Jump to content

NAVY GULF WAR VET

Seaman
  • Content Count

    9
  • Donations

    $0.00 
  • Joined

  • Last visited

Community Reputation

0 Neutral

About NAVY GULF WAR VET

  • Rank
    E-3 Seaman

Recent Profile Visitors

The recent visitors block is disabled and is not being shown to other users.

  1. Hi Berta, 

    Currently Im SC at 90%, and have been for over 3 years. (70% PTSD, 50% Sleep Apnea, 30% IBS and 20% hemorrhoids).  I only work 15 days a month and I have a pending claim for headaches secondary to PTSD. I have submitted all of the treatments for my headaches over the years along with what I think to be decent notes from my wife, neuro doctor, and a headache diary.  

    My claim has went from GOE to PFD back to to GOE and the PFD and so forth for over 8 months. I had a exam with QTC doctor  about six weeks ago for my frequent headaches and today I see this notice on my ebenefits: 

    "You may be entitled to compensation at the 100 percent rate if you are unable to secure and follow a substantially gainful occupation because of your service-connected disabilities. If you believe you qualify, complete, sign, and return the enclosed VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability."

    As of today,  I'm back to the GOE stage!  I don't want  to apply for TDIU yet bc Im eligible for retirement in the next two years and Im only scheduled to work 15 days a month.  I was never offered to apply for TDIU with my 70% PTSD rating.

    1) Could this be that I'm getting a new rating for my "pending" headaches that may take me to 100%? OR

    2) If I don't complete the TDIU form, will my entire claim may be denied or have a negative impact on me?  

    1. doc25

      doc25

      I received the offer to apply for TDIU when I was increased to 70% PTSD. This was in 2016. Check your decision letter, it might be in there. 

      1.) Probably, but ebenefits is an unreliable source until you see the change or no change in your disability % on there. The most reliable source is the decision letter we all receive in the mail.

      2.) You can apply for TDIU at anytime, from my understanding.

      I've provided rating criteria for Headaches. 

      Migraine Headaches

      Code 8100: Migraine headaches are a type of headache caused by the swelling of the blood vessels in the brain. They are often more severe than other kinds of headaches (stress, sinus, etc.), and so interfere more with the individual’s ability to work and function in daily life. If another kind of headache interferes significantly with daily life, it can also be rated here.

      Two things are taken into account when rating migraines: frequency (how often they occur) and severity (how bad they are). To receive a proper rating, it is essential that the physician records these clearly along with how they affect the individual’s ability to work and function.

      The term “prostrating” means that the individual must stop all activity, take medication, and either seek medical attention or seclude himself for the rest of the day. The individual is unable to perform any occupational or daily activities either because of the migraine itself or because the migraine medication makes him too drowsy, etc.

      The ratings for migraines only go up to 50%. The Rating Authorities, however, can give a higher rating if the case is so severe that 50% doesn’t truly reflect the disability. It is completely up to the Rating Authorities, however, exactly what makes a condition severe enough to warrant a higher rating.

      Frequency

      Severity

      Rating

      2 or more times per month

      Prostrating

      50%

      Once a month

      Prostrating

      30%

      Once every 2 months and prostrating

      10%

      Once every 3 months or less

      Prostrating

      0%


      If the condition does not make occupational activity impossible, then it cannot be rated more than 0%.

  2. Logged into eBenefits today and my (migraine/headache) claim went from PFD back to GOE. The estimated completion dates has been moved back to another 4 to 6 months again! The message states "We closed the notice for Request 1" which was an C&P exam. It states developmental letter sent. Previous post says this means and C&P exam has been scheduled, while another vet posted this means a C&P is not needed bc I have enough evidence. Any feedback?
  3. Thanks @Buck52. I have been following this site for a while and your knowledge and advice is greatly appreciated. So, the C&P exam listed above was from 2015. It looks like I have all the signs of the migraines, however at that time, I wasn't having them at the rate/frequency I am now. For the recently submitted claim I filed headaches related to PTSD and migraines secondary to PTSD to cover my tracks bc the 2015 C&P exam indicated I was diagnosed with tension headaches and no migraine diagnosis on the VA level. As of March 2017 I now have a diagnosis of migraines and migraine prescriptions from private PCP and private neurologist and within the past year my VA PCP prescribed and recorded my migraine headaches in my VA file and also prescribed Topamax and Sumatriptan as well. My claim has went from PFD to GOE 3 differ times within the last 6 weeks and each time its always extended over the estimated date of completion before they keep editing and changing the dates of completion. As of yesterday I went from PFD back to gathering evidence with a completion date around 7/29/2019 - 10/11/2019 and no C&P exam has been ordered (from what I can see) I know ebenefits can be tricky and I have to play the waiting game like every other vet, but has anyone every went through this for migraine claim with dates constantly changing and being prolonged for FULLY DEVELOPED CLAIM.
  4. Thanks. I submitted my claim for OSA about a year after I was SC 70% for PTSD. My wife was concerned with the lack of sleep, nightmares, and everything else mentally going on with me . Later she scheduled an appointment with my PCP who ordered me to see an ENT specialist. The ENT doctor ordered a sleep study and I was diagnosed me with OSA. The ENT doctor completed the DBQ and provided medical facts that supported PTSD and sleep apnea relationship. I submitted my claim to the VA with all of the information and they then ordered me to another specialist who indicated my PTSD was least likely affecting OSA. About 6 months later the VA approved the claim and awarded OSA.
  5. Thanks. I submitted my claim for OSA about a year after I was SC 70% for PTSD. My wife was concerned with the lack of sleep, nightmares, and everything else mentally going on with me . Later she scheduled an appointment with my PCP who ordered me to see an ENT specialist. The ENT doctor ordered a sleep study and I was diagnosed me with OSA. The ENT doctor completed the DBQ and provided medical facts that supported PTSD and sleep apnea relationship. I submitted my claim to the VA with all of the information and they then ordered me to another specialist who indicated my PTSD was least likely affecting OSA. About 6 months later the VA approved the claim and awarded OSA.
  6. Thank you for responding. What's concerning is the fact they have not schedule me for another C&P exam. I was told C&P exams are needed for majority of VA claim cases. My claim was scheduled to be completed on 02/22/2019. That date passed & then Ebenefits was updated on 03/22/2019 to be completed within 7 days on 03/29. Yet it's still in PFD. No information is needed from me or others and yet the date keeps getting pushed out. I know the process is slow, however do you have any suggestions on what may be happening with my case and why the dtae was updated to 7 days and then still surpassed? Just wondering
  7. Thank you for responding. What's concerning is the fact they have not schedule me for another C&P exam. I was told C&P exams are needed for majority of VA claim cases. My claim was scheduled to be completed on 02/22/2019. That date passed & then Ebenefits was updated on 03/22/2019 to be completed within 7 days on 03/29. Yet it's still in PFD. No information is needed from me or others and yet the date keeps getting pushed out. I know the process is slow, however do you have any suggestions on what may be happening with my case and why the dtae was updated to 7 days and then still surpassed? Just wondering!
  8. I'm a Gulf War Veteran. Over the years my migraines headaches have gotten worse and I recently submitted a claim for migraines secondary to PTSD since Im rated at 70% SC for PTSD and 50% SC for sleep apnea. See my 2015 C&P exam for migraines below: 2015 Migraine C&P Exam [ ] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. [ ] Review of available records in conjunction with a telephone interview with the Veteran (without in-person or telehealth examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided sufficient information on which to prepare the DBQ and such an examination would likely provide no additional relevant evidence. [ ] Examination via approved video telehealth [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 now have or has he/she ever been diagnosed with a headache condition? [X] Yes [ ] No [X] Tension ICD code: ICD-9-CM 307.81 Date of diagnosis: unknown 2. Medical History ------------------ a. Describe the history (including onset and course) of the Veteran's headache conditions (brief summary): He denies any specific head injuries that precipitated headaches. He reports that he was diagnosed with headaches while on active duty. He reports that his headaches are intermittent in nature. He has a headache about every other day that is rated a "6". He takes Aleve for his headaches. He denies having to leave work due to his headaches. 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): He takes Aleve ii tabs by mouth as needed to get rid of his headache. 3. Symptoms ----------- a. Does the Veteran experience headache pain? [X] Yes [ ] No [X] Pulsating or throbbing head pain [X] Pain localized to one side of the head [X] Pain worsens with physical activity 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] Sensitivity to light c. Indicate duration of typical head pain [X] Less than 1 day 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? [ ] Yes [X] 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 conditions listed in the Diagnosis section above? [ ] Yes [X] No 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? [ ] Yes [X] No 8. Remarks, if any: ------------------- Medical Opinion; VBMS was reviewed and there was no mention on his exit paperwork that he had any problems with headaches. When the veteran came to the VA for treatment, in 2009, his PCP appt. put this statement about his headaches in the record, "NEURO-tension headaches , had CT scan of head in the County ER and it was negative. No migraine headaches. No seizures, no stroke." The veterans current headache problems are diagnosable with a partially known etiology. This condition is less likely as not caused by or a result of his active duty service time in the Navy over 20 years ago. _______________________________________________________________________________________________________________________________________________________________________________________________ Since 2015 my headache severity and occurrences have almost tripled. I submitted a claim for migraines secondary to PTSD since Im rated at 70% SC for PTSD and 50% SC for sleep apnea. I submitted case notes from my PCP stating I have migraines along with prescription meds and dr. notes from non-va neurologist who diagnosed me as well and prescribed migraine meds. In January of this year, my VA dr. started prescribing me meds for my migraines as well since my insurance changed and visits to the neurologist were billed as out of network and was too high to pay out of pocket. I submitted a lay of statement from my wife, a migraine diary with 6 months of records, and my neuro dr. notes that indicate that I missed almost 5 days per month out of the 15 scheduled days because of these headaches along with meds prescribed for my PTSD that has side effects that cause headaches. Will this be enough to assist with establishing my claim? My claim has been in PFD for over 45 days and have exceeded the estimated time of completion twice and no C&P exam has been scheduled or pending. Any comments?
×
×
  • Create New...

Important Information

{terms] and Guidelines