C&p Scheduled

[Cammy]

First let me say that I have spent many hours lurking here and have learned a great deal from you all. I want to thank all of you for your time and dedication to your fellow veteran.

I retired from the Air Force in June of 2005 and was awarded a combined rating of 90%. 50% of that rating is for chronic migraine headaches. In September of 2006 I asked the VA to reopen my claim for the headaches due to the frequency and severity of the headaches increasing. I have a C&P scheduled for 1 November.

Here is my question.

Knowing that the VA can award an extra-schedular rating what are the chances that this may happen? I know that this type of rating is applied in the rare case but how rare does it have to be? In that rare case where they award an extra-schedular rating how much higher do they go (or are they inclined to go)?

[carlie]

Cammy,

Extra schedular ratings being awarded are very rare. How do the headaches effect your life so much that VA should consider an extra schedular rating ? That is what they are going to want and need to know. You might do better shooting for IU

if a doc will write a statement for you in regards to :

stating something like:

In my medical opinion the veteran is unable to sustain financial gainful employment due solely to medical conditions this veteran is already in receipt of service connection for. It is also my medical opinion that the veterans medical conditions are static in nature and show no chance for improvement.

This is quite good for all vets but hard to get.

List the docs credentials and all medications you are on to include any side effects from these medications.

VA is not inclined to award extra schedular compensation, yet if this happened they could always go to 100 % - but i've not seen it happen in the research I've done.

What are the other disabilities that brought you up tp the 90% ?

Any chance if increasing those ?

JMHO,

carlie

[Guest jstacy]

Hi Cammy, You have asked a very complex question, 50 percent is the maximum xcheduled allowance for headaches. Headaches are rated undser the Migraine Criteria.

I did a little research and have found out that it is not impossible to get an extraschedular rating. It is extremely difficult.

The 50 percent criteria says Frequent prostrating attacks productive of a severe economic impact.

If you can show the Headaches effect your life by keeping you at home, or in the bed, Then you may have a chance. I have never heard of housebound by headache but it is not beyond the realm of possibility.

I have attached a BVA case that is a denial but it will give you somethinng to compare to.

http://www.va.gov/vetapp99/files3/9925693.txt

Edited October 16, 2006 by jstacy (see edit history)

[carlie]

Cammy,

Have you called VA to find out exactly what your C&P is for?

Anytime you go for a C&P they can and do make statements and evaluate other disabilities so be aware of this.

You can be at a C&P for neurology - say evaluation of headaches, and if you make mention of other conditions this would also be likely mentioned in the report, say

back pain, muscle spasms etc... from a injury or illness.

I always suggest taking prior documentation of medical findings (and any calander

or journal you've kept) of medical disabilities and/or symptoms that have increased, to the C&P with you. The examiners will usually make some copies

of this to include in their evaluation, or at least make mention of it for the record.

JMHO,

carlie

[john999]

Cammy

Is what you are after a 100% rating so you can get the concurrent receipt? You could easily get IU, but I don't thing you get concurrent receipt for IU. If you can squeeze 10% out of your entire diability rating and get 100% that would be an ideal goal. IU would pay 100% benefits if you are not working. I am not retired military so I don't know the ins an outs of concurrent receipt. If headaches are maximum 50% then maybe you want to go after some other disability and try and get that raised up. Do you have depression or other type disorders due to your disabilities? Are you working now or are you totally disabled? Why not list your disabilities and we can figure which ones have the best shot at being enhanced with evidence to get you to 100%. Are you a combat vet? I ask because their are some different rules for combat vets as far as evidence.

[Cammy]

Never thought about getting rated TDIU. I guess its a pride thing. Too many of these guys that were in Vietnam, Gulf War, OIF, Afganistan and other places that came home shot up gave more than me. My family always says I should be proud that I did 20 years but feel like I didn't do my share sometimes.

Funny you should mention the depression. Not funny ha ha but I am rated at 10% based on treatment for alcohol abuse in 1995. 10% awarded based on mild symptoms transient in nature, GAF score of 80. I did not utilize mental health services after 1995 while on active duty (don't want people to think I'm crazy thing) but did use the chaplin service A LOT.

Started seeing a VA shrink shortly after getting into the VA system. Initially declined meds but have since started Brupropion. This is the only antidepressant that I can take that will not interfere with my headache meds. VA shrink has changed diagnosis to mild to moderate do not know if GAF has changed.

Headaches playing a major role in the depression. At this point the pain is unbearable and the uncertanty of when and where the next headache will come is wearing me down. Some days it is a real struggle just to get out of bed.

Headaches are like being shot in the head and come on in a mater of a couple of minutes. Imagine the worst icecream headache you have ever had and multiply it by 10. shrink it to the size of a quarter focus it behind your right eye and have it go through your head and come out behind your right ear. Now at the same time have the entire right side of your face go numb and droop, your right arm go limp and have speech become a problem. Sounds like a stroke right? Nope thats my headache. Now have that headache last three to four hours and happen everyday for a week to two months one to two times a day. Never at the same time during the year, never knowing a precursor and you can see why I am asking for an extra schedular rating.

I work as an on call substitute teacher for now but cannot work for fear of getting a headache in the classroom. I would like to pursue a career as a teacher but at this time it is not looking good.

[carlie]

Cammy,

What is the etiology of your headaches - medical reason for them?

carlie

[Cammy]

Hi Cammy, You have asked a very complex question, 50 percent is the maximum xcheduled allowance for headaches. Headaches are rated undser the Migraine Criteria.

I did a little research and have found out that it is not impossible to get an extraschedular rating. It is extremely difficult.

The 50 percent criteria says Frequent prostrating attacks productive of a severe economic impact.

If you can show the Headaches effect your life by keeping you at home, or in the bed, Then you may have a chance. I have never heard of housebound by headache but it is not beyond the realm of possibility.

I have attached a BVA case that is a denial but it will give you somethinng to compare to.

http://www.va.gov/vetapp99/files3/9925693.txt

While the case does mention headaches there are a lot of other factors in this case. The gentleman won his case in that he was awarded a 50% rating (previous was 10%) but the board thought that other health factors contributed to his inability to work. I am hoping that the frequency and severity of my headaches alone are enough to warrant a higher rating.

[Cammy]

Cammy,

What is the etiology of your headaches - medical reason for them?

carlie

No known reason. Have had MRI, X-ray, chiropractor, Herbal remadies, done food diary, kept track of weather, kept track of allergy reports, you name it have tried it. I have seen two different neurologists (military) and both just handed me perscriptions for what ever would make the headache stop. If you told me chicken feet would make it stop I would try it today.

[Guest jstacy]

VA shrink has changed diagnosis to mild to moderate do not know if GAF has changed.

Cammy, check into it. It your SC condition is worse, Ask for an increase. Check into it. That may solve your problem. Migraines are terrible. I hope you find the right mix of Meds to get them less frequent. I have tried everything from Topomax to Imitrex and nothing worked.

Can you take torodol for your migraines when they come on?

[Cammy]

Cammy

Is what you are after a 100% rating so you can get the concurrent receipt? You could easily get IU, but I don't thing you get concurrent receipt for IU. If you can squeeze 10% out of your entire diability rating and get 100% that would be an ideal goal. IU would pay 100% benefits if you are not working. I am not retired military so I don't know the ins an outs of concurrent receipt. If headaches are maximum 50% then maybe you want to go after some other disability and try and get that raised up. Do you have depression or other type disorders due to your disabilities? Are you working now or are you totally disabled? Why not list your disabilities and we can figure which ones have the best shot at being enhanced with evidence to get you to 100%. Are you a combat vet? I ask because their are some different rules for combat vets as far as evidence.

John, Concurent reciept for retiree's is automatic if they are service conected and rated at 50% or higher. I'm not worried about "sqeezing" I'm looking for the slam dunk. I've got nothing but time and don't mind doing the research to to win.

[Cammy]

VA shrink has changed diagnosis to mild to moderate do not know if GAF has changed.

Cammy, check into it. It your SC condition is worse, Ask for an increase. Check into it. That may solve your problem. Migraines are terrible. I hope you find the right mix of Meds to get them less frequent. I have tried everything from Topomax to Imitrex and nothing worked.

Can you take torodol for your migraines when they come on?

Started on Topomax a week ago just seems to dull the headache so its just not as sharp. I take Zomig to abort the headache. The problem is each dose is $33.00 and the VA only gives me 6 doses a month. The VA doc gave a perscription that Tri-Care fills but they fill it at 6 doses every three weeks. Sounds like a story problem from school, "How many days does Cammy spend without meds?" Now can you see where the depression comes in to play?

[carlie]

Cammy,

Most service connected vets and/or people with disabilities spend NO days without medications and their side effects.

Are you having to pay for any of these drugs ? My understanding is that if you are S/C'd at 50 % or more you pay nothing for meds.

Someone please correct me here if this is not accurate.

JMHO,

carlie

[Cammy]

Cammy,

Most service connected vets and/or people with disabilities spend NO days without medications and their side effects.

Are you having to pay for any of these drugs ? My understanding is that if you are S/C'd at 50 % or more you pay nothing for meds.

Someone please correct me here if this is not accurate.

JMHO,

carlie

I don't pay for VA meds and I have a $9.00 co-pay for Tri-care meds.

Carlie you say "Most service connected vets and/or people with disabilities spend NO days without medications and their side effects." UMMM HELLO? I get at best 18 doses of Zomig in 30 days. worst case scenario 2 headaches a day X 30 days = 60 doses required. Best case scenario 1 headache a day X 30 days = 30 doses required. Ok just for the for the off chance that the three week Tricare script got filled early it's 18 doses a month. If not we are talking only 12 doses in a 30 day period.

Side effects of my meds are no headaches. I'll take that.

[john999]

Cammy

I would read up on all my disabilities and their ratings. Usually, the VA will rate you as low as they can on all your disabilities so there is probably room for increases. Do you see a pyschiatrist for anything like depression. Go to your VAMC and complain about all your symptoms. Everytime you do this it goes into the record. Documentation is how you get higher ratings. Just start pulling the thread on every medical problem you have and it can lead to higher and even new ratings. Often times one medical problem can cause or aggravate other problems. I was rated for DMII due to agent orange. I had foot problemes and this was service connected to my DMII. Now I have PAD and I am going to get this connected to my DMII.

If I have PAD then I may have other cardiovascular problems. All this goes back to getting a rating for DMII even though it is just a ten percent rating.

[timetowinarace]

I also get the 6 doses a month of Zomig. I get the 2.5mg. There is a way around this that will help if your neuro will do it. My VA neuro sent me six 5mg tabs after my last appointment. I still get the usuall six 2.5 monthly.

So if your taking the 2.5mg ask for the 5mg to cut in half for twelve doses per month. The cost on meds is per pill no matter if it's 2.5 or 5. Double the meds at same cost to VA.

I think you'd have better luck with IU or an increase on the depression rating than getting more than 50% for migrains. As a daily sufferer I don't think migrains should be capped at 50% but they are. I spend 50% of my time literally hoping I'll die, the other 50% I spend hoping the meds will give me a few hours to get out and live. Mine are post traumatic (head injury).

Time

[Cammy]

I also get the 6 doses a month of Zomig. I get the 2.5mg. There is a way around this that will help if your neuro will do it. My VA neuro sent me six 5mg tabs after my last appointment. I still get the usuall six 2.5 monthly.

So if your taking the 2.5mg ask for the 5mg to cut in half for twelve doses per month. The cost on meds is per pill no matter if it's 2.5 or 5. Double the meds at same cost to VA.

I think you'd have better luck with IU or an increase on the depression rating than getting more than 50% for migrains. As a daily sufferer I don't think migrains should be capped at 50% but they are. I spend 50% of my time literally hoping I'll die, the other 50% I spend hoping the meds will give me a few hours to get out and live. Mine are post traumatic (head injury).

Time

Time, Sounds like you have the system working for you. Unfortunatly for me I take 5mg of Zomig in a nasal inhaler. Most times it knocks the headaches down in a matter of 15 to 20 minutes. However there are those times that it just takes the edge off for a few hours. I understand the want to die comment, been there begged for that a few nights.

There was acctually a group that petitioned Congress to enact a bill that would provide for a 100% rating for migraines. Of course that was back in the '90's and nothing ever came of it. But hey they VA change 38 CFR to make it harder for Vets to get compensated for back injuries so they do change things.

[timetowinarace]

I'm at 100% but have no migrain rating. The headaches are supposed to be considered with the headinjury claim. I have a re-eval C&P this week and if I'm not given P&T this time around I will file a claim for the migraines. Maybe I should anyway. Just fought too hard for too long and haven't wanted to jump back into it yet.

If I take Promethazine (phenagren [sp]) with the Zomig it helps more. That's what they do for me if I have to go to the ER. Morphine and phenagran. I don't take Topamax anymore cause I'm allready loopy and don't need to make worse. Now I'm taking Verapamil and am undecided if it helps at all.

Time

[saltydawg]

dose anyone know what antidepresant will work with zomig? thanks

[Cammy]

dose anyone know what antidepresant will work with zomig? thanks

I am currently taking burupropion (welbutrin) check spelling on both of these as I tend to spell these phonetically cause I'm too lazy to go get it out of the cabinet. Too soon to tell if it helps but it does save on the alcohol. Tell my wife it feels like I've got a cheap beer buzz without the hangover.

[Guest jstacy]

I took elavil or Amitrypteleyne as well as Zomig, Zomig never worked for my migraines.

I have found th ebest effective med is injected torodol. It Knocks the HA in a matter of minutes with no druggy effects. Cannot take it in pill form for it can cause GI bleed