditions are related to service. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102. Service connection for an eye disability is not warranted. 3. Service connection for a respiratory disability, including allergic rhinitis and bronchitis. The Veteran contends that he suffers from rhinitis and bronchitis due to exposure to the "elements" while working on the flightline during service. See March 2023 claim. The Veteran's VA treatment records reflect treatment for bronchitis and allergic rhinitis. See February 2022, June 2025 VA treatment notes. As previously noted, the Veteran participated in TERA during service, to include exposure to perchloroethylene, trichloroethylene, vinyl chloride, benzene while stationed at Camp Lejeune and other compounds associated with his military duties as a mechanic. See March 2023 VA memorandum. Regarding nexus, in August 2025, a VA examiner reviewed the Veteran's medical history and concluded that he does not have a respiratory disability related to service. The examiner explained that the Veteran's manifestations of bronchitis during service and during the claim period were the result of acute infections and therefore are not related. Consequently, the examiner further explained that the Veteran's current episodes of bronchitis are the result of bacterial infection and therefore cannot be properly attributed to the in-service TERA. The Board finds this medical opinion adequate for review. The opinion included an adequate rationale and referenced pertinent medical literature. See Nieves-Rodriguez, 22 Vet. App. at 302. The Board will thus afford it substantial evidentiary weight. The examiner's findings also comport with earlier VA medical opinions and are not substantively controverted by the available treatment records. The Board has reviewed the Veteran's lay statements regarding the etiology of his respiratory conditions. The Veteran is competent to report the onset and recurrence of symptoms, and the Board will thus assign his statements evidentiary weight. See Layno, 6 Vet. App. at 470. However, the question of the etiology of the Veteran's diagnoses is medically complex. See Jandreau, 492 F. referenced pertinent medical literature. See Nieves-Rodriguez, 22 Vet. App. at 302. The Board will thus afford it substantial evidentiary weight. The examiner's findings also comport with earlier VA medical opinions and are not substantively controverted by the available treatment records. The Board has reviewed the Veteran's lay statements regarding the etiology of his respiratory conditions. The Veteran is competent to report the onset and recurrence of symptoms, and the Board will thus assign his statements evidentiary weight. See Layno, 6 Vet. App. at 470. However, the question of the etiology of the Veteran's diagnoses is medically complex. See Jandreau, 492 F.3d at 1377 n.4. Accordingly, the Board will assign the greatest probative weight to the competent medical evidence on this topic. The Board has reviewed the Veteran's lay statements regarding the etiology of his respiratory conditions. The Veteran is competent to report the onset and recurrence of symptoms, and the Board will thus assign his statements evidentiary weight. See Layno, 6 Vet. App. at 470. However, the question of the etiology of the Veteran's conditions is medically complex. See Jandreau, 492 F.3d at 1377 n.4. Thus, the Board will assign the greatest probative weight to the competent medical evidence on this topic. Accordingly, the evidence is persuasively against the claim. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102. Service connection for a respiratory disability, including allergic rhinitis and bronchitis, is not warranted. 4. Service connection for a skin disability, other than facial scars. The Veteran contends that he has chloracne due to exposure to the "elements" while working on the flightline in Japan and Vietnam during service. See March 2023 claim. In August 2025, a VA examiner reviewed the Veteran's treatment records and medical history and concluded that the Veteran does not have chloracne. The examiner explained that chloracne is separate and distinct from acne vulgaris, for which the Veteran received treatment during service. Additionally, the examiner stated that chloracne is a rare condition associated with specific toxic exposures, including herbicide agents, and there is insufficient evidence in the Veteran's treatment history that he has ever been diagnosed with this condition. The Board notes that the Veteran's service personnel records (SPR) confirm service in Japan but do not corroborate service in Vietnam. The Board finds the August 2025 examiner's opinion well-reasoned and thorough, and it is uncontroverted by the available treatment notes. Therefore, there is insufficient evidence of a current diagnosis of chloracne to support the Veteran's claim. However, the Board will broadly construe the Veteran's claim to encompass any skin condition. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). The Veteran has already been granted service connection for facial scars, which are therefore excluded from the present claim. The Veteran was diagnosed with porphyria cutanea tarda during a September 2024 VA examination. While this diagnosis was questioned by the August 2025 VA examiner, the Board will resolve all reasonable doubt in the Veteran's favor. Therefore, a current diagnosis has been established. As previously noted, the Veteran participated in TERA during service, to include exposure to perchloroethylene, trichloroethylene, vinyl chloride, and benzene while stationed at Camp Lejeune and other compounds associated with his military duties as a mechanic. See March 2023 VA memorandum. Therefore, an in-service incurrence has also been established. Regarding nexus, the examiner who conducted the September 2024 VA examination opined that the Veteran's porphyria cutanea tarda is not related to service, emphasizing that the onset of the condition occurred over thirty years after service. The examiner also acknowledged the Veteran's TERA participation but opined that there is no known association between the Veteran's exposures and his skin diagnosis. The August 2025 VA examiner disputed the Veteran's diagnosis of porphyria cutanea tarda but also stated that there is insufficient medical literature supporting a connection between this condition and the Veteran's toxic exposures. The examiner also emphasized that the condition is genetic and was not noted during service. Particularly when read in concert, the Board finds the September 2024 and August 2025 VA medical opinions adequate for review. The opinions included adequate rationale and anea tarda is not related to service, emphasizing that the onset of the condition occurred over thirty years after service. The examiner also acknowledged the Veteran's TERA participation but opined that there is no known association between the Veteran's exposures and his skin diagnosis. The August 2025 VA examiner disputed the Veteran's diagnosis of porphyria cutanea tarda but also stated that there is insufficient medical literature supporting a connection between this condition and the Veteran's toxic exposures. The examiner also emphasized that the condition is genetic and was not noted during service. Particularly when read in concert, the Board finds the September 2024 and August 2025 VA medical opinions adequate for review. The opinions included adequate rationale and referenced medical literature. Accordingly, the Board fill afford these opinions evidentiary probative weight. The examiners' findings also comport with earlier VA medical opinions and are not substantively controverted by the available treatment records. The record also includes a December 2009 letter from the Veteran's private provider implying that the Veteran has excised lesions on his face related to service. This opinion pertained to the Veteran's acne scars claim, which has already been granted. The Board has reviewed the Veteran's lay statements regarding the presence of chloracne and etiology of his porphyria cutanea tarda. The Veteran is competent to report the onset and recurrence of symptoms, and the Board will thus assign his statements evidentiary weight. See Layno, 6 Vet. App. at 470. However, the questions of the presence of a chloracne diagnosis and the etiology of the Veteran's porphyria cutanea tarda are medically complex. See Jandreau, 492 F.3d at 1377 n.4. Thus, the Board will assign the greatest probative weight to the competent medical evidence on this topic. Accordingly, the evidence is persuasively against the claim. There is insufficient evidence that the Veteran has been diagnosed with chloracne or that the Veteran's porphyria cutanea tarda is related to service. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102. Service connection for a skin disability, other than facial scars, is not warranted. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Hayes, 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.