Citation Nr: 0005158 Decision Date: 02/28/00 Archive Date: 03/07/00 DOCKET NO. 96-42 453 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Waco, Texas THE ISSUE Entitlement to service connection for migraine headaches. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD K. R. McCormack, Associate Counsel INTRODUCTION The veteran had active naval service from August 1993 to April 1995. This matter comes to the Board of Veterans' Appeals (Board) from a Department of Veterans Affairs (VA) St. Petersburg Regional Office (RO) November 1995 rating decision which denied, inter alia, service connection for migraine headaches. The veteran has relocated to Texas; the Waco RO now has jurisdiction over this claim. Subsequent to issuance of the last supplemental statement of the case, two VA examination reports were associated with the claims folder. The RO did not issue a supplemental statement of the case; however, as these examination reports do not contain any report or finding pertaining to migraine headaches, they need not be referred to the RO for inclusion in another supplemental statement of the case. 38 C.F.R. §§ 19.31, 19.37, 20.1304 (1999). FINDING OF FACT No competent medical evidence has been presented to show that the veteran currently experiences migraine headaches, nor is there any link shown between any such headaches and his active service. CONCLUSION OF LAW The veteran has not submitted a well-grounded claim of entitlement to service connection for migraine headaches. 38 U.S.C.A. § 5107(a) (West 1991). REASONS AND BASES FOR FINDING AND CONCLUSION The veteran contends that he currently experiences migraine headaches about once every two weeks, and that they began during his period of active service; thus, he argues that service connection is warranted for migraine headaches. Before reaching the merits of the veteran's claim, the threshold question is whether the veteran has presented evidence that his claim of service connection is well grounded. See 38 U.S.C.A. § 5107(a) (West 1991); Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). A well-grounded claim is a plausible claim, meritorious on its own or capable of substantiation. Id. at 81. An allegation alone is not sufficient; the appellant must submit evidence in support of his claim that would justify a belief by a fair and impartial individual that the claim is plausible. 38 U.S.C.A. § 5107(a) (West 1991); Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992). In order for a claim to be well grounded, there must be competent evidence of current disability (a medical diagnosis); of incurrence or aggravation of a disease or injury in service (lay or medical evidence); and of a nexus between the inservice disease or injury and the current disability (medical evidence). See Caluza v. Brown, 7 Vet. App. 498 (1995). Where the determinant issue involves a question of medical causation or medical diagnosis, competent medical evidence to the effect that the claim is plausible or possible is required to establish a well-grounded claim. Lay assertions of medical causation cannot constitute evidence sufficient to render a claim well grounded under 38 U.S.C.A. § 5107(a). Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). Furthermore, if there is no showing of the current existence of the disability, the claim is not well grounded. Rabideau v. Derwinski, 2. Vet. App. 141 (1992). Service connection may be granted for disability resulting from chronic disease or injury incurred in or aggravated by active service. 38 U.S.C.A. § 1110. Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (1999). 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, as distinguished from merely isolated findings or a diagnosis including the word "chronic." Continuity of symptomatology is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b) (1999). The veteran's service medical records reveal that a clinical evaluation of his head and neurologic system revealed normal findings at the time of his October 1992 service entrance medical examination. In August 1993, a clinical evaluation of his head and neurologic system again revealed normal findings. The remainder of the service medical records do not include any report or clinical finding of migraine headache. VA outpatient treatment records, dated in May 1995, do not show that the veteran received any treatment for headache complaints. On VA neurological examination in July 1995, the veteran reported that he experienced headaches. Examination did not reveal that he had any organic cerebral cranial nerve, bulbar or cerebellar abnormality. It was noted that his was a normal neurological examination, and he was headache free. It was also noted that the headaches he described suggested a muscle contraction pattern. On VA medical examination, conducted earlier in July 1995, the veteran reported that he experienced severe headaches about once or twice a month. Examination of his head and neurologic system was normal. The impression was that the veteran's physical complaints appeared to be part of a chronic tension state which may be part of a pattern of hypochondriasis. It was noted that he did not find any indication of significant medical illness. At his March 1997 hearing, the veteran testified that he first began to experience headaches in August 1994. He also testified that, when he sought treatment for his headaches at that time, he was advised that they were part of a back problem. He reported that he had treated his in-service headaches with Motrin. He also reported that he had a headache condition on service separation, and that the severity of his migraine headaches had increased since that time. He indicated that he continued to experience headaches about once every two weeks. On the basis of the foregoing, the Board finds that the veteran has not presented evidence of a well-grounded claim of service connection for migraine headaches. There is no competent medical evidence of record which establishes that the veteran currently experiences chronic migraine headaches, much less that they are of service origin. In particular, his service medical records are totally devoid of any report or clinical finding of a migraine headache. In addition, the VA outpatient treatment records are likewise negative for any post-service report or clinical finding of migraine headache. Moreover, although a recent VA neurological examination report includes a notation that he complained of occasion headaches, this notation was based on the veteran's own history, alone. Furthermore, this report shows that he was headache free and negative for any organic cerebral cranial nerve, bulbar or cerebellar abnormality. The Board also observes that on recent VA medical examination of the veteran in 1995, neurologic examination was normal. Thus, there is no competent medical evidence of record which establishes that the veteran currently experiences migraine headaches of service origin. While the Board is sympathetic to the views of the veteran, his claim of service connection for migraine headaches may not be viewed as well grounded under these circumstances. Caluza, 7 Vet. App. at 506. The Board has considered the veteran's contentions regarding the etiology of his claimed migraine headaches. However, as there is no showing that he is other than a layman, he is not competent to render an opinion as to a medical diagnosis, etiology or causation. See Espiritu v. Derwinski, 2 Vet. App. 492 (1992). In denying the veteran's claim of service connection for migraine headaches, the Board has considered the matter of resolution of the benefit of the doubt. However, the benefit-of-the-doubt rule is only applicable when a claim is well grounded. Epps v. Gober, 126 F.3d 1464 (Fed. Cir. 1997). Such is not the case where, as reported earlier, there is no competent medical evidence of record which establishes that the veteran currently has migraine headaches which are of service origin. ORDER Service connection for migraine headaches is denied. J. F. Gough Member, Board of Veterans' Appeals