Does The Va Make A Distinction Between Migraines And Headaches

[mountain tyme]

Hello I have some pointed questions and need help.

I am in the middle of helping a retired veteran with his va claim. At the time of discharge he was granted...0 percent I may be reading his record wrong so please read the following out of his VA records (yellow paper) done at time of retirement.

Decision:

4. Service connection is afforded for muscle tension headaches and a less than 10 percent evaluation is in order.

reason:

4. Service medical records show initial complaint of headaches as early as xx/xx/83 at which time migraine was diagnosed. Subsequent service medical records show diagnosis of tension headaches or muscle tension headaches and this was the diagnosis at the time of the VA exam. A diagnosis of migraine headaches was not given, however. The veteran stated that these have been present for 15 years and are located in the posterior occipital area. Tey occur approximately every 10-12 days and last about 4-8 hours. However, they are not accompanied by nausea or vomiting and there is no vison change. Service connection is afforded as the headaches were chronic in service. However, as migraines were not involved a 10 percent or higher evaluation is not in order. (Which could be assigned with characteristic prostrating attacks averaging one in two months over the last several months).

FAST FOWARD____________

In Feb. 07 the said veteran put in for an increase for muscle tension headaches. In Oct 07 the veteran received his decision the decision stated...

*We determined that the following service connected conditions haven't changed: Muscle tension headaches 0%

reason:

2. Evaluation of muscle tension headaches currently evaluated as 0 pecent disabling.

VA exam shows you reported that you have two to three headaches per week that are not prostrating. Your motor and sensory exams were normal.

The evaluation of the muscle tension headaches is continued as 0 percent disabling because the evidence fails to show this condition has worsened to a compesable level. A noncompensable evaluation is assigned unless there are charateristic prostrating attacks averging one in two months over the last several months.

With that said...

I went through his decision and discovered that his medical records from the family practice clinic at the base (he has tricare)were not included in the evidence. I asked the veteran if he submitted the doctor's notes and he said that he was told by the service rep (state of M0.) that the VA would get those records. What the VA did was they retrived the records from his VA health care team which they did.

but not from the air force base's primary care department.

This veteran has been seen on a regular basis for headaches thoughout his retirement...and the headaches turned into migraines...

As noted in Feb 07...his medical records state

Cheif Complaint:

Pt is here for migraines pt had migraine yesterday, stillhas headache today pt. states he has had two migrines in the last two weeks.

Migraine headaches, treated with imittrex. Has frequent "non migraine" headaches, states he can feel the difference with photophobia, N/V imitrex not aborting HA's

:Gastrointestinal symptoms: Nausea with migraine and vomiting with migraine

:Head symptoms: Headache preceded by aura

Conclusion:

1.) Migraine Headache: naprosyn 500mg bid for 2 weeks then PRN. Imitrex not aborting migraines so will swith to Maxalt 20mg.

F/U in two weeks

_____________________________________________________

in two weeks he went in for his F/U and he was still having increased migraines that he had to stop whatever he was doing and lay down...his wife called the family practice at the base and talked to the doctor and he would tell her if his pain does not subside within 4 hours or gets worse to bring him into the ER...

at his two week appointment they added another medication to help prevent the migrains which is called.

so he is not taking

Rizatriptan (Maxalt)10 mg twice a day

Propranolol (inderal) 40 mg. three times a day

The veteran told me that the medication has helped but he still has migraines at least 3 times a month but not as frequently as he did...as long as he stays on his medication as prescribed.

So this brings us back to the claim for increase...

since the VA is stating muscle tension headaches and do not use the word migraine...should the veteran put in a NEW CLAIM FOR MIGRAINS or should he just put in for a reconsideration and send in the medical records from the family practice clinic from the base.

I feel based on the Diagnosic code 8100 that this veteran should rate out at the 30% level...

I don't want to tell them the wrong thing...but after reading the decision that you have before you...I think the VA only addressed the headaches and not the migraines...

We will be very grateful for any help you can give us in how to proceed with this claim...i have another tread regarding this but I had two issure in that thread so I want to concentrate on this one first.

Thank you all in advance

MT

[mountain tyme]

rentalguy...where would I look to see what code he was rated under...I read his letter from the va and I didn't see any codes...where would they be found?

thanks

mt

[rentalguy1]

If it's not in the initial decision, or any of the SOC's, then have him call the 800 # and ask them. They should be able to tell him easy enough.

[carlie]

Rentalguy1 has provided some very good info for you. It's very important to always know

what diagnostic codes a claimant is being rated under. I do not feel most claimants pay enough attention to this and I have posted about this in past.

jmho,

carlie

[Ricky]

Yes migraines are different from other headaches. They probably did some crazy thing like rate him under 9304 which is kinda like a catch all. Most of the disabilities especially in the neuro area provide 9304 as the code to rate SUBJECTIVE complaints such as headaches. If he had migraines, and he still has them backed up by medical evidence then he should fight the issue.

From what you have posted he does deserve a higher rating. Just make sure you go through his med records looking for such a diagnosis and then look at his civilian diagnosis and bounce that off the rating schedule for migraines.

[timetowinarace]

9304 Dementia due to head trauma.

I'm doubting he was rated under that code. It's a mental disability rating not neuro.

It is usually neurologists that specialize in diagnosing and treating migrains. I would suggest going to one, both for better treatment and a diagnoses the VA can't reject as easily.

Time

[mountain tyme]

rentalguy wrote: "It all depends on what code he is actually rated under currently. If he is currently rated under code 8100, then the answer is no. Just claim an increase.

If he is under another code, then yes. Tell them that VA has him erroniously rated under DX Code XXXX, and it should be changed to code 8100, with a rating of 30%. If you don't ask for a particular percentage, then the claimant is the only one to blame when he gets low-balled. The worst thing they can do if you ask for a particular rating is say no, to which you reply with a NOD. Good Luck! "

UPDATE: I went over and had him call the 800 number as you suggested...and the Diagnosis code is 8100...so I told him to put in for a reconsideraion for an increase for 30% and attach the medical records from family practice...regarding his treatment on the new onset of the migrain headaches as stated on his medical records from

*************Feb 07...his medical records state*************

Cheif Complaint:

Pt is here for migraines pt had migraine yesterday, stillhas headache today pt. states he has had two migrines in the last two weeks.

Migraine headaches, treated with imittrex. Has frequent "non migraine" headaches, states he can feel the difference with photophobia, N/V imitrex not aborting HA's

:Gastrointestinal symptoms: Nausea with migraine and vomiting with migraine

:Head symptoms: Headache preceded by aura

Conclusion:

1.) Migraine Headache: naprosyn 500mg bid for 2 weeks then PRN. Imitrex not aborting migraines so will swith to Maxalt 20mg.

F/U in two weeks

since the VA did not consider these records when they made there Decision in Oct 07...by leaving his rating at service connected at 0% I think that submitting these medical records will change there rating...fingers crossed...

Is there anyways he should word this request for a reconsideration???

any help would be appricated

MT