oldtimer92

@broncovet, thanks for your advice. I want to apologize for this long post but I wanted to give you dome history. think I could do this on my own but it seems as though every time I think I have the i’s dotted and t’s crossed then the VA sucker punches me with something else. I filed for and increase of migraines in 2015 due to fact that I developed a facial tic during and after attacks. The VA referred me to. Botox doctor to treat both conditions. My claim for facial tics was denied, so I was advice to claim the diagnosed condition secondary to migraines. And that is where this journey began. I had an intent to file done every year since the initial claim was denied in 2015 until I opted into RAMP at that point I was told I didn’t need to do one because the claim was being reviewed. That was in 2018. When the claim appeared in ramp, it again read as service connected condition and I kept telling the va that it for secondary condition and not direct service connected. During this time the VA sent me to c&p exam that was suppose to be for both conditions but the examiner was only sent DBQ for increase and not second condition. But the examiner did make remarks regarding the second condition based on my history and current condition. When decision letter came they stated the examiner did not find a connection for the secondary condition. I knew this to be false because she said that it was 50 % or greater that is was from sc condition. I went to examiner and she wrote a statement to clarify this and I sent it with the supplemental claim. So I’m thinking how can you deny something that you did not ask for an opinion for? So once the supplemental was was submitted the secondary condition’s medical terminology had been changed to another condition. I was sent to another c&p exam for that condition and the examiner said that the confirm was correct. My V and VII facial nerves were damaged and she agreed at 50 or greater as well. She also stated this would affected the sc connected migraines. She also made remarks that my right side of the face was showing symptoms as well. So when I finally see the claim was closed. First thing I see is the condition rated is not the same condition that I was sent to exam for, they have made up names that are not even listed in CFR as conditions, but as symptoms. Second thing is they rated it at the lowest percentage, when CFR clearly states those symptoms should be rated higher. Third thing I see is the also rated the right side with 0 percent with the same medical terminology that I have been using since 2015. And they did that based on remarks from examiner but did not rate the condition from the other exam based on the remarks of the examiner. i think I can explain all of this in a higher level review but think an attorney would be an option after that. Again I apologize for the long post and I hope it makes sense

Can someone riddle me this please? So how does the va get away with changing the condition that you have been trying to claim for four years and they have denied before (facial nerve disorder that secondary to migraines) give you a low ball rating on the left side affected area but not the nerve that caused it. They sent me to c&p exam for facial nerve disorder. Examiner stated 50 % or greater secondary to migraines. They made up conditions like unequal smile, unequal eyebrow raise, left side droop to face. I could only find these when looking up the nerve itself and not these as conditions. Then they rate the right side with the same condition that you have been putting on my claim and denied for in the past at 0 service connected. Changed effective date to late c&p exam in 2019 because that’s when the affected areas where listed on exam.

Thanks everyone . I was wondering the same thing in regards to her writing the statement but she volunteered to do it so I’m assuming she isn’t afraid of any backlash from VA. I do know one thing she really wanted to address was the fact that they denied the secondary claim based on the exam findings and the secondary condition was not listed anywhere to be evaluated by her. But she did address it due to our conversation and put on the medical opinion that the secondary condition was at least as likely as not (50% or greater probability) due to or the result of the service connected condition and they still denied the secondary condition. Diagnosis, connection and favorable findings. So I don’t know what really happened here.

First let me apologze for this long post. I had a NOD that was submitted in 2016, I opted into RAMP in 2018. I had a c&p done in my hometown by an outsource company called LHI. Exam was very detailed and i think that was due to the fact the examiner was prior military and she suffered the same conditions i filed on my claim. i thought the exam was for both claims because we discussed both conditions. I was requesting an increase for migraines and the other was for a secondary condition from the botox injections given for the migraines. i thought it went ver well, the examiner asked me to keep in touch and let her know how everything came out. I was estatic because I felt like I was finally getting heard. Fast forward, I get my decision and both claims are denied. The letter listed all evidence reviewed, all favorable evidence with diagnosis for each condition. The denial letter said the increase was denied because examiner only stated one episode per month and the secondary was denied because examiner did not find a connection to migraines. I was baffled and lost. But I also know how exams can go great and denials come later, so my next step was to get VSO to file an appeal. Fast forward again, Im in out at the grocery store one day and the examiner seen me and walked up to asked how things were going. I wanted to say a few choice words, but I politely told her the claims were denied and the letter stated due to VA exam findings. She told me that she remembered me and my claims because she had the same conditions. She said that was not what she put on the forms and she receiving nothing in regards to the secondary condition. She said she received a questionnaire to evaluate the migraines and a medical opinion for the migraines only. She told me to request a copy of the exam and to come see her once I received it. When I got the copy, i took them to her and she read them and wrote a statement on my behalf concening both conditions. I also had VSO to help me with my statement to include with her statement. I was told by an ex-claims rater that this may not be considered new evidence. So my question: will this be considered new evidence under the supplemental lane? Or should I have done an appeal?

Update: Went in for 2nd mental health exam. I was thinking it was another one for the claim for anxiety or a followup on the noncombat ptsd. I get there and she tells me it is for a new claim for depression. So now, I am totally lost because again my claims were for 2 other conditions. Now my question is, did VA change the condition and requested a medical opinion and will they automatically deny the other claim and I have to reapply for the new claim that I went for?? by the way, the mental health doctor did service connect me for Major recurring depression with anxious distress due to traumatic event that occurred in service. Now just waiting to see what VA can come up with now!!!

Some exams are just for the fun of it for VA. I am getting sooooooooooooooooooooo frustrated right now I can just scream!!!!!!!!!!!!!!!!!!!!!!!!! Put in claim for anxiety and another claim for Ptsd (didnt know they rated under one) ONLY after speaking with VA psychologist the first time. He eventually recommended me to speak with VA Psychiatrist for medicines to help me. Now i am seeing both of them I personally sent in my medical records with dates and hospital stay of stressor/ Buddy statements, etc. Went for exam with contractor. Spent 2 hours with him, he stated that he couldnt decide if I suffered from Ptsd with anxiety disorder and depression or more anxiety and depression. As I looked back at my sessions, I have been diagnosed with as Generalized Anxiety Disorder and Adjustment DO with depression from psychologist, but never PTSD. From VA Psychiatrist it states Insomnia, other trauma related anxiety, mood disorder, panic disorder, but AGAIN, never has written ptsd. First time ptsd was said to me was during the c&p exam by the VA contractor BUT, I am assuming the doc for the Ptsd wasnt clear enough in his wording because after all these months claim went back to gather evidence for a medical opinion and/or 2nd ptsd exam. I had requested my C-file and C/P notes in February, I am told they are behind and it could be 3-6 months before I get them. What on God's green earth could possibly be the hold up now?

Thanks Buck52 and Berta, I have copies of my medical and the event, with dates are in there along with some of the info. But my reports does not got into detail regarding the things that occurred while I was in ICU, like the hemorraging, blood transfusions, etc at the hospital. I did send in a Buddy statement from my roommate that was there with me thru the whole thing.

UPDATE: This is what the status of my claim changed to as of this morning. I submitted SMR, lay statements and VA clinic medical records, also had a C&P exam thru QTC for anixety and PTSD. Now they are wanting this, what gives? Are they trying to help me or give more reason to deny claim. We need specific details of the stressful incident(s) in service that resulted in post traumatic stress disorder (PTSD). It is important that you read the following information and respond to our request within 30 days from the date of this letter. If you do not respond, VA may deny your claim. * Complete and return the enclosed questionnaire. If you are not able to provide the exact date of the incident, please indicate the location and approximate time (a 2-month specific date range) of the stressful event(s) in question. * Provide reports of private physicians, if any, who have treated you for this condition since discharge. The reports should include clinical findings and diagnosis. * If you have been treated for this condition at a VA medical facility, furnish the date(s) and place(s). We will obtain the report(s).

Ok, in Nov '16, I sent in a letter requesting a reconsideration with new material and evidence on a decision that was denied in Dec '15. I sent this information to the Intake Center, well Dec 23, I finally just sent information again on ebenefits so I would not lose my 1 year date, but on Ebennie, I also included new claims that I was told I needed to submit. I completed the NOD form and included it with documents for the claims I disagreed. At the beginning of March claimed moved to prep for decision, then 2 weeks later it was sent back to review of evidence, the next day it moved back to review of evidence. They hadn't rated any of the claims, but they sent me a letter stating they needed a NOD form from me, but I had already sent one. So now I am waiting in Gathering of evidence. So any ideas as to why they requested that form again?

So what is going on for the claim to get stuck in prep for decision if no other documents are needed?

My claim status went to prep for decision on 3/3 but estimated date changed from April to May. I was confused on this too because no more documents needed. So why move the date further out? Thanks

I went online and googled the VA ROI form and faxed it to the intake center. It will give you the fax number to send it to. Hope this helps.

Gastone, No sir, I had a QTC exam with Psychiatrist for my claims. I have been seeing VA Psychologist for last 8 months, he has referred me to VA Psychiatrist for mental health counseling and medication regulation. Never done PTSD screenings. During the evaluations with the QTC Psychiatrist and the VA Psychiatrist, both made the statement that I have PTSD symptoms but dont fit all the criteria to be diagnosed with it totally. QTC doctor stated he couldnt make a opinion if I was suffering more from PTSD or depression.

ok, so I went to 1st mental health appointment with psychiatrist yesterday. He also said symptoms of PTSD but not full criteria. Don;t see his notes on HealthVet yet. He also wants to study mt sleep habits and feel like I may have sleep disorder. Gave me sleep diary to do for 2 weeks. Will decide on my next visit in a month if I need to do sleep study. I sent in ROI for QTC exams, I was told it could take up to 30 days to get them and claim maybe already decided by the time I get them.

Thank you both. The exam was for both claims. I do have current diagnosis from Va mental health psychologist of generalized anxiety disorder which also includes depression diagnosis. He has also referred me to see psychiatrists to get correct medicine. Both stressors have to do with near death event while an active duty and the psychologist is the one that really pointed out to me that I keep living in the past and can't get past it and the trigger was the death or my sister(my best friend) and then her husband 2 months later and coping with that because we live right across the street from one another.

Hello All, Put in 1 claim for anxiety and depression and 1 for ptsd(noncombat). Had QTC exam today.. Doctor said I have signs of ptsd but dont meet full criteria for it. Definitely have anxiety and depression. But he couldnt say if my issues are more of the ptsd or the depression, but I needed to continue counseling. So is this good or bad?

OK Experts, I am currently rated 30% under migraines for headaches NOS. Before i ever put in a claim, I was experiencing jumping of my left eye. I kept going to my family doctor and telling her about the issue and also at my year eye exams. Explained the issue with my optometrist. Kept being told it could be stress, eye strain, lack of sleep. As my headaches became more frequent due to the issue or thee issue made headaches that much worse and the jumping moved down the side of my face to my lips. Well this scared me so I made an appointment with an opthamology specialist, he ordered a cat scan. Diagnosed as hemificial spasms: hemifacial spasm by definition a disorder of the facial nerve characterized by unilateral involuntary paroxysmal contractions of the facial muscles,caused by high-frequency bursts of motor units lasting from a few msec to several seconds; reported causes include compression of the ipsilateral facial nerve near its exit from the 9pons by a vascular malformation, compression of theipsilateral facial nerve by a posterofossa neoplasm, and idiopathic derivations Condition is the same as having convulsive tics or terret syndrome. I was told by the opthamologist that I could have a surgery or do botox injections. This would help with the tics and the headaches. So I choose to do botox every 4 months. First few rounds went great no issues, now all of a sudden I have muscle weakness and a droopy left eye. Given eye drops to help raise the eye lid. This of course is affecting my vision in my left eye. I filed a claim with hemifacial spasms secondary to migraines, of course the claim was DENIED. VA says that this was not caused by headaches and I know it started when headaches increased and intensified. I was going to drop it and let it go, but now with these new issues and I am being told that they dont know if this will reverse it self or this will be my permanent look. I have until December to file for an appeal. Do I submit a new claim or do I file for muscle weakness, convulsive tics, droopy eye or all separate as secondary to migraines or secondary to botox that was treating the migraines? Thanks in advance

Sorry in advance, but this is a long one. History: currently 30% for migraines. Diagnosed with this eye condition through MRI and told it is caused by migraines. Had C&P exam for increase on migraines. then they scheduled this one. I have attached both exam. the first one is for the increase. the second one is for the secondary conditions that I feel are caused by the migraines. This last exam looks like it shot my in the head dead. please tell me you opinion. first exam no medical opinion. second exam states IMP not related. but I have an appointment with the VA opthamologist surgeon later this month. Was the Veteran's VA claims file reviewed? [X] Yes [ ] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: vbms If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [ ] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: 1. Diagnosis ------------ Does the Veteran now have or has he/she ever been diagnosed with a headache condition? [X] Yes [ ] No [X] Migraine including migraine variants ICD code: 784.0 Date of diagnosis: 2009 2. Medical History ------------------ a. Describe the history (including onset and course) of the Veteran's headache conditions (brief summary): CO- "patient not aware when headache and migrains strated but got got worst in basic training, also in Germany after she delivered her daughter with migrains". Frequency of headache and migrains-18 per month. Prostrating attack frequency-5 per month. Work:- Computer private sector-full time for past three years b. Does the Veteran's treatment plan include taking medication for the diagnosed condition? [X] Yes [ ] No If yes, describe treatment (list only those medications used for the diagnosed condition): Meloxicam.Sumatriptan. 3. Symptoms ----------- a. Does the Veteran experience headache pain? [X] Yes [ ] No [X] Pain on both sides of the head [X] Other, describe: sharp b. Does the Veteran experience non-headache symptoms associated with headaches? (including symptoms associated with an aura prior to headache pain) [X] Yes [ ] No [X] Nausea [X] Vomiting [X] Sensitivity to sound [X] Other, describe: dizzy,eye twitches,concentration problems c. Indicate duration of typical head pain [X] 1-2 days d. Indicate location of typical head pain [X] Both sides of head 4. Prostrating attacks of headache pain --------------------------------------- a. Migraine / Non-Migraine- Does the Veteran have characteristic prostrating attacks of migraine / non-migraine headache pain? [X] Yes [ ] No b. Does the Veteran have very prostrating and prolonged attacks of migraines/non-migraine pain productive of severe economic inadaptability? [X] Yes [ ] No 5. Other pertinent physical findings, complications, conditions, signs and/or symptoms ----------------------------------------------------------------------------- a. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis section above? [ ] Yes [X] No b. Does the Veteran have any other pertinent physical findings, complications, conditions, signs and/or symptoms related to any 56 conditions listed in the Diagnosis section above? [X] Yes [ ] No If yes, describe (brief summary): HTN,Anxiety 6. Diagnostic testing --------------------- Are there any other significant diagnostic test findings and/or results? [ ] Yes [X] No 7. Functional impact -------------------- Does the Veteran's headache condition impact his or her ability to work? [X] Yes [ ] No If yes, describe the impact of the Veteran's headache condition, providing one or more examples: Slows her prodoctivity. 8. Remarks, if any: ------------------- PE: BP-136/75 -HEENT-normocephlaic,EOME,PERLA,no facial drops or tongue deviations,cranial nerves II/XII gorssly normal. -Neck-Supple, no JVD or carotid bruits. Current level of headache and migrain severity:- moderate to sever based on subjective reporting by patient. [X] In-person examination Evidence review --------------- Was the Veteran's VA claims file reviewed? [X] Yes [ ] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: VBMS If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [ ] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: 1. Diagnosis ------------ Does the Veteran have a peripheral nerve condition or peripheral neuropathy? [X] Yes [ ] No Diagnosis #1: henifacial spasm Date of diagnosis: 2014 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's peripheral nerve condition (brief summary): 51 Y/O female. Service connected for headaches. Pt was in the National Guard until 2003. Onset of twiching left eye in 2012. The twiching has progressed to a left hemifacial spasm at the present. b. Dominant hand [X] Right [ ] Left [ ] Ambidextrous 3. Symptoms ------ Does the Veteran have any symptoms attributable to any peripheral nerve conditions? [X] Yes [ ] No Constant pain (may be excruciating at times) [X] Other symptoms (describe symptoms, location and severity): Left facial nerve 4. Muscle strength testing -------------------------- a. Rate strength according to the following scale: 0/5 No muscle movement 1/5 Palpable or visible muscle contraction, but no joint movement 2/5 Active movement with gravity eliminated 3/5 Active movement against gravity 4/5 Active movement against some resistance 5/5 Were special tests indicated and performed for median nerve evaluation? [ ] Yes [X] No b. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms? [X] Yes [ ] No If yes, describe (brief summary): Pt received the first and only Botulin toxin injections March 2015 with an improvement of the spasms of 60%. it was a small dose. 15. Diagnostic testing a. Have EMG studies been performed? [ ] Yes [X] No b. Are there any other significant diagnostic test findings and/or results? [X] Yes [ ] No If yes, provide type of test or procedure, date and results (brief summary): Normal MRI and CAT of the head reported by the patient 16. Functional impact --------------------- Does the Veteran's peripheral nerve condition and/or peripheral neuropathy impact his or her ability to work? [X] Yes [ ] No If yes, describe impact of each of the Veteran's peripheral nerve and/or peripheral neuropathy condition(s), providing one or more examples: Data entry on a computer. Spasms distracts her concentration at work. 17. Remarks, if any: -------------------- IMP Left hemifacial Spasms unrelated to her service connected Migraines headaches

Hello All, not sure if I am posting this right so I am trying it again. Here is my c&p exam for increase on migraines. I also filed the new claim for hemifacial spasms, other facial nerve disorder, eye twitching. After I got back from my exam, I got a call to see an Opthamology Surgeon next month for the spasms. Also I am concerned about the mention of anxiety and HTN in the remarks from the doctor. Any Feedback?? Was the Veteran's VA claims file reviewed? [X] Yes [ ] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: vbms If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [ ] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: 1. Diagnosis ------------ Does the Veteran now have or has he/she ever been diagnosed with a headache condition? [X] Yes [ ] No [X] Migraine including migraine variants ICD code: 784.0 Date of diagnosis: 2009 2. Medical History ------------------ a. Describe the history (including onset and course) of the Veteran's headache conditions (brief summary): CO- "patient not aware when headache and migrains strated but got got worst in basic training, also in Germany after she delivered her daughter with migrains". Frequency of headache and migrains-18 per month. Prostrating attack frequency-5 per month. Work:- Computer private sector-full time for past three years b. Does the Veteran's treatment plan include taking medication for the diagnosed condition? [X] Yes [ ] No If yes, describe treatment (list only those medications used for the diagnosed condition): Meloxicam.Sumatriptan. 3. Symptoms ----------- a. Does the Veteran experience headache pain? [X] Yes [ ] No [X] Pain on both sides of the head [X] Other, describe: sharp b. Does the Veteran experience non-headache symptoms associated with headaches? (including symptoms associated with an aura prior to headache pain) [X] Yes [ ] No [X] Nausea [X] Vomiting [X] Sensitivity to sound [X] Other, describe: dizzy,eye twitches,concentration problems c. Indicate duration of typical head pain [X] 1-2 days d. Indicate location of typical head pain [X] Both sides of head 4. Prostrating attacks of headache pain --------------------------------------- a. Migraine / Non-Migraine- Does the Veteran have characteristic prostrating attacks of migraine / non-migraine headache pain? [X] Yes [ ] No b. Does the Veteran have very prostrating and prolonged attacks of migraines/non-migraine pain productive of severe economic inadaptability? [X] Yes [ ] No 5. Other pertinent physical findings, complications, conditions, signs and/or symptoms ----------------------------------------------------------------------------- a. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis section above? [ ] Yes [X] No b. Does the Veteran have any other pertinent physical findings, complications, conditions, signs and/or symptoms related to any 56 conditions listed in the Diagnosis section above? [X] Yes [ ] No If yes, describe (brief summary): HTN,Anxiety 6. Diagnostic testing --------------------- Are there any other significant diagnostic test findings and/or results? [ ] Yes [X] No 7. Functional impact -------------------- Does the Veteran's headache condition impact his or her ability to work? [X] Yes [ ] No If yes, describe the impact of the Veteran's headache condition, providing one or more examples: Slows her prodoctivity. 8. Remarks, if any: ------------------- PE: BP-136/75 -HEENT-normocephlaic,EOME,PERLA,no facial drops or tongue deviations,cranial nerves II/XII gorssly normal. -Neck-Supple, no JVD or carotid bruits. Current level of headache and migrain severity:- moderate to sever based on subjective reporting by patient.

Hello All, Thanks for responding to my question. Yes, I had the brain MRI with and without contrast in March 2015. The optometry specialist I was seeing did write a statement saying the migraines and spasms do affect each other. So I am going to have to experience that again and its only been 4 months. All records from optometrist and MRI paperwork requested from VA. I am going to the C&P next week,

Thanks for all the replies back. That helps me a lot but please tell me this: For the 30% granted on migraines, I told the examiner that I was having these 1-2 a week, he put once a month on exam. Ironically last week before I got my c & p exam results & decision in the mail, I had gone to private doctor to change medicine because of the frequency of the migraines that were happening. So do I get something for private doctor or just go to VA and wait a couple of months.