Previously Denied Service Connection - Retropay

[KiKi]

Greetings

In 2002 I was denied service connection for migraines even though in service treatment records show diagnosis and continued treatment.  I have reopened my claim twice both with denials of service connection.  This time I reopend it again and the VA sent me for a C&P exam.  Based on the information I found in my medical records from the recent c&p exam below I have two questions. 1. What is the likelyhood that my claim will now be considered service connected?  I mean the c&p doctor seems to be saying it was service connected but I'm not sure.  2. Based on your understanding of the VA laws and stuff can you speculate on if it is deemed service connected with the VA back date my retropay to the original claim date in 2002?  Please note that the only "new evidence" is my continued treatment for migraines in the VA health system and the findings listed in the ACE Review from the C&P Exam listed below.  Thanks in advance.  KiKi

ACE and Evidence Review ----------------------- Indicate method used to obtain medical information to complete this document: [X] In-person examination Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS MEDICAL OPINION SUMMARY ----------------------- RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: "Does the Veteran have a diagnosis of (a) migraine headaches that is at least as likely as not (50 percent or greater probability) incurred in or caused by (the) frequent headaches in service during service?  b. Indicate type of exam for which opinion has been requested: HEADACHE TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. c. Rationale: the veteran's headaches began in 1993 after she struck her head on a tree limb during physical training, and headaches of similar character have been ongoing since that time.

[Berta]

 "2. Based on your understanding of the VA laws and stuff can you speculate on if it is deemed service connected with the VA back date my retropay to the original claim date in 2002?  "

The VA will not address any backpay retro, unless they call a CUE on themselves regarding the old denials.

(And they sure do not call CUE on themselves often)

In the denials did they list the migraines as NSC with a rating?

" Rationale: the veteran's headaches began in 1993 after she struck her head on a tree limb during physical training, and headaches of similar character have been ongoing since that time."

"What is the likelyhood that my claim will now be considered service connected? "

Have you proven that this accident occurred with treatment entries in your SMRs and/or buddy statements?

[broncovet]

I agree with Berta and Vetquest.  You appear to have the caluza elements, that is, presuming:

1.  Va actually has all this evidence in their file, in other words they did not lose or shred any of it.  (This assumption is not always correct). 

2.  The VA representative can read.  (This assumption is not always correct).  

     Importantly, does the VA have records "in their possession", such as documentation of injury in service?  The only way to know this is to order a copy of your cfile and read it yourself.  

    And, lets be an optimist, and assume you will be awarded SC.  If the effective date is wrong, then you can appeal the effective date.  It should be the later of "the date you FIRST applied" or the facts found (the date the doc said you were disabled).  

 

[KiKi]

On 6/27/2019 at 9:12 AM, Berta said:

 "2. Based on your understanding of the VA laws and stuff can you speculate on if it is deemed service connected with the VA back date my retropay to the original claim date in 2002?  "

The VA will not address any backpay retro, unless they call a CUE on themselves regarding the old denials.

(And they sure do not call CUE on themselves often)

In the denials did they list the migraines as NSC with a rating?

" Rationale: the veteran's headaches began in 1993 after she struck her head on a tree limb during physical training, and headaches of similar character have been ongoing since that time."

"What is the likelyhood that my claim will now be considered service connected? "

Have you proven that this accident occurred with treatment entries in your SMRs and/or buddy statements?

Thank you....

No - migraines were listed as NSC - there was no rating assigned because it was not considered service connected at that time.

Yes - my STRs show the initial accident and show ongoing treatment.

 

[vetquest]

It looks like you have the caluza elements needed.  If you are denied this time make sure you appeal the denial.  As I stated before the VA will most likely try to lowball you if they award benefits.  That is where I would get buddy letters from you supervisors about how your condition affects your job and appeal to the BVA.  IMHO migraines are underrated by the VA in that you max out at 50%.  The headache association has tried to get migraines changed at the VA so that they are rated higher unsuccessfully.  The 50% rating requires severe economic adaptability.