Migraine - 30% Vs 50%?

[TiredCoastie]

Got the white envelope in the mail today. The good news is that the VA rated me 30% for migraines, which put me in bed flat between 2.25 and 2.5 days per month, with migraines running for up to 5 days. Looking at the decision package, they rated me at 30% based on having, on average, one prostrating migraine per month over the last several months. The trip wire for 50% is defined by 38 CFR 4.120 is "With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability." The raters did not find that my claim met that threshold, despite the outside doctor stating that I cannot work and my migraines are twice the 30% rating threshold.

Do I have an argument for a 50% rating?

Edited March 22, 2014 by TiredCoastie

[justrluk]

Hmmm...Justrluk...if you're rated at 50% for migraines (in which they wrapped up the TIAs from our earlier discussion), then they ought to do the same for me. I've had TIAs as well but they didn't leave any lasting disability.

I believe they should rate you this way as well. Get whatever documentation from neurologists, wife, other family, etc. with proof of the TIAs and don't stop until you get the 50% rating for this. I don't know about you, but I see the VA neuro about twice a year. I call every time I have a migraine that lasts more than a day. What treatment protocol do you have (daily and rescue meds)?

[TiredCoastie]

I believe they should rate you this way as well. Get whatever documentation from neurologists, wife, other family, etc. with proof of the TIAs and don't stop until you get the 50% rating for this. I don't know about you, but I see the VA neuro about twice a year. I call every time I have a migraine that lasts more than a day. What treatment protocol do you have (daily and rescue meds)?

I've got a stack of medical records, headache logs, etc... I see an outside neurologist a couple times a year or more, but she's fairly useless for emergency treatment so I typically don't bother her. I take Plavix and 81mg of aspirin every day (blood thinnners) along with Lopressor (anti-spasm for arteries), magnesium, and a homeopathic that includes butterburr root extract, all OK'd by the neurologist. In Europe, they treat migraine with Plavix, aspirin, and butterburr root. As a rescue, I throw in a couple of Tylenol, take two little aspirins, and get extract butterburr and maybe magnesium. It's moderately successful but not totally. The neurologist wants to inject botox, but I'm against the medical use of chemical warfare agents. So from a treatment standpoint, we're at a stand-still. And I haven't had an actual stroke yet, so that part's good.

[justrluk]

It sounds like you have all the documentation you should need. Keep pressing. Don't give up on this one.

[TiredCoastie]

It sounds like you have all the documentation you should need. Keep pressing. Don't give up on this one.

Thanks for the encouragement! My C-file should have all of this documentation already, which boggles the mind that the RO didn't make the 50% call the last time around. Second NOD will be submitted once our family crisis has blown over and I've had a chance to look into the BVA cases as Carly suggested.

[USMC_VET]

Thanks! I've been doing just that for several years using MyHeatheVet's medical events log.

How often do you have prostrating migraines? Sorry to pry, but looking for something more solid than the CFR as a gauge before submitting a NOD.

It seems to me that the criteria is very subjective and very open to local interpretation anyway. As Meghp says, if I just give the RO a statement from my neurologist that matches the language in the reg, it's hard to argue. I'm just trying to figure out if that information is already in hand on the DBQ.

Thats great advice.

I am transcribing my hard copy headache log into the medical events log now.

[stnorm23]

My understanding is that migraines is one of the most "underrated" disabilities by the VA. I'm not sure if they don't understand their own regs, or they just try to lowball and see who won't appeal. At my C&P, I made sure the doctor understood that I had a decade long problem with migraines which had been treated with meds and massage therapy (that didn't work well, but it felt great! :-). I also had a year long "headache diary" that dated back from the day of the C&P......AND STILL.....I was rated 10%. I now have a DBQ from my neurologist that states that I have on average 3+ prostrating attacks per month, take daily meds, and have appts with him every 90 days. I'm thinking I have a great shot at the appeal....but still frustrated that this wasn't handled correctly the first time.