Clarification From A Post In 2006

[Shyne-I]

Hi Berta and Carlie,

I saw this post and wanted to know when you asked, "if they denied stating that the claim was not 'well grounded'?", can that be a basis for a CUE? I filed a claim for headaches and sinusitis. I was granted a noncompensable rate for sinusitis but the claim for headaches was denied because it was not well grounded, but there were at least 3 different occassions when I was seen for headache complaints and even once were they assessed it as a tension headache. On my separation examination it noted a history of frequent tension headaches and frequent sinus infections.

Any ideas about it not being well grounded and whether or not this is a CUE?

Posted 24 May 2006 - 09:22 AM

Renne- I agree with Carlie as to the CUE claim-

It is the only way a claim, that has been denied and never appealed, can produce more retro-

I assume the other claim was denied and never appealed but then you re-opened.

Carlie is right- it takes studying CUE claims to understand their specifics-

In the denied 1996 decision did they account for the docs C & P statement in the old C & P at all?

Did they deny saying that claim was not "well grounded" ?

Did you have a migraine disability documented at that time?

The examples of CUE that Carlie gave you show you what VA needs- proof that a legal error in a past decision caused you loss of benefits.

Did they put a diagnostic code with a NSC rating for migraines on the rating sheet with that past decision?

GRADUATE ! Nov 2nd 2007 American Military University !


When thousands of Americans faced annihilation in the 1800s Chief
Osceola's response to his people, the Seminoles, was
simply "They(the US Army)have guns, but so do we."
Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

[Berta]

"I saw this post and wanted to know when you asked, "if they denied stating that the claim was not 'well grounded'?", can that be a basis for a CUE?"

No,not due the 'not well grounded" statement.. VA denied thousands and thousands of claims that way years ago.

"I was granted a noncompensable rate for sinusitis but the claim for headaches was denied because it was not well grounded, but there were at least 3 different occassions when I was seen for headache complaints and even once were they assessed it as a tension headache. On my separation examination it noted a history of frequent tension headaches and frequent sinus infections."

Can you scan and attach that older decision here? (cover the personal stuff)as to their exact denial?

If this was a BVA denial can you give us the Citation number and the Docket number for it?

Do you now have a current rating for the headaches? and a ratable level of SC comp for the sinus condition?

[Shyne-I]

Hi Berta,

It wasn't a BVA denial and no I don't have a current rating for headaches. I asked for an increase for my sinusitis in July of last year and that was granted pretty quickly. My other claims were deferred and they just made a decision on those on 4/5/13 and my claim was closed on 4/10/13, I'm just waiting to receive my envelope although I'm not too confident that they will be approved because there has not been a change in my AB8 letter yet. I wanted to see if I could do a CUE on the claim for headaches because I was just seen by a neurologist who informed me that the majority of the headaches that I was having that had been diagnosed as sinus headaches were actually migraine headaches and that they most likely started while I was in the service because Migraine headaches normally develop in your 20's. .I don't know how to upload the document...

[Shyne-I]

Hi Berta,

I just decided to type it in:

ISSUE:

1. Service connection for sinusitis.

2. Whether the claim for headaches, and urinary tract infection is well grounded.

EVIDENCE:

Service Medical Records November 1993 to November 1994

VA Examination dated 02-17-95 from VA Medical Center Lake City FL.

DECISION:

1. Service connection for sinusitis is granted with a 0 percent (noncompensable) evaluation assigned.

2. The claim for headaches, and urinary tract infection is not well grounded.

REASONS AND BASES:

The veteran contends that service connection should be granted for headaches, sinus condition, and urinary tract infection, based on onset of the conditions during service.

Service medical records were reviewed and considered. Enlistment examination 11-18-93, noted no abnormal findings regarding claimed conditions.

The veteran was evaluated in March 1994 for complaint of sinus congestion. Assessment was upper respiratory infection. Evaluation in July 1994 noted some maxillary sinus tenderness with complaints of left ear pain and drainage, and temporal headaches. Evaluation in August 1994 noted complaints of headaches and slight ear pain. Examination noted right maxillary sinus tenderness. Assessment was allergies.

The veteran was evaluated in July 1994 for complaint of headaches. Assessment was tension headaches.

Service medical records indicate treatment for a urinary tract infection in May 1994.

Separation examination 11-18-94, noted history of frequent tension headaches and frequent sinus infections.

The report of the VA examination 02-17-95 was received. The veteran complained of sinus headache, chronic sinus problems, and post-nasal drip with sore throat. She reported that this condition has existed since 1993. She also gives history of upper urinary tract infection in May 1994 that resolved with treatment.

VA examination noted the following: There was some slight tenderness over the right maxillary sinus and right frontal sinus area. The nasal passages were slightly congested. X-ray examination of the sinuses showed clouding of the frontal sinuses suggestive of frontal sinusitis. Urinalysis was normal. Diagnoses were mild frontal sinusitis, history of urinary tract infection, and sinus headache.

Service connection for sinusitis.

Service connection is granted for sinusitis as the evidence shos onset of the condition(s) during military service.

Edited April 14, 2013 by Shyne-I

[Shyne-I]

Hi all,

Does anyone have any idea why I was denied service connection for the headaches?? I tried to find out if the criteria for headaches was different back in 1995 but I couldn't find a change in the regulations, but I know that the only evaluation they have for headaches is for "Migraines". I am assuming that this would have fallen under an Analogous rating even in 1995?? The tension headache that they list under the Reason and Bases section actually required 1 day SIQ which should qualify as a prostrating attack shouldn't it?