Jump to content
  • 0

Denied Increase


ArmygirlRJ

Question

I recently received my letter of denial for increase on the grounds that I needed to have more than one prostating migraine in 2 months and even though my VA medical records never mentioned the word prostrating the Neurologist does say on multiply times that the patient is unable to work during attacks and he has also stated that I needed to lye down in a dark room. The only problem is that it is a teaching hospital so each time I see a different resident and maybe a different attending also. I have become a test dummy for the Neurologist because I have been on multiple medications and have failed therapy but I still try. My attacks can be from 2-5 headaches a month with each one lasting at least 2 days the only reason I haven't lost my job is that the neurologist filled out a Family Medical leave paper which allow me to miss periods at work without being fired but believe me my job is ready to dismiss me if they can find the loophole. With everything in my medical records I thought I would at least get 30%. Can anyone help me understand what to do? At the C&P the ARNP asked me all the questions and said that she could only write what was in my doctor notes the only thing I could think is that she read the resident notes without reading the attending notes. I have sent back my NOD already highlighting what the attending notes say in my VA medical records for the last two years. Also I have no idea what the C&P notes say because they did not send me that and I can not find it in my medical records. Please Help

Link to comment
Share on other sites

Recommended Posts

  • 0

Thank you to everyone for responding and providing me with help. Reason for Descision: We have assaigned a 10 percent evaluation for your migraine headaches based on Characteristic prostrating attacks averaging one in 2 months over the last several months. A higher evaluation of 30 percent is not warrent for migraine unless the evidence shows characteristic prostating attacks occuring on an average once a month over the last several months. When you mention C-file would that be my VA medical records? If so I enclosed them with my NOD highlighted with the Doctors stating that my migraines does not allow me to work if that is not my c-file how do I attain it?

Link to comment
Share on other sites


  • 0

Your neurologist would not have completed your FMLA paperwork unless you had a chronic health condition that warranted it. You should include your FMLA paperwork as part of your evidence and if you could get an IMO from the neurologist, have him/her discuss the circumstances that justified the completion of that paperwork.

There is no "loophole" in FMLA. That's not to say that employees are not harassed for taking advantage of FMLA, but an employer's interference in an employee's right to access FMLA will be very costly to the employer. Short of a reduction in force that includes other people, the employer would have a very high hurdle to clear trying to defend firing someone who has not exhausted their FMLA leave.

  • Like 2
Link to comment
Share on other sites

  • 0

Sounds like you may already have insurance privately. Costs are money out of pocket I get it but get a consult to a non teaching hospital neurologist and take with you all the documentation and exam notes etc. If you haven't started get a headache diary going. Write daily on the hard copy and then transcribe into the myhealthevet. Go to travel v k health and then medical events log. Do this for headache and everything else sc

  • Like 1
Link to comment
Share on other sites

  • 0

Sorry to hear of your issues bud. I was 30% for migraines/tbi and recently was reviewed by the VA, and it back fired in fact they increased to 50%. I get injections in head every 3 months by Neuro at VA, and take 2 different migraine Meds, and have had Alpha Stem treatment at VA which I was discharged from due to failure. What I am trying to say is that you need a lot of well documented treatment at VA. Good luck and God Bless

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Answer this question...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

  • Ads

  • Ads

  • Similar Content

    • By FlyboyLeRoy
      Submitted a claim for meniers increase and migraines secondary to meniers. Had a private, favorable dqb from my ENT doctor, too. Any idea what this means? I’m already connected for meniers and a list of other ear issues. 

    • By harry59
      Hello all,
      It has been many years since I have gone through the VA claims process, so I have no doubt a lot has changed.  I am in the process of submitting claims for my secondary conditions.  In my Veteran Statements I am writing, I am referencing certain U.S. Court of Appeals Decisions (like Walsh v. Wilkie) and certain VA Citation Numbers (like Citation Nr: 1340261) that pertain to my secondary claims.
      My question is...should I have my VSO upload and submit the Court Decisions and Citation Numbers as evidence in my file?  Or is it sufficient enough just to reference them in my statement, but not necessary to upload them to my file at this point?  I asked my VSO this question and he said I would only need to submit them if my claims go to the VBA.  I'm just looking for a second opinion from someone that has recently been through the process and want to make sure that I do things right the first time.
      To give you a better picture of what I'm talking about, the paragraph below is from my Veteran Statement.  It reads:
      "It is my contention that my service-connected disabilities, in particular those affecting my musculoskeletal system, have greatly impacted my ability to exercise, which has caused, or aggravated, my weight gain/obesity, which in turn has caused my Obstructive Sleep Apnea (OSA). My obesity, caused by my inability to effectively exercise or engage in any physical activity, is the intermediate step (the bridge), that connects my secondary condition (my OSA) to my service-connected musculoskeletal disabilities, as stated in the Walsh v. Wilkie decision from the U.S. Court of Appeals on Feb 24, 2020, and VA Citation Nr: 1340261. I also reference VA Citation Numbers 1426481, 1435836, 1447259, and 1536140 that show prior VA decisions linking OSA to a lower back condition (through weight gain). This should satisfy the requirement under 38 CFR 3.310(a) for service connection for Sleep Apnea on a secondary basis. I have also attached to my claim, credible sources that directly link OSA to weight gain/obesity."
       
      Thank you for your time, and to all that reply!
       
    • By Lolo Square Pants
      Request to Reinstallation for Sleep Apnea and Low back condition claims

       


      Back in January 2021, I received via mail a CD containing information to be used before the Board of Veteran Affairs for the MDD condition. I discovered VFW submitted a document on Jul/2011 where he withdraws the claims for Sleep Apnea and Low Back condition. This was the first time I learned about this document.
      For the claim of Sleep Apnea, I hand-delivered favorable IMO to the Hearing officer in 2010 and at the time they had also an IMO for the Low Back Condition(2008) along with a full medical report from the same doctor.

      After reviewing the CD and my paperwork, I asked the VA via phone on Feb/2021 about communications between July and September 2011. The VA representative emailed me a document dated 8/1/2011(attached) with multiple issues on it and an indication of; “We also withdrew all other issues on appeal as per your Veterans of Foreign Veterans letter dated and received July 2011".

      I kept working on the claims throughout the years; these were done in two different RO and to all effects VA indicated that they were working on these claims as presented in their communications on Feb/2012 and Jun/2012.

      Interestingly, for the latter communications, VA does not indicate a withdrawal of appeals nor that my claim is “reopened”. Finally, on Apr/2013, VA use different wording like “denied the reopening” since “Evidence no show event, Evidence not new. Claim not reopened. Not Substantive”. While still, VA did not evaluate IMO on the record.

      Out of frustration, I did not further pursue these claims; until I received the CD in January 2021, and realize that my claims for Sleep Apnea and Low back claims were withdrawn without my consent in 2011.

      Significantly, the VFW letter offers a conditional appeal, where indicates: (1) “As longer his appeals for increase in the other conditions…”, (2) “He would be satisfied with the decision made,” (3) “This withdraw does not mean…” Additionally, there’s an undated additional handwritten note in the printed proposal that indicated another “conversation” with the veteran.

      As I learned under Warren v. McDonald, docket no. 15-0641 (Sep 14, 2016) it is, held: An appellant or his/her representative may withdraw an appeal, but unless the withdrawal is on the record at, it must be in writing. A withdrawal “is only effective where withdrawal is explicit, unambiguous, and done with a full understanding of the consequences of such action on the part of the claimant.”

      I tried to get a hold of the VFW trough 12 emails (for 2 months) and multiples calls without success. I did change the VSO. Also, I wrote a letter detailing the events to the VA. Now the VA wants the request in a Form (20-0995). This form explicitly indicates that is to be used for “New and relevant evidence to submit for VA to consider”.

      I request that my claims of Sleep Apnea (2008) and Low back(2005) be reinstated at their original claim date since they were worked continuously since their inception and there was evidence that were not evaluated. As today My sleep apnea is worse indicated in a VA Study in 2019 and had Spinal Fusion in Kentucky (2015).


       
      I appreciate any help you can provide.


       
    • By aggravating_coyote
      The American Legion is my assigned VSO.  How do I change the particular person working on my claim?
    • By Jackets90
      My headache claim was denied. I had headaches prior to service but they turned into migraines while I was in and I still suffer with them monthly. My supplemental claim came back and it was denied. Best part is it says 
       
      “I have been diagnosed with a disability. VA examinations on the dates confirm diagnosis of migraines” what do I do here? Refile with a claim for migraines?   

  • Ads

  • Our picks

    • I already get compensation for bladder cancer for Camp Lejeune Water issue, now that it is added to Agent Orange does it mean that the VA should pay me the difference between Camp Lejeune and 1992 when I retired from the Marine Corps or do I have to re-apply for it for Agent Orange, or will the VA look at at current cases already receiving bladder cancer compensation. I’m considered 100% Disabled Permanently 
      • 20 replies
    • 5,10, 20 Rule
      The 5, 10, 20 year rules...



      Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.



      Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.



      Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.



      If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"



      At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.



      NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.



      ------



      Example for 2020 using the same disability rating



      1998 - Initially Service Connected @ 10%



      RESULT: Service Connection Protected in 2008



      RESULT: 10% Protected from reduction in 2018 (20 years)



      2020 - Service Connection Increased @ 30%



      RESULT: 30% is Protected from reduction in 2040 (20 years)
        • Like
      • 58 replies
    • Post in New BVA Grants
      While the BVA has some discretion here, often they "chop up claims".  For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.  

      I hate that its that way.  The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.  
        • Like
    • Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!

      My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.

      Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
      • 18 replies
    • I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even  reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and  nothing about stressor,
  • Ads

  • Popular Contributors

  • Ad

  • Latest News


  • veteranscrisisline-badge-chat-1.gif

  • Fund HadIt.com

    381%
    $5,723.00 of $1,500.00 Donate Now
  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    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 ...
    Continue Reading
     
  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • VA Watchdog

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    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

×
×
  • Create New...

Important Information

{terms] and Guidelines