MUSCULOSKELETAL

MICHELLE L. KANE · 2026 · Case ID: A26040532

DENIED

Summary

The veteran, who served from September 2017 to October 2024, appeals the denial of service connection for bilateral shoulder and foot conditions, and seeks initial compensable ratings for hypertension and tension headaches. The Board denied service connection for the bilateral shoulder condition, finding no current diagnosis or objective evidence of pathology, and that any in-service condition had resolved. The Veteran's lay assertions were deemed insufficient to establish a current disability. For the bilateral foot condition, the Board acknowledged a current diagnosis of pes planus but found no in-service complaints or nexus to service, relying on a VA examiner's opinion that the condition was less likely than not related to service. The Board denied an initial compensable rating for hypertension, finding that while the Veteran takes medication, his blood pressure readings, both historically and currently, did not meet the criteria for a compensable rating under Diagnostic Code 7101. For tension headaches, the Board denied a compensable rating, noting that the Veteran's headaches, while recurring, were not prostrating or prolonged to the extent required for a compensable rating, and did not cause severe economic inadaptability, despite the VA examiner's finding that they did not impact occupational tasks. The Board found no benefit of the doubt to resolve in the Veteran's favor for any of the denied claims.

Rationale

No current diagnosis of bilateral shoulder condition.; No objective evidence of shoulder pathology.; In-service condition resolved.; Lay assertions insufficient to establish current disability.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250331-529315

Full Decision Text

Citation Nr: A26040532
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 250331-529315
DATE: April 30, 2026

ORDER

Entitlement to service connection for a bilateral shoulder condition is denied.

Entitlement to service connection for a bilateral foot disability is denied.

Entitlement to an initial compensable rating for hypertension is denied.

Entitlement to an initial compensable rating for tension headaches is denied.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis related to the bilateral shoulders.

2. The evidence of record persuasively weighs against finding that a current left or right foot disability began during active service, or is otherwise related to an in-service injury or disease.

3. The objective clinical findings reflect that, during the period on appeal, the Veteran was on continuous medication for control of hypertension, and there are no readings (current or historical) of diastolic pressure predominantly 100 or more or systolic pressure predominantly 160 or more.

4. At no point during the appeal period did the Veteran's service-connected tension headaches involve symptoms approximating characteristic prostrating attacks or completely prostrating and prolonged attacks productive of severe economic inadaptability of any frequency.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for a bilateral shoulder disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for entitlement to service connection for a bilateral foot disability have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307.

3. The criteria for entitlement to a compensable initial rating for hypertension have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.159, 4.1, 4.2, 4.3, 4.6, 4.7, 4.104, Diagnostic Code 7101.

4. The criteria for entitlement to a compensable initial rating for tension headaches have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.400, 4.3, 4.7, 4.14, 4.21, 4.124a, Diagnostic Code 8100.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from September 2017 to October 2024.

The Appeals Modernization Act (AMA) applies to this matter. The rating decisions on appeal were issued in February 2025 (increased ratings for hypertension and tension headaches) and March 2025 (service connection for bilateral feet and bilateral shoulder pain). In March 2025, the Veteran selected the Direct Review docket for this appeal; the Board will therefore consider only the evidence of record as of the date the February 2025 and March 2025 rating decisions were issued. See 38 C.F.R. § 20.301.

None of the evidence added to the file after the February 2025 and March 2025 decisions can be considered, based on the Veteran's choice of the Direct Review docket. 38 C.F.R. § 20.300. If the Veteran would like VA to consider any evidence that was added to the claims file 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, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

VA regulations provide that, "[u]pon request, a claimant is entitled to a hearing on any issue involved in a claim... before VA issues notice of a decision on an initial or supplemental claim." 38 C.F.R. § 3.103(d)(1). That regulation does not indicate that the claimant is entitled to pre-decisional notice of this optional hearing. In fact, 38 C.F.R. § 3.103(b)(1) provides that, following a decision, "[c]laimants and their representatives are entitled to notice of any decision made by VA affecting the payment of benefits or the granting of relief... [including] the right to a hearing on any issue involved in the claim as provided in paragraph (d) of this section...." Read together with § 3.103(d), the only notice § 3.103(b) requires is that a claimant be provided notice of the right for a hearing with notification of the decision (by definition, a post-decisional notice). In November 2022, VA amended VA Form 21-526EZ and in May 2024 VA amended VA Form 20-0995 to inform claimants of the right to a hearing at any time during the claims process. The claims in this appeal were filed on VA Form 21-526EZ in October 2024. As such, the Veteran received notice of his right to a pre-decisional hearing.

Service Connection

Service connection may be granted directly as a result of disease or injury incurred in service based on nexus using a three-element test: (1) The existence of 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 in or aggravated by service. See 38 C.F.R. §§ 3.303 (a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009).

Where the evidence shows a "chronic disease" in service or "continuity of symptoms" after service, the disease shall be presumed to have been incurred in service. For the showing of "chronic" disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With chronic disease as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service-connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally, a showing of "continuity of symptoms" after service is required for service connection. 38 C.F.R. § 3.303 (b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Additionally, where a veteran served ninety days or more of active service, and certain chronic diseases become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309 (a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. Id.

The requirement for a current disability is satisfied if the disability is present at any point proximate to the claim, during the claim, or to the appeal period. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2014). If there is no evidence of a present disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

1. Entitlement to service connection for a bilateral shoulder condition is denied.

The Veteran seeks entitlement to service connection for a bilateral shoulder condition. The Veteran asserts that his bilateral shoulder condition is related to weightlifting during his active service. See VA Form 21-526EZ
, during the claim, or to the appeal period. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2014). If there is no evidence of a present disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

1. Entitlement to service connection for a bilateral shoulder condition is denied.

The initial threshold question for the Board is whether the Veteran has a current disability, and if so, whether that disability began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current diagnosis related to his bilateral shoulders and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 5107(b); Holton, 557 F.3d at 1366; Romanowsky, 26 Vet. App. at 294 (2013); McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303 (a), (d).

The Veteran was provided a VA examination related to his bilateral shoulders in February 2025. The VA examiner noted that the Veteran does not have a current diagnosis associated with his bilateral shoulders. Upon examination, the Veteran had normal bilateral range of motion measurements. Additionally, the VA examiner noted that the Veteran's bilateral shoulder condition does not impact his ability to perform any type of occupational task. In a February 2025 addendum opinion, the same VA examiner noted that the Veteran's service treatment records reflect a diagnosis of bilateral shoulder rotator cuff during active service. The VA examiner noted there was no objective evidence of rotator cuff pathology during the examination and that the examination findings indicate that the diagnosis from service has resolved and that there is no current objective evidence of shoulder joint pathology.

Further, the Board finds that the evidence does not show any functional impairment affecting earning capacity such that it constitutes a disability pursuant to Saunders, as the Veteran has made no statements as to the impairment resulting from the claimed condition. See Saunders v. Wilkie, 886 F.3d 1356, 1363 (Fed. Cir. 2018). The standard of "functional impairment of earning capacity," pursuant to Saunders, can be met by "showing manifestations of a similar severity, frequency and duration as those VA has determined by regulation would cause impaired earning capacity in an average person." Wait v. Wilkie, 33 Vet. App. 8, 17 (2020). The evidence of record, at present, demonstrates that he complained of bilateral shoulder pain. The Veteran filed a claim for a bilateral shoulder condition, generally asserting they it is related to service, but providing no further lay evidence as to current symptoms/impairment, other than pain. The evidence does not rise to the level of a showing that he has any symptoms of a bilateral shoulder condition that causes functional impairment affecting earning capacity such that it constitutes a disability.

The Board acknowledges the Veteran's contention that he has a bilateral shoulder condition that is etiologically attributable to his active service. The Veteran, as a lay person, is not competent to diagnose a particular disability. See Layno v. Brown, 6 Vet. App. 465, 469 (1994); Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Diagnosing such a disability requires knowledge of particular disabilities and the appropriate diagnostic testing for those disabilities. The Veteran has not been shown to possess the medical expertise or knowledge to diagnose a shoulder disability. Therefore, his contentions do not constitute competent evidence of a current service-connectable disability related to his bilateral shoulders.

In view of the foregoing, the Board concludes that the evidence of record persuasively weighs against finding that the Veteran has had a bilateral shoulder condition at any time during or proximate to the pendency of the claim. While he was treated for his shoulders during service, a medical professional has clearly stated that condition has resolved. As noted above, in the absence of proof of a current disability, there can be no valid claim for entitlement to service connection. Brammer, 3 Vet. App. at 225. Because the evidence persuasively weighs
possess the medical expertise or knowledge to diagnose a shoulder disability. Therefore, his contentions do not constitute competent evidence of a current service-connectable disability related to his bilateral shoulders.

In view of the foregoing, the Board concludes that the evidence of record persuasively weighs against finding that the Veteran has had a bilateral shoulder condition at any time during or proximate to the pendency of the claim. While he was treated for his shoulders during service, a medical professional has clearly stated that condition has resolved. As noted above, in the absence of proof of a current disability, there can be no valid claim for entitlement to service connection. Brammer, 3 Vet. App. at 225. Because the evidence persuasively weighs against a finding that there is a current disability, the doctrine of reasonable doubt is not for application, and the claim is denied.

2. Entitlement to service connection for a bilateral foot disability is denied.

The Veteran seeks entitlement to service connection for a bilateral foot disability. The Veteran asserts that he did not have the disability prior to service and started having pain while running. See VA Form 21-526EZ, received October 2024.

In the March 2025 rating decision, the AOJ found that there is a current disability of bilateral pes planus. The Board is bound by this favorable finding. See 38 C.F.R. § 3.104(c). Therefore, the Board must determine whether the Veteran had an in-service injury or disease and whether there is a nexus between the Veteran's current condition and any in-service incident.

The Veteran's service treatment records are silent for any treatment or complaints during his active service. There are no records reflecting that the Veteran complained of or was treated for a bilateral foot disability. As he was without any noted abnormalities of the bilateral feet during service, the Board concludes that a current bilateral foot disability did not onset during service.

The Veteran was provided a VA foot conditions examination in February 2025. During the examination, the Veteran reported he did not know when the condition began. He further reported that there is no current foot pain, no current treatment, and no functional impairment. Competent evidence has not been presented suggesting that any current bilateral foot disability is related to any in-service disease, injury, or other incident of service. To the extent the Veteran links his current bilateral foot disability to service, such statements are not within the realm of knowledge of a layperson. Rather, the question of whether the current, post-service foot disabilities are related to the Veteran's active-duty service is a complex question that requires expertise regarding orthopedic disabilities.

As to whether there is a nexus between the Veteran's current bilateral foot disability and his active service, the February 2025 VA examiner opined that the Veteran's bilateral foot disability was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. As rationale, the VA examiner explained that the only document showing a diagnosis of pes planus was the February 2025 VA examination. The VA examiner noted that a June 2024 medical note showed the Veteran complained of "flat feet"; however, the examiner did not comment on the Veteran's feet in the physical examination or diagnosis section of the note. The VA examiner concluded that as there are no treatments or diagnosis related to flat feet found in the file during the active duty service timeframe, no nexus was established. The Board affords the February 2025 VA examiner's opinion probative value because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Prejean v. West, 13 Vet. App. 444 (2000); see also Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). There is no contrary medical opinion.

In summary, the Board notes that, while the evidence of record shows the Veteran has a current bilateral foot disability, the evidence of record does not indicate that such a disability is related to his service. Consequently, service connection for a bilateral foot disability is not warranted.

Increased Ratings

Disability ratings are determined by the application of VA's Schedule for Rating Disabilities (Schedule), which is based on the average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Pertinent regulations do not require that all cases show all findings specified by the Schedule, but that findings sufficient to identify the disease and the resulting disability and, above all, coordination of the rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21
that such a disability is related to his service. Consequently, service connection for a bilateral foot disability is not warranted.

Increased Ratings

Disability ratings are determined by the application of VA's Schedule for Rating Disabilities (Schedule), which is based on the average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Pertinent regulations do not require that all cases show all findings specified by the Schedule, but that findings sufficient to identify the disease and the resulting disability and, above all, coordination of the rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21; see also Mauerhan v. Principi, 16 Vet. App. 436 (2002).

When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3. Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7.

The Board will consider whether separate ratings may be assigned for separate periods of time based on facts found, a practice known as "staged ratings," in all claims for increased ratings. Fenderson v. West, 12 Vet. App. 119, 126-27 (1999).

Period on Appeal

As service connection for hypertension and tension headaches were awarded effective October 8, 2024, that is the beginning date of the period on appeal. However, while the Veteran's continuously pursued claim is before the Board on appellate review, there is a defined evidentiary record. Here, based on the Veteran's direct review docket choice and the evidentiary rules established by Congress for AMA appeals, the evidence closed February 20, 2025 (the date of the decision on appeal). If the Veteran would like VA to consider any evidence that was added to the claims file 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.

3. Entitlement to a compensable initial rating for hypertension is denied.

The Veteran seeks a compensable initial for hypertension.

Under Diagnostic Code 7101, a 10 percent rating is warranted for diastolic pressure predominantly 100 or more; systolic pressure predominantly 160 or more; or for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. A 20 percent rating is warranted for diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more. A 40 percent rating is warranted for diastolic pressure predominantly 120 or more. A maximum 60 percent rating is warranted for diastolic pressure predominantly 130 or more.

The word "predominantly" is not defined in the Rating Schedule. According to Merriam-Webster, "predominant" is defined as "being most frequent or common." See Merriam-Webster's Online Dictionary, https://www.merriam-webster.com/dictionary/predominant. The use of such terminology by VA examiners or other physicians, although an element of evidence to be considered by the Board, is not dispositive of an issue. All evidence is evaluated in determining an increased rating. See 38 C.F.R. §§ 4.2, 4.6.

Turning to the relevant evidence of record, the Veteran was provided a VA hypertension examination in February 2025. The Veteran took medication related to his hypertension. Upon examination, the Veteran had blood pressure readings of 145/88, 136/82, and 140/88.

The evidence of record does not show any systolic pressure readings of 160 or more, and the Veteran's diastolic pressure readings were predominantly lower than 100. That said, it is clear from the Veteran's history that he was prescribed medication for hypertension. The plain text of Diagnostic Code 7101 directs VA to consider historical, rather than current, blood pressure readings and that the relevant "historical blood pressure readings" are those taken before the Veteran began medication. See Wilson v. McDonough, 35 Vet. App. 75, 81 (2021). Here, the 2025 examination indicates the Veteran's condition started in 2018. A February 2019 treatment record reflects a blood
The evidence of record does not show any systolic pressure readings of 160 or more, and the Veteran's diastolic pressure readings were predominantly lower than 100. That said, it is clear from the Veteran's history that he was prescribed medication for hypertension. The plain text of Diagnostic Code 7101 directs VA to consider historical, rather than current, blood pressure readings and that the relevant "historical blood pressure readings" are those taken before the Veteran began medication. See Wilson v. McDonough, 35 Vet. App. 75, 81 (2021). Here, the 2025 examination indicates the Veteran's condition started in 2018. A February 2019 treatment record reflects a blood pressure reading of 138/82. A November 2019 treatment record reflects a blood pressure reading of 147/96. An October 2022 treatment record reflects a blood pressure reading of 129/82. A November 2023 treatment record reflects that the Veteran was not taking medication. He had a blood pressure reading of 119/79. A June 2024 treatment record reflects a blood pressure reading of 135/94.

Therefore, although the Veteran takes medication, none of the medical evidence either prior to taking medication or contemporaneous with it have shown diastolic pressure of 100 or more or systolic pressure of 160 or more. He simply does not meet the criteria for a compensable rating.

The Board finds that for the entire period on appeal an initial compensable rating is not warranted for the Veteran's hypertension. There is no benefit-of-the-doubt that can be resolved in his favor, as the rating is based on his objective blood pressure readings.

4. Entitlement to a compensable initial rating for tension headaches is denied.

The Veteran seeks a compensable initial rating for tension headaches.

Notably, while this appeal was pending, the Veteran filed a claim for an increased rating in October 2025, and the RO subsequently increased the evaluation assigned to this service-connected disability to 30 percent, effective October 19, 2025, in a November 2025 rating decision. The period on review currently before the Board under the AMA does not include consideration of any evidence developed in connection with that 2025 claim. The Board has no jurisdiction to review the propriety of the 30 percent evaluation assigned as of October 19, 2025, and that period of time will not be reviewed or discussed in this determination. He was notified of that decision on November 13, 2025, so he is within the time period to appeal it if he wishes to do so. Instead, the February 2025 rating decision on appeal granted service connection for tension headaches effective October 8, 2024, with an initial noncompensable rating.

Under Diagnostic Code 8100, a 10 percent rating is warranted for characteristic prostrating attacks averaging one in 2 months over the last several months; a 30 percent rating is warranted for characteristic prostrating attacks occurring on average once a month over the last several months; and a 50 percent rating, the highest schedular rating, is warranted for very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. In rating headaches or migraines, the Board may not consider the ameliorative effects of medication. See Jones v. Shinseki, 26 Vet. App. 56, 63 (1992).

The phrase "characteristic prostrating attacks" is used in the criteria corresponding to 10 percent and 30 percent ratings under Diagnostic Code 8100 to describe the nature and severity of migraines, but it is not defined in the regulation. Pursuant to Dorland's Illustrated Medical Dictionary 1531 (32d ed. 2012), prostration is defined as "extreme exhaustion or powerlessness." In Johnson, the United States Court of Appeals for Veterans Claims (Court) defined prostrating as "lacking in vitality or will: powerless to rise: laid low," citing to WEBSTER'S THIRD NEW INTERNATIONAL DICTIONARY OF THE ENGLISH LANGUAGE UNABRIDGED 1822 (1966). Johnson v. Wilkie, 30 Vet. App. 245, 252 (2018). The Court further explained that "[b]ecause DC 8100 specifically governs migraine headaches, the phrase 'characteristic prostrating attacks' plainly describes migraine attacks that typically produce powerlessness or a lack of vitality." Id. at 252.

The criteria for a 50 percent rating similarly contain several undefined phrases. The descriptive phrase "very frequent" connotes a frequency at least greater than once a month, as is required by the rating criteria corresponding to a lesser 30 percent rating. Johnson, 30 Vet. App. at 253. The phrase "completely prostrating" generally means that the migraines attack must render the veteran entirely powerless. Id. The completely prostrating attacks must also be "prolonged," which is defined as "to lengthen in time: extend duration: draw out: continue, protract." Id. (internal citation omitted). Lastly, the 50 percent rating criteria requires that the very frequent completely prostrating and prolonged attacks be "productive of severe economic inadaptability." Productive can be read as having either the meaning of "producing" or "capable of producing," and, with regard to severe economic inadaptability, nothing in Diagnostic Code 8100 requires that the claimant be completely unable to work in order to qualify for a 50 percent rating. Pierce v. Principi, 18 Vet. App. 440, 445-46 (2004).

The Veteran was provided a VA examination related to his tension headaches in February 2025. The Veteran reported strong headaches and vertigo that have slowed down but are recurring. The Veteran was not currently taking medication related to his headaches. The Veteran reported pulsating or throbbing pain and pain on both sides of the head. He also reported non-headache symptoms of dizziness. His headaches typically last less than one day. The VA examiner noted that the Veteran does not have characteristic prostrating attacks of migraine/non-migraine headache pain. Additionally, the Veteran did not have any other pertinent physical findings, complications, conditions, signs, or symptoms related to her tension headaches. The VA examiner noted that the Veteran's headaches do not impact his ability to perform any type of occupational task.

After review of the lay and medical evidence, the Board finds that a compensable rating is not warranted. Significantly, there is simply no evidence of record to suggest that the Veteran experienced any more than less frequent attacks of headaches during the appeal period. At no point has he endorsed or has an examiner or provider documented that he experienced headaches of a variety or severity so as to approximate characteristic prostrating attacks or completely prostrating and prolonged attacks productive of severe economic inadaptability at any frequency. While he may have headaches daily, they are not prostrating.

The Board finds that the Veteran's headaches did not raise to the level of economic inadaptability at any frequency. As noted above, the 50 percent rating criteria requires that the Veteran's headaches to be very frequent completely prostrating and prolonged attacks that are "productive of severe economic inadaptability." However, as noted by the VA examiner, the Veteran's headaches did not impact his ability to perform any type of occupational task. There is no evidence that the Veteran's tension headaches manifested in very frequent completely prostrating and prolonged attacks that were productive of severe economic inadaptability.

In making the above findings, the Board considered other reported symptoms that the Veteran has attributed to his headaches, including dizziness. Diagnostic Code 8100 contemplates these symptoms, and the rating criteria are focused on the frequency, duration, severity, and economic impact of the attacks. See Holmes v. Wilkie, 33 Vet. App. 67, 72-73 (holding that Diagnostic Code 8100 is not concerned merely with one symptom headaches but also other symptoms that a veteran experiences because of migraine attacks). In Holmes, the Court emphasized that this reading of Diagnostic Code 8100 does not foreclose the possibility of secondary service connection under 38 C.F.R. § 3.310 (a) or where a veteran's headaches cause or aggravate a separate disability or go beyond economic inadaptability. Id. at 73. There is no such evidence here, however.

The evidence is not in approximate balance, but is persuasively against the claim; therefore, there is no reasonable doubt to be resolved in favor of the Veteran. Entitlement to a compensable rating for service-connected tension headaches is denied.

MICHELLE L. KANE

Veterans Law Judge

Board of Veterans
because of migraine attacks). In Holmes, the Court emphasized that this reading of Diagnostic Code 8100 does not foreclose the possibility of secondary service connection under 38 C.F.R. § 3.310 (a) or where a veteran's headaches cause or aggravate a separate disability or go beyond economic inadaptability. Id. at 73. There is no such evidence here, however.

MICHELLE L. KANE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board LeMoine, Brian

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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