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C&p Exam Error

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happpig

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Hey everybody thanks for being here.

I'm pretty new to the world of the VA and fortunately everything has gone (mostly) smoothly since my discharge and filing my claim. Today I received my ratings in the mail and for the most part it was what I expected. However, my rating for migraines was 10 percent, while I was expecting 30. The award letter states that I received that rating for prostrating attacks averaging one in 2 months, rather than warranting a higher rating for one a month.
I could have sworn that I stated I had a prostrating attack every month, but I reviewed the C&P exam notes and the Doc indeed wrote 1 every 2 months.

So the question I have is what is the most expeditious way to appeal that? I have read about DRO reviews vs traditional appeals and I honestly don't understand a word of it. Is it sufficient to file and NOD and essentially just state that the doctor was mistaken in saying I had one headache every two months?

In other news and as an aside, the award letter noted that I had another compensable condition that I hadn't claimed that I should file for. So in that way, I think I must be on the VAs good side haha.

Thanks in advance

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  • HadIt.com Elder

Welcome to Hadit. I like DRO Review at least you get to present your claim to a live human.

Good Luck Hadit is here to help

Veterans deserve real choice for their health care.

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Jump on the "NEW VA Reconsideration" train. Do you have supporting VA or Non VA medical records supporting your at least " once a month" contention? Very important that you have a "Medical Clinician Notes Trail" to support your claim.

If that doesn't work within a month or so, file your NOD requesting a DRO Personal Hearing. Worked for me but took almost 41/2 years to get the Hearing. You will need New & Material Evidence, this is mandatory, that wasn't available to the original rater.

Think about using a "Sworn Affidavit" to support your claim, see Chris Attig Veterans Law Blog.

Semper Fi

Gastone

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VA has difficulty with claims they cannot physically see or touch- like PTSD and migraines. With migraines VA often underates the disability. The important tool that you have at your disposal here is your own competency to provide evidence on your behalf. What I mean by that is that you do not need any special medical training to state that your headaches are so bad that the only way that you can get them to go away is to lie down. Contrast that with you not being competent to say that the lump in your leg is a cancerous tumor-- you would need a doctor with special training for that statement.

So what you need is, as Gastone stated, a sworn affidavit of your statement talking about your day to day life with migraines and how often you are laying down as a result of them. I use a VA 21-4138, Statement in Support of a Claim because you do not have to have the form notorized. I would also get statements from everyone that sees you on a daily basis as to how often they see you laying down.

What you want from your doctor is not a prescription for lying down for your headaches but just to note it in your history of the disability. It would be great if he does that but it is not fatal if he doesn't because you are competent to enter this evidence yourself.

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HAPPPIG

Can you enlighten us of how many contentions that you applied for versus how many got service connected and how many months that it took for you to finally get your final ratings? I'm close getting my final ratings resolved, but have an eye on what I would need to do if I don't do well on my contentions. Besides the NOD, it seems that the DRO Review is a pretty good option to getting claims resolution at the lawest level possible. I've tried to be very proactive with my claim and in some cases it's appeared to work and others it has not....I now have 2 new exams that just came up after my claim was reviewed for final decision but I'm close to getting them done.....

Edited by rootbeer22
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Welcome aboard and good luck as I too have 50% for Migraines, just had a nasty Brain Scan at the VA today. God Bless

100% PTSD

100% Back

60% Bladder Issues

50% Migraines 
30% Crohn's Disease

30% R Shoulder

20% Radiculopathy, Left lower    10% Radiculopathy, Right lower 
10% L Knee  10% R Knee Surgery 2005&2007
10% Asthma
10% Tinnitus
10% Damage of Cranial Nerve II

10% Scars

SMC S

SMC K

OEF/OIF VET     100% VA P&T, Post 911 Caregiver, SSDI

 

 

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