IRRITABLE COLON SYNDROME

KRISTY L. ZADORA · 2026 · Case ID: A26037110

GRANTED

Summary

The veteran, who served from April 2009 to April 2013, appeals the denial of service connection for migraine headaches as secondary to his service-connected tinnitus and PTSD, and seeks a 30 percent rating for irritable bowel syndrome (IBS). The Board granted the 30 percent rating for IBS, finding that the veteran's condition met the severe criteria under Diagnostic Code 7319, characterized by frequent abdominal pain, changes in stool frequency and form, bloating, and the need for medication and lifestyle modifications. The Board found the private physician's opinion adequate, noting it addressed the veteran's reported symptoms and provided a well-reasoned rationale linking IBS to his service. For migraine headaches, the Board granted service connection as secondary to tinnitus and PTSD. The veteran claimed exposure to loud machinery and jet engines during service, and submitted a private medical opinion from Dr. E.M. that linked his migraines to service-connected tinnitus and PTSD, citing shared physiological and psychological pathways. The Board found this opinion adequate and probative, noting the lack of a contrary VA opinion on secondary service connection. The Board also considered the veteran's service treatment records, which were negative for headache complaints, and his separation report denying frequent or severe headaches. However, the Board found the private opinion persuasive in establishing the secondary service connection for migraines.

Rationale

Private DBQ found severe IBS symptoms; VA exam noted moderate IBS symptoms; Board found IBS met 30% criteria

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

7319

Docket No.

250215-520718

Full Decision Text

Citation Nr: A26037110
Decision Date: 04/21/26 Archive Date: 04/21/26

DOCKET NO. 250215-520718
DATE: April 21, 2026

ORDER

Entitlement to a rating of 30 percent for irritable bowel syndrome is granted.

Entitlement to service connection for migraine headaches as secondary to service connected tinnitus and posttraumatic stress disorder (PTSD) is granted.

FINDINGS OF FACT

1. Throughout the period on appeal, the Veteran's irritable bowel syndrome manifested in abdominal pain related to defecation at least one day per week during the previous three months, a change in stool frequency, a change in stool form, altered stool passage, and subjective distention.

2. The Veteran's claimed migraine headaches was proximately caused by his service connected tinnitus and PTSD.

CONCLUSIONS OF LAW

1. The criteria for a 30 percent rating for irritable bowel syndrome have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1-4.14, 4.114, Diagnostic Code 7319.

2. The criteria for service connection for migraine headaches have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from April 2009 to April 2013.

The matters come before the Board of Veterans' Appeals (Board) from a February 2025 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The rating decision on appeal constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the February 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 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 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.

Increased Rating Criteria

Disability ratings are determined by application of the criteria set forth in VA's Schedule for Rating Disabilities, which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. When a question arises as to which of two ratings applies under a particular diagnostic code, the higher rating is assigned if the disability more closely approximates the criteria for the higher rating. Otherwise, the lower rating applies. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of a veteran. 38 C.F.R. § 4.3.

Separate evaluations may be assigned for separate periods of time if such distinct periods are shown by the competent evidence of record during the appeal, a practice known as "staged" ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). VA's determination of the present level of a disability may result in a conclusion that the disability has undergone varying and distinct levels of severity throughout the entire time period the increased-rating claim has been pending. Hart v. Mansfield, supra.

Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. Although a rating specialist is directed to review the recorded history of a disability in order to make a more accurate evaluation, see 38 C.F.R. § 4.2, the regulations do not give past medical reports precedence over current findings. Francisco v. Brown, 7 Vet. App. 55 (1994). However, the Board must also consider staged ratings. Hart v. Mansfield, supra.

The veteran's entire history is considered when assigning disability ratings. 38 C.F.R. § 4.1;
claim has been pending. Hart v. Mansfield, supra.

The veteran's entire history is considered when assigning disability ratings. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). A review of the recorded history of a disability is necessary to make an accurate rating. 38 C.F.R. §§ 4.2, 4.41. The regulations do not give past medical reports precedence over current findings where such current findings are adequate and relevant to the rating issue. Francisco v. Brown, supra; Powell v. West, 13 Vet. App. 31 (1999). The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, supra.

The assignment of a particular diagnostic code is dependent on the facts of a particular case. See Butts v. Brown, 5 Vet. App. 532, 538 (1993). One diagnostic code may be more appropriate than another based on such factors as an individual's relevant medical history, the current diagnosis, and demonstrated symptomatology. In reviewing the claim for a higher rating, the Board must consider which diagnostic code, or codes are most appropriate for application in the veteran's case and provide an explanation for the conclusion. See Tedeschi v. Brown, 7 Vet. App. 411, 414 (1995).

The basis of disability evaluation is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10.

The veteran is competent to report symptoms and experiences observable by his senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a).

Although the Board has an obligation to provide reasons and bases supporting its decision, there is no obligation to discuss, in detail, the extensive evidence of record. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that the Board must review the entire record but does not have to discuss each piece of evidence). Therefore, the Board will summarize the relevant evidence where appropriate, and the Board's analysis will focus specifically on what the evidence shows, or fails to show, as it relates to the Veteran's claims.

The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for evidence that it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. See Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992); Hatlestad v. Derwinski, 1 Vet. App. 164 (1991).

The veteran can provide competent reports of factual matters of which he has first-hand knowledge, such as experiencing pain in service, reporting to sick call, being placed on limited duty, and undergoing physical therapy. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a lay person is competent to identify the medical condition (noting that sometimes the lay person 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 lay person is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Similarly, laypersons are competent to diagnose and provide nexus opinions to some extent, notably where the diagnosis or opinion is not of a complex nature. Id.; see also Davidson v
a condition when (1) a lay person is competent to identify the medical condition (noting that sometimes the lay person 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 lay person is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Similarly, laypersons are competent to diagnose and provide nexus opinions to some extent, notably where the diagnosis or opinion is not of a complex nature. Id.; see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).

The determination as to whether the requirements for service connection are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. 38 U.S.C. § 7104(a); Baldwin v. West, 13 Vet. App. 1 (1999).

When there is an approximate balance of positive and negative evidence as to any issue material to the determination of a matter, VA will resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

1. Entitlement to a rating of 30 percent for irritable bowel syndrome is granted.

The Veteran generally contends that his irritable bowel syndrome warrants a compensable rating. See February 2025 VA Form 10182. Specific argument in support of this appeal has not been submitted.

The Veteran filed his claim for increased rating for irritable bowel syndrome in October 2024. See October 2024 Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ). Thus, the appeal period begins October 21, 2024, to include the one-year "look back" period provided by 38 U.S.C. § 5110(b)(2), 38 C.F.R. § 3.400(o)(2), and Gaston v. Shinseki, 605 F.3d 979, 982 (Fed. Cir. 2010).

The Veteran's irritable bowel syndrome is currently rated as noncompensable. See 38 C.F.R. § 4.114, Diagnostic Code 7319.

The rating criteria applicable to Diagnostic Code 7319, which applies specifically to irritable colon syndrome (spastic colitis, mucous colitis, etc.), or irritable bowel syndrome were amended effective May 19, 2024. 38 C.F.R. § 4.114, Diagnostic Code 7319 (2023). The former regulations are applicable both before and after the date of the change in regulations, and the revised regulations are applicable only on or after their effective date. See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003); VAOPGCPREC 7-2003.

Under the prior rating criteria, Diagnostic Code 7319 states that a noncompensable rating is assigned for mild irritable bowel syndrome, with disturbances of bowel function with occasional episodes of abdominal distress. A 10 percent rating requires moderate irritable bowel syndrome, with frequent episodes of bowel disturbance with abdominal distress. A 30 percent rating requires severe irritable bowel syndrome with diarrhea or alternating diarrhea and constipation, with more or less constant abdominal distress. See 38 C.F.R. § 4.114, Diagnostic Code 7319 (2023). There is no higher evaluation available under this rating code.

The terms "mild," "moderate," and "severe" are not specifically defined in the Schedule or Diagnostic Code 7319. Rather than applying a mechanical formula, the Board must evaluate all the evidence to the end that its decisions are equitable and just. 38 C.F.R. § 4.6.

Initially, the Board notes that, under the prior rating criteria, a single rating will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. See also 38 C.F.R. § 4.113 (coexisting abdominal conditions); 38 C.F.R. § 4.14 (avoidance of pyramiding).

Under the revised rating criteria, a 10 percent rating is for assignment where there is abdominal pain related to defecation at least once during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distention. A 20 percent rating is warranted for abdominal pain related to defecation for at least three days per month during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension. A 30 percent rating is warranted for abdominal pain related to defecation at least one day per week during the previous three months; and two or more of the following: (1) change in stool frequency, (2) change in stool form, (3) altered stool passage (straining and/or urgency), (4) mucorrhea, (5) abdominal bloating, or (6) subjective distension. There is no higher rating available under this Diagnostic Code.

Note (1) states that this diagnostic code may include functional digestive disorders (see 38 C.F.R. § 3.317), such as dyspepsia, functional bloating and constipation, and diarrhea. Evaluate other symptoms of a functional digestive disorder not encompassed by this diagnostic code under the appropriate diagnostic code, to include gastrointestinal dysmotility syndrome (Diagnostic Code 7356), following the general principles of §§ 4.14 and 4.114.

Additionally, the Board observes there is no evidence of a functional digestive disorder, such that the Veteran is entitled to a separate disability evaluation under Diagnostic Code 7346, in accordance with the revised rating criteria. In this regard, the Board observes that the Veteran does not experience dyspepsia, gastroenteritis, or other functional digestive symptoms not encompassed by her current rating under Diagnostic Code 7319. To this point, the Board observes that the Veteran has denied experiencing heartburn, nausea, and vomiting.

Turning to the evidence of record, an October 2024 private Disability Benefits Questionnaire (DBQ) report completed by P.K, a physician's assistant reflected the Veteran's reports that his symptoms have progressively worsened with severe diarrhea or alternating diarrhea and constipation, accompanied by chronic and constant abdominal distress. The examination report also reflects his reports of experiencing abdominal pain related to defecation at least one day per week with changes in stool frequency and form, episodes of abdominal bloating, and that continuous medication was required to manage symptoms and lifestyle modifications to include dietary changes and stress management techniques. The examination report reflects that Veteran has reported trying over-the-counter medication with minimal improvement. The provider found that the Veteran's irritable bowel syndrome resulted in abdominal pain related to defecation at least one day per week during the previous three months. The provider further found that the Veteran's irritable bowel syndrome showed signs and/or symptoms of change in stool frequency, change in stool form, altered stool passage, abdominal bloating, and subjective distention. The provider found that the Veteran did not have any other surgeries or diseases and that the functional impact included impacting the Veteran's ability to anxiety and need to stay close to a bathroom, affecting his ability to work and participate in social activities. The provider noted that the Veteran has experienced decreased productivity due to his irritable bowel syndrome.

A February 2025 VA examination report reflects the Veteran's reports of experiencing recurrent bouts of diarrhea since 2012 and that he has loose stool on two to three days per week with bloating and abdominal discomfort. The examiner noted that the Veteran had not undergone imaging, scoping, or other intervention/treatment. The examiner found that there was no evidence of melena, nausea, vomiting, weight loss or other symptoms. The examiner noted that the Veteran's treatment plan did not include taking daily prescribed medication for the diagnosed condition and that his irritable bowel syndrome resulted in abdominal pain related to defecation at least one day per week in the previous three months. The examiner found that the signs or
productivity due to his irritable bowel syndrome.

Further review of the record shows that the Veteran receives treatment at VA for various disabilities, to include his irritable bowel syndrome. However, there is no indication from the treatment notes of record that the Veteran has reported symptoms of such disorder that are worse than those noted in the various VA examination reports of record.

Based on the foregoing, the Board finds that a rating of 30 percent for irritable bowel syndrome is warranted throughout the appeal period. The record establishes that the Veteran's irritable bowel syndrome has manifested in abdominal pain related to defecation at least one day per week during the previous three months as well as a change in stool frequency, change in stool form, and abdominal bloating. This is the maximum schedular rating under Diagnostic Code 7319.

Further, 38 C.F.R. § 4.113 provides that there are diseases of the digestive system, particularly within the abdomen, which, while differing in the site of pathology, produce a common disability picture characterized in the main by varying degrees of abdominal distress or pain, anemia and disturbances in nutrition. Consequently, certain coexisting diseases in this area, as indicated in the instruction under the title "Diseases of the Digestive System," do not lend themselves to distinct and separate disability evaluations without violating the fundamental principle relating to pyramiding as outlined in § 4.14. Additionally, 38 C.F.R. § 4.114 indicates that ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive, will not be combined with each other. Rather, a single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such evaluation. Therefore, as the Veteran's irritable bowel syndrome is evaluated under Diagnostic Code 7319, a higher or separate rating under any other potentially applicable diagnostic code is not warranted.

The Board notes that Diagnostic Code 7319 does not contemplate the use of medication. The Board is cognizant of the recent Court decision in Ingram v. Collins, in which the Court reaffirmed prior holdings that in rating disabilities, the Board must discount the beneficial effects of medication when the relevant rating criteria do not contemplate medication use. Ingram v. Collins, 38 Vet. App. 130 (2025); see also Jones v. Shinseki, 26 Vet. App. 56 (U.S. 2012); McCarroll v. McDonald, 28 Vet. App. 267 (U.S. 2016). Here, in reporting that he used Pepto-Bismol, Gas-ex and Tums to address his symptoms, the Veteran did not report that the use of any medication ameliorated his symptoms in any way, and the Board has thus discounted the ameliorative effects of medication in reaching its determination in this case.

In making its determination in this case, the Board acknowledges the Veteran's belief that his irritable bowel syndrome is more severe than the current rating reflects. While the Board recognizes that the Veteran is competent to provide statements regarding his observable symptomatology, he is not competent to provide an opinion regarding the severity of his symptomatology in accordance with the rating criteria. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). Rather, the Board finds the medical evidence in which professionals with medical expertise examined the Veteran, acknowledged his reported symptoms, and described the manifestations of such is more probative.

The Board has considered whether a staged rating under Hart v. Mansfield, supra. is warranted; however, the Board finds that
, he is not competent to provide an opinion regarding the severity of his symptomatology in accordance with the rating criteria. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). Rather, the Board finds the medical evidence in which professionals with medical expertise examined the Veteran, acknowledged his reported symptoms, and described the manifestations of such is more probative.

The Board has considered whether a staged rating under Hart v. Mansfield, supra. is warranted; however, the Board finds that the Veteran's symptomatology has been stable throughout the period on appeal. Therefore, assigning a staged rating is not warranted. Further, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).

Additionally, the Board has considered whether an inferred claim for a total disability based upon individual unemployability has been raised pursuant to Rice v. Shinseki, 22 Vet. App. 447 (2009). The Veteran had reported being employed full-time as a heating/cooling specialist in June 2017 and his current employment status is not clear from the record. The Veteran has not alleged, and the record does not establish, that the Veteran's employment was not gainful or was otherwise in a protected environment. As such, a Rice claim is not raised during the applicable appeal period.

Based on the foregoing, the Board finds that a rating of 30 percent for irritable bowel syndrome is warranted. To that extent, the appeal is granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, supra.

Service Connection Criteria

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). Service connection may also be granted for any disease diagnosed after discharge, when all evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may be granted based on evidence of (1) a current 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. 38 C.F.R. § 3.304. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Service connection may be established on a secondary basis for a disability that is proximately due to or the result of a 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) caused by or (b) aggravated by a service-connected disability. 38 C.F.R. § 3.310(a); Allen v. Brown, 7 Vet. App. 439 (1995). VA has amended 38 C.F.R. § 3.310 to explicitly incorporate the holding in Allen, except that it will not concede aggravation unless a baseline for the claimed disability can be established with evidence created prior to any aggravation. 38 C.F.R. § 3.310(b).

2. Entitlement to service connection for migraine headaches as secondary to service connected tinnitus and PTSD is granted.

The Veteran contends that his migraine headache were caused by an in-service event, injury or exposure as he worked on and operated loud machinery and worked in close proximity to jet engines a minimum of 12 hours a day. See October 2024 VA Form 21-526EZ. The February 2025 rating decision favorably found that the Veteran has been diagnosed with migraine including migraine variants on February 1, 2025 and that participation in a toxic exposure risk activity is conceded; the Board is bound by these favorable findings.

Service treatment records are negative for complaints regarding headaches. During the separation Report of Medical History in February 2013, the Veteran specifically denied having or having had frequent or severe headaches.

In October 2024, the Veteran submitted an opinion from Dr. E.M., an emergency medicine physician in support of his appeal. The provider
on and operated loud machinery and worked in close proximity to jet engines a minimum of 12 hours a day. See October 2024 VA Form 21-526EZ. The February 2025 rating decision favorably found that the Veteran has been diagnosed with migraine including migraine variants on February 1, 2025 and that participation in a toxic exposure risk activity is conceded; the Board is bound by these favorable findings.

In October 2024, the Veteran submitted an opinion from Dr. E.M., an emergency medicine physician in support of his appeal. The provider confirmed a diagnosis of migraines and opined that the Veteran's service connected tinnitus and PTSD are most likely the cause of his neurologic symptoms and at the very least has exacerbated and worsened his headache disorder. In support of this opinion, the provider explained that through clinical research, case studies and series, and clinical reports, PTSD, tinnitus, and headache disorders, namely migraine headaches, have been shown to share multiple complex pathways that contribute to their development and worsening. The provider reasoned that there are multiple physiological and psychological pathways that these two conditions share, which ultimately very likely lead to one condition causing the onset of the other. The provider indicated that there is an abundance of data and literature that shows how headache disorders, tinnitus, and PTSD aggravate each other. The provider opined that the Veteran's tinnitus and PTSD have shown to have a bidirectional causal relationship and the diagnosis of headache disorder and ultimately opined that the Veteran's migraine headache is highly likely to be secondary and as a direct result of his service-connected event.

The Board finds the October 2024 private opinion to be adequate. Notably, the October 2024 private physician reviewed the claims file, discussed applicable medical studies and provided an internally consistent and adequate opinion supported by a well-reasoned rationale. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A] medical opinion must support its conclusion with an analysis the Board can consider and weight against contrary opinion"). The opinion is therefore afforded probative weight. While a February 2025 VA examiner provided an etiology opinion as to direct service connection, an opinion as to secondary service connection was not provided. There is therefore no contrary opinion of record as to secondary service connection.

In sum, the Veteran has a current diagnosis of migraine headaches. The private opinion supports the Veteran's claim for entitlement to service connection on a secondary basis. Moreover, there is no sufficient basis for the Board to reject the October 2024 supportive opinion and to further develop the claim. Cf. Mariano v. Principi, 17 Vet. App. 305, 312 (2003) (holding that, because it is not permissible for VA to undertake additional development to obtain evidence against an appellant's case, VA must provide an adequate statement of reasons or bases for its decision to pursue such development where such development could be reasonably construed as obtaining additional evidence for that purpose).

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Accordingly, the Board finds that service connection for migraine headaches as secondary to service connected tinnitus and PTSD is warranted. The appeal is granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, supra.

KRISTY L. ZADORA

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Audrey Kim, 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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