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IU C&P result

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dt124345

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This is my first post. I am rated 70% overall, 50% for migraines, 30% for shoulder, and 20% for back. This rating came in mid-november 2015 and I immediately applied for IU. I had another set of C&P exams that were requested and performed only four months after my original C&P exams in August. My veterans representative has sent me copies of all three C&P exams. The exam for the back has rom that is more restrictive then the original exam. It says that flexion is now 0 to 30 degrees, and extension 0 - 10 degrees. The first back exam said 0 - 40 + 0 - 15. The shoulder exam was unchanged. The back exam also says "veteran is unable to perform both sedentary and manual labor due to rom and pain." The shoulder exam says veteran unable to do manual labor, due to pain and limited range of motion, especially unable to do any overhead lifting. Now the migraine exam is the one I have a real problem with. My first migraine exam said veteran has frequent and prostrating migraines 2 - 3 times per month, & I saw the second exam and the boxes were not checked for prostrating and frequent migraines. These exams were all performed by a different doctor than the first exams just four months earlier. The back and shoulder exams that I just had we're by an orthopedic surgeon at the local VA hospital. The 2nd migraine exam was performed by a retired radiologist who is under contract to MSLA. So my question is, can the VA reduce my migraine rating based on the more recent exam, even though I told the examiner that my migraines have gotten worse and are prostrating and frequent? And a second question is, since the DBQ on both of my back exams both said that sedentary and manual labor was not possible, are just those exams enough to award IU?

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1 hour ago, dt124345 said:

This is my first post. I am rated 70% overall, 50% for migraines, 30% for shoulder, and 20% for back. This rating came in mid-november 2015 and I immediately applied for IU. I had another set of C&P exams that were requested and performed only four months after my original C&P exams in August. My veterans representative has sent me copies of all three C&P exams. The exam for the back has rom that is more restrictive then the original exam. It says that flexion is now 0 to 30 degrees, and extension 0 - 10 degrees. The first back exam said 0 - 40 + 0 - 15. The shoulder exam was unchanged. The back exam also says "veteran is unable to perform both sedentary and manual labor due to rom and pain." The shoulder exam says veteran unable to do manual labor, due to pain and limited range of motion, especially unable to do any overhead lifting. Now the migraine exam is the one I have a real problem with. My first migraine exam said veteran has frequent and prostrating migraines 2 - 3 times per month, & I saw the second exam and the boxes were not checked for prostrating and frequent migraines. These exams were all performed by a different doctor than the first exams just four months earlier. The back and shoulder exams that I just had we're by an orthopedic surgeon at the local VA hospital. The 2nd migraine exam was performed by a retired radiologist who is under contract to MSLA. So my question is, can the VA reduce my migraine rating based on the more recent exam, even though I told the examiner that my migraines have gotten worse and are prostrating and frequent? And a second question is, since the DBQ on both of my back exams both said that sedentary and manual labor was not possible, are just those exams enough to award IU?

Where do you work?  Who did you work for?  When did you leave or lose your job?  Have you applied for SSDI?  Why the reevaluation on the shoulders and back seem optimistic.  I believe the you need a doctors statement stating due to the severity of your migraines. The Veteran is more likely unable to maintain any gainful employment.  Furthermore, it's my (doctors opinion) the condition is permanent & total in nature.  The VA doctors can place this opinion right into your VA medical records.  Getting the doc to concur is the trick.

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Left work in 2009 due to above disabilities.  On SSDI as of 2011.  First C&P exam for migraines said as likely as not service connected and said migraines were frequent and prostrating. Migraines were rated at 50% from August 2015 c&p exam.  I do not know why December C&P exam for  migraines  did not list migrsines as prostrating.  The examiner had all my records and check the box that he reviewed them. Can va reduce migrains for the second CMP exam?

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Reductions must meet very specific criteria.  There are "3" rating protection milestones.

1.  5 years or Permanent and Total.  If you have had a rating for more than 5 years OR VA has rated you as P and T, then your condition is considered "stabalized, as in 38 CFR 3.344:

3.344 Stabilization of disability evaluations.

(a) Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.
(b) Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, §3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.
(c) Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.
end of 3.344 quote.
2.  The next milestones, which makes it even harder for VA to reduce are at 10 (service connection)  years and 20 years which can not be reduced unless the VA can prove fraud.  
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2 hours ago, dt124345 said:

This is my first post. I am rated 70% overall, 50% for migraines, 30% for shoulder, and 20% for back. This rating came in mid-november 2015 and I immediately applied for IU. I had another set of C&P exams that were requested and performed only four months after my original C&P exams in August. My veterans representative has sent me copies of all three C&P exams. The exam for the back has rom that is more restrictive then the original exam. It says that flexion is now 0 to 30 degrees, and extension 0 - 10 degrees. The first back exam said 0 - 40 + 0 - 15. The shoulder exam was unchanged. The back exam also says "veteran is unable to perform both sedentary and manual labor due to rom and pain." The shoulder exam says veteran unable to do manual labor, due to pain and limited range of motion, especially unable to do any overhead lifting. Now the migraine exam is the one I have a real problem with. My first migraine exam said veteran has frequent and prostrating migraines 2 - 3 times per month, & I saw the second exam and the boxes were not checked for prostrating and frequent migraines. These exams were all performed by a different doctor than the first exams just four months earlier. The back and shoulder exams that I just had we're by an orthopedic surgeon at the local VA hospital. The 2nd migraine exam was performed by a retired radiologist who is under contract to MSLA. So my question is, can the VA reduce my migraine rating based on the more recent exam, even though I told the examiner that my migraines have gotten worse and are prostrating and frequent? And a second question is, since the DBQ on both of my back exams both said that sedentary and manual labor was not possible, are just those exams enough to award IU?

My apologies but I think you are getting a little ahead of yourself. I am not trying to be insensitive but try to relax.  It is very normal for VA to request more exams once a veteran files a claim for TDIU. Your ratings may or may not change but VA wants to know if your service connected disabilities causes you to be unemployable. As long as you have a medical opinion that at least one of your service connected disability cause you to be unemployable then you should be fine.

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1 hour ago, dt124345 said:

Left work in 2009 due to above disabilities.  On SSDI as of 2011.  First C&P exam for migraines said as likely as not service connected and said migraines were frequent and prostrating. Migraines were rated at 50% from August 2015 c&p exam.  I do not know why December C&P exam for  migraines  did not list migrsines as prostrating.  The examiner had all my records and check the box that he reviewed them. Can va reduce migrains for the second CMP exam?

Were you being treated for migraines in the service?  Are you a combat Veteran? Yes, the VA can propose to reduce migraines should there be any indication of improvement.  You'll get a proposal to reduce from the VA via the mail. If that is in fact what they decide.  If they should propose to reduce.  The service officer should request a hearing.  Which allows you to get new medical evidence regarding your migraines.  The evidence needs to show at least no improvement and at best worsening.

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Also, I did not yet answer your second question:

1. (No I dont think they can reduce unless they do a proposed reduction where they give you sixty days notice and an opportutunity for a hearing.)

2.  Yes, your evidnece for TDIU is favorable.  You posted,   "veteran is unable to perform both sedentary and manual labor due to rom and pain." 

     As long as you are service connected for "rom and pain", this would be compelling evidnece for TDIU, which is "inability to maintain SGE due to sc conditions.".  Hopefully the doc explained WHY (medical rationale).  

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