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

[TiredCoastie]

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.

You're probably right about how many of us are rated lower than our migraines actually are. You're clearly at or above the 30% level. The KEY component to the 50% level is how badly it impacts your ability to work. If your doc will make a statement regarding your migraines' impact on our ability work, like you can't or are hampered, you've got a great case. Other options are pointing to your job history, statements from your current employer, difficulty in school, etc.

The rest of my story -- I was rated at 50% from 30% after I NOD'd the claim decisions and then filed a Form-9 when the RO still didn't agree with the evidence. The DRO re-reviewed my package before certifying it to go to the BVA and decided in my favor at that very late point. In the Form-9, I pointed to the statements my outside neurologist made on the DBQ form and in her records as well as pointed to my headache log, the duration of my migraines, and my difficulty in finding part time work in the morning when I'm at my best (migraines for me are often like thunderstorms in Florida: they're regular afternoon events).

It's going to take a little work on your part, but you've got a great argument for 50% from what it sounds like. Wishing you the best!

[justrluk]

I supported a 50% rating with a copy of my timesheets and calendar that reflected days and periods of work missed. I also keep a journal of headaches (and other conditions) that prevent me from working on given days. I can't stress this enough. If you don't keep track (days, times and pain levels) you risk losing objective evidence similar to what a doctor or hospital would capture to get a complete picture of your health. It seems small, but has made a huge difference in keeping my ratings and filing for increases I felt were justifiable and supportable.

[TiredCoastie]

I supported a 50% rating with a copy of my timesheets and calendar that reflected days and periods of work missed. I also keep a journal of headaches (and other conditions) that prevent me from working on given days. I can't stress this enough. If you don't keep track (days, times and pain levels) you risk losing objective evidence similar to what a doctor or hospital would capture to get a complete picture of your health. It seems small, but has made a huge difference in keeping my ratings and filing for increases I felt were justifiable and supportable.

Excellent point, Justrluk! I keep all that in my headache log myself. Impact is a HUGE piece.