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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
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    • Exams that were being sent strictly to contractors before, due to VAMCs not being open, are starting to be routed back to VAMCs. This is going forward from last Friday- not sure if prior scheduled exams will be re-created for VAMC vs vendor.
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    • Mere speculation in your VA C and P exam

      M21-1, Part III, Subpart iv, Chapter 3, Section D – Examination Reports III.iv.3.D.2.r. Examiner Statements that an Opinion Would be Speculative Pay careful attention to any conclusion by the examiner that an opinion could not be provided without resorting to mere speculation (or any similar language to that effect). VA may only accept a medical examiner’s … Continue reading
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TiredCoastie

Migraine - 30% Vs 50%?

Question

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 by TiredCoastie

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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.

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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.

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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.

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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!

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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.

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    • How to get your questions answered...


      All VA Claims questions should be posted on our forums. Read the forums without registering, to post you must register it’s free. Register for a free account.

      Tips on posting on the forums.

      Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question’.


      Knowledgable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.


      Use paragraphs instead of one huge, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph there are fewer who will investigate to dig it out.


      Leading to:

      Post clear questions and then give background info on them.

      Examples:

      A. I was previously denied for apnea – Should I refile a claim?


      I was diagnosed with apnea in service and received a CPAP machine but claim was denied in 2008. Should I refile?



      B. I may have PTSD- how can I be sure?

      I was involved in traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?



      This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

      Note:

      Your firsts posts on the board may be delayed before they show up, as they are reviewed, this process does not take long and the review requirement will be removed usually by the 6th post, though we reserve the right to keep anyone on moderator preview.

      This process allows us to remove spam and other junk posts before they hit the board. We want to keep the focus on VA Claims and this helps us do that.
      • 0 replies
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