bellrungboxer

@Warrior and @goaltender, sorry to revive an old and possibly "dead" post, but I have a SC TBI and complex sleep apnea (mainly central). I have a VA sleep doc who filled out a DBQ and is on record saying my central aspect of my sleep apnea is "more likely than not" due to my TBI, but I just found out my secondary connection claim failed. Did either of you receive any connection to your head injuries for a central/mixed/complex sleep apnea?

So I took a look through Myhealthevet and found a note from November 2018 where my infectious disease doctor noted that I had "1 to 2 migraines a month" when I was hospitalized for meningitis. I was just approved for 50% due to 1 to 2 migraines per month and sometimes lasting more than one day, which was submitted October 2019. Aside from that, I submitted my migraine log that went back to July 2019, so maybe there is a fighting chance...but what I don't understand in the quoted text above is what is listed in subparagraph B. This was the rating that took me to 100% P&T, but I don't get the 30 days part. Hopefully all of this is moot if another claim of mine that goes back to August 2018 gets approved.

That...is definitely odd. Why can't more C&P exams come with snack opportunities? The WH hotline was also surprised when I informed him that I was never screened for COVID-19, there was a man who had just been in the patient room coughing his lungs out in the lobby with no mask on, and I had to ask them to sanitize the patient room before I went in. This place more resembled a place you would go to sell one of your kidneys on the black market than a health care provider's office. Just yikes all around. I should have everything that I need in my treatment records while in service and at the VA. The previous denial is because the rater did not see "enough evidence between diagnosis in service and current diagnosis to establish a chronic issue". This was how the topic of evidence came up because I told her that when you have GERD and don't have health insurance, you don't go and see the doctor multiple times about heartburn/nausea/regurge....you take some OTC meds, change your diet, and hope for the best. Luckily, I had a patient record from back in 2015 showing that I saw a doctor for chest pain radiating to back and arm with nausea/heartburn where I was sent to get a gallbladder scan that showed no issues. Hopefully, they don't make me dig for more between 2010 and 2015...but I wouldn't put it past them.

I submitted the online survey and I'll look up how to contact the WH phone # for good measure. Hopefully they will give GERD the service connection needed, rate it to 30% and then I can start the process of getting the effective date changed. May even challenge the effective date of my migraine increase because I submitted my journal that went back to June and they set the date to receipt of request in October. ** I contacted the WH hotline and told them about this experience (there was even more that went wrong at this C&P) and the guy who answered was floored. He said that everyone has stories about bad C&P exams, but that mine was beyond belief. They asked if I wanted a new C&P done, but I said I would request that if denied. He then told me he was forwarding my account to the undersecretary.

Thanks @Vync I had my GERD C&P exam this morning and I'm not confident that it went well. The NP didn't have my records, admitted she would know less than my GI doc at the VA (who claims it is related to SC anxiety), and she was looking up information about GERD treatment on her phone! Top it all off, when I gave her my copies of my records I brought and said "the evidence is in here but the VA refuses to look at it" she piped back telling me that if the proof isnt there the raters will deny because of "so many people faking to get free money". I'll be filling out my survey card and we will see how things go

Has anyone here ever received a separate rating for GERD and IBS? I had claims for Diverticulitis, IBS & GERD, and it appears that they have lumped Diverticulitis and IBS together, but GERD is its own condition and I'm trying to figure out why. The IBS claim was not listed in my STRs and it is claimed as secondary to SC anxiety. This was backed up by my VA doctors, and should be rated at a 30%, but the raters combined it with Diverticulitis and gave it a SC 0% rating (will be appealed soon). GERD was listed in my STRs and I have two VA Doctor's medical opinions that it is worsened by SC anxiety. The original claim was due to the diagnosis in my STRs, and it is in appeals because they denied it because they deemed that it had no functional impact on my life and was not chronic enough. I have all the symptoms to meet the 30% requirement and I have a C&P exam through QTC tomorrow for the deferred GERD claim. Very strange that they haven't moved them together to give one 30% rather two, but I won't complain...I just want to know if it is possible/has ever been done?

@broncovet I think I figured it out, and I'm afraid it won't be in my favor, but I could be wrong. I looked through "My Documents" tab on eBenefits, and the earliest document available on there is a VA 21-526EZ, Fully Developed Claim that was signed and submitted by my VSO on August 28, 2018. It lists my shoulder, ankle, laryngitis, GERD. I'm guessing that my VSO saw these items in my STRs and put the claim in for me. These issues would have all been dated back to their diagnosis date while in the service circa 2007 to 2009. What is surprising is that this claim includes my tinnitus claim as well. I cannot remember if I had claimed the Tinnitus for my original ITF that had the TBI/Migraines/Depression, but the award date for the Tinnitus claim was set to my original ITF date of June 2007. These were all combined into one claim, so maybe that is why it is all screwy. Your comment on the doctor giving an effective date, would this be found in the C&P exam? I am hoping my VSO is willing to comb through the C-file to sort this stuff out...

Thanks @broncovet, As I read more and more on this website, I'm learning quite a bit about my situation. I'll take a look at the increase for the migraine headaches, but since my situation is that I did not give an accurate account on the frequency of them at my first C&P exam, my guess is that they won't rate it back to the original claim date...but I won't complain if they do. The supplemental claims I am waiting on being reviewed are for Mixed Sleep Apnea (Secondary to TBI, should be 50%), Migraine Headaches (increase to 50%), GERD (Secondary to anxiety/depression, should be 30%), and they combined my IBS (should be 30%) with a SC 0% rating for Diverticulitis. My VSO called to let me know that my Migraine Headaches were going to go up to 50% and put me at 100% P&T, but made it sound like my IBS & Diverticulitis was still rated at 0% because they are for some reason rating it as if it is a peritoneal adhesion rather than IBS symptoms...the IBS symptoms hit 30% no problem and the higher rating should prevail...but they keep saying that although I have near constant alternating diarrhea and constipation, bloating, and gas pain (IBS 30%) I don't meet the peritoneal adhesion for 10%, so it is a 0% SC rating. However, I just learned about 4.114 (Pyramiding Digestive Issues), which may change things. Currently my GERD is being rated separately from the other digestive issues and is showing that it is still "deferred". It seems like they would end up combining it with the IBS and Diverticulitis, and hopefully give me 30% for the rating because I know my symptoms meet the 30% GERD rating to a T...I also hope they would rate these secondary to my anxiety/depression, which is a static disability. The hope that I have for a change to the effective dates for my previous shoulder, ankle, laryngitis/pharyngitis, and GERD claim, is that I am awarded the GERD and it is set at the incorrect August 28, 2018 date. I will then file for a NOD based on the fact that two of my rating decision letters (Feb 2019 and Sept 2018) that involved these claims state the following: The September 11, 2018 decision letter granted the TBI, migraine, and depression/anxiety, but deferred the other items above. The introduction still says that the original disability claim was received on March 30, 2018, and has no mention of anything being submitted or received August 28, 2018. The TBI, migraine, depression/anxiety, and my tinnitus were all in my very first intent to file June 26, 2017. The rest of the issues (aside from my diverticulitis) I'm assuming were submitted as claims after their receipt of my service treatment records showed these diagnoses because I never personally submitted them myself. I have contested the diverticulitis/IBS twice since this letter and the noncompensable evaluation basis has also included: On May 2nd, 2019 Abdominal distress Disturbances of bowel function (38 CFR 4.31) On January 4, 2020 Alternating diarrhea and constipation Diarrhea (38 CFR 4.31) Sorry for the encyclopedia, I tend to lose focus and ramble (TBI), so I hope some of this made sense. I wish I had found this community earlier, but you all have been helping me a ton since joining, so thank you!

Now that I'm thinking about this, I don't know that I can file a NOD for the effective date because I think I'm past the 1 year mark. I might be able to push my GERD back to the correct date, but it won't do me any good if my other issues aren't also moved to the correct date... ...maybe this would be a CUE claim since it would have sent me from 90% to 100% at an earlier date?

I had a TBI in service and had to dig and dig and press and call to get those service records and it not only granted me the TBI, but it opened up new claims for things I hadn't thought to claim. I was lucky and I had a private practice TBI doc and Psych for my C&Ps who were nice. Unless you saw a therapist in the service, you will need the documentation for the TBI. Mine only stated that I was treated for post-concussion syndrome and it warranted them to perform the C&P. Once you get the TBI records, you will have your nexus, service diagnosis, and current diagnosis/treatment. If you get the TBI claim approved, the headaches, depression and anxiety should be able to be tied to the TBI as secondary conditions. Fight hard to get that record, it will be well worth the struggle!

You prompted me to do a double check on my EEDs to see if there were any issues...at a quick glance of my second set of claims they definitely put the effective date of my C&P (Aug. 2018) rather than the date they received my submittal (March 2018) for several issues that were in my STRs. The GERD was in that group and would have netted me a 100% at that time if they rated me for the 30% it should be...so I'm wondering if I have a case for a few extra months of back pay.

Do you have a current diagnosis of GERD? I have been fighting for my GERD secondary to TBI/depression/anxiety and despite there being notes of "reflux" in my STRs, statement of self treatment with diet and otc drugs, and an endoscopy confirming GERD. They keep hanging their hats on a doctor's note that misquoted me when I said that my self treatment reduced the frequency of symptoms...it's frustrating. I don't know what symptoms you have, but because I was having difficulty swallowing and regurgitation, my speech pathologist ruled out everything but GERD with a swallow test. They then sent me for an endoscopy and it scored me the diagnosis. I'm still waiting on my complex sleep apnea claim from my TBI as well, so I'm pulling for you!

Nothing formal yet, and I'm shocked at how quickly they made their decision on this supplemental, so I'm holding off on the real celebrations until then. When my claimed conditions disappeared in vets.gov tracking, I asked my VSO if there was a reasoning for it. She stated that the 0% to 50% cleared, but my IBS claim was yet again denied because they continually confuse it as being a claim for diverticulitis (which I also have). They combined the two of them as "diverticulitis with irritable bowel syndrome" so that they can continually made the argument that there is no sign of diverticulitis, so nothing is warranted despite IBS being an entirely different issue. So there is a fight there to be won since it is secondary to the anxiety/depression from my TBI, and I'm still waiting to hear back on my secondary Central Sleep Apnea and GERD claims. If the GERD comes through, I'm putting my money on an EED appeal. Those should be 30%, 30%, and 50% and give me breathing room above the 100%.

You nailed it on the head. My VSO just called to let me know that one of those missing issues was granted and put me to 100% P&T!

Well...disregard my previous post. My VSO had a coach contact our VARO about my missing claimed conditions on vets.gov, and they just called me to say that the migraines were increased from 0% to 50%! I finally reached 100% P&T!!!

I posted on this a little bit in another forum with Pete and Vync, but I never received a proposed reduction notice and my disability was supposedly "static" when it was given the EED of June 26, 2017. That decision letter has no date for reevaluation and states that "A higher evaluation of 50 percent is not warranted for migraine unless the evidence shows very frequent completely prostrating and prolonged attacks productive of severe economic inadaptibility. My very first rating's C&P, I only had an approximation and told the doctor it was roughly once a month. I went for the increase because my TBI doctor asked me to keep a log of my migraines in June 2019 and as of October 2019, I was averaging 2 workdays lost per month due to migraines with the highest amount being 3 days in a month. Literally, right before this C&P exam in December I had a two day long migraine and the doctor even made mention of it. This was what the C&P Exam says: So his C&P exam is conflicting. He states that I have to be home from work because they're prostrating, but it doesn't impact my economic inadaptability...I have 2 or more occurrences a month, but he stated it is "less frequent attacks". He also then somehow confused a shoulder claim I have with my TBI related migraines. In all honesty, this doctor is in his late 70s or early 80s and struggled to use his computer to go through my records...which made us run out of time on the exam and he said he would complete the rest on his own. Here is the Decision Letter:

I'm new to the site and I've been reading a lot of posts talking about how seeing claim or appeal status via vets.gov/VA.gov. I was able to use this site for my regular claims, but for my supplemental claims, I have always had the status of "We don't know your status". I also had two of my "issues on review" just completely disappear from the tracking site. I've called Peggy and I've gone through the "Submit a question to VA" and they both had no idea what was going on. Has any body else dealt with issues like this on vets.gov/VA.gov?

I recently submitted a request for increase (30% to 50%) for my migraine headaches and when I was denied, they also dropped my rating to 0%. I am in the process of appealing and I am wondering if they are to deny the 50% and restore my rating back to 30%, will my Effective Date for the original Migraine rating be changed to the date of the increase request? This would make a HUGE difference because if my GERD rating that is deferred from August 2018 were to be successful, it would have put me at 100% almost two years ago had I not made the mistake of submitting a migraine increase request in October 2019...did I screw myself here?

Ok, I'm sorry I got it confused. I'm relatively new to this cat and mouse game and was excited to finally see some hope.

The decreased rating decision was made on January 4th and I submitted a supplemental appeal the day that I received news of my 0% reduction ( January 6th). I then made the appointment to meet with my TBI doc at the VAMC to get a DBQ filled and submitted on January 30th. EBenefits shows that they changed the effective date to the date of the C&P examination (December 11th), which I thought should be the date that my request was received October 21st. So the treatment notes from my TBI doctor on December 13th states that I have "Chronic headaches [1-2 "migraines" / month with severity 7 or 8 out of 10]" which I guess was never reviewed by the rater? Your point about the doctor not being able to state that I deserve a higher rating makes sense, but his C&P exam notes are all over the place: So his C&P exam is conflicting. He states that I have to be home from work because they're prostrating, but it doesn't impact my economic inadaptability...I have 2 or more occurrences a month, but he stated it is "less frequent attacks". He also then somehow confused a shoulder claim I have with my TBI related migraines. In all honesty, this doctor is in his late 70s or early 80s and had no grasp on how to use his computer...which made us run out of time on the exam. So, I don't get the increase to go to 95%, and instead end up going from 93% to 89% My guess is that they claimed there is no new information on file showing that I have more than 1 migraine per month average...but even without viewing that evidence that was available on December 13th, my June visit with my TBI doctor where he advised me to keep a migraine log states: "Reports HAs ~ 1x/ month, some relationship to stress". I think that would be enough to keep my 30%, and the rater is not justified whatsoever in giving me a reduction. It only gets worse from there though: I had another C&P exam scheduled for February 27th. After talking with the front desk clerk scheduling the appointment AS WELL AS contacting Peggy 1-800 it was confirmed to me that the new C&P was for my supplemental appeal for GERD. On the day of my appointment, I was called saying that my C&P examiner was out sick and instead of rescheduling, they put me with a new C&P examiner. When I get to the exam, I am informed that my C&P is for my migraine headaches appeal, which I have none of my evidence for. The examiner then admits she had not reviewed any of my treatment records or medical history and questioned my eligibility as a veteran... I stopped the C&P exam at that point, stated that I was extremely uncomfortable with continuing under the circumstances and filed a statement explaining why I should be rescheduled for a new C&P exam with my VSO.

This exact scenario just happened to me and I don't know if I have handled it correctly or if I need to go further. My VSO has not really given me much advice because most of their staff are new employees and I think my previous VSO got my file red flagged because he submitted a claim for every diagnosis in my STRs and didn't teach me how the process worked before filing for claims that I had not received a diagnosis. A few years ago, I was given 30% rating for migraines secondary to my TBI. During that C&P exam, the doctor asked the frequency of migraines and because I had no record, I estimated 1 per month that kept me home from work. TBI and Migraines were awarded and I began utilizing the VA healthcare to speak with a TBI doctor on related symptoms. Last year my TBI doctor advised me to record my migraines so that we would know if they were to ever become more frequent. 3 months into recording these, I noticed that I wasn't averaging 1 migraine per month, but 2 and some were days long. So what did stupid me decide to do? File for an increase to 50%. During the increase C&P my examiner stated that things "had been stable" because I explained how during my first C&P exam I was speculating on the amount. I told him that I had since kept track and found that the amount should have been reported higher. My condition had not worsened, it was just under stated on the first examination. I wasn't asked about turning in my migraine log that I showed him, and I was assured that the rater would view my TBI doctor's notes for an appointment I had scheduled for the next day. The TBI doctor's notes corroborated everything I said to the C&P examiner and he gave me a script for Sumatriptan. All that to be dropped from 30% to 0% with a statement that "my condition had improved". It was reflected in my eBenefits portfolio as 0% within the 60 day period. That decision was made in early January, and I got my TBI doc at the VA to fill out a DBQ which was submitted in January. In February, my VSO advised me to upload my migraine log and to give a statement about why the increase was made so that my point of view was reflected. A 50% rating would have taken me from 93% to 95%, so I think that played a role in the VA's determination as well.

I joined this forum just to reply to this post because this is my story. You have no idea how helpful it is to read that there is an actual spotlight on this. The TBI I received from Plebe boxing has robbed me of my ability to have a military career, my health, and my happiness and this whole time I have just felt like an outlier and a weakling.