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Confused? 30% or 50% - Migraines C&P Exam

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KiKi

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Greetings,

I am trying to decipher if after I am granted service connection for migraines whether I will be possibly rated at 30% or 50%.  My C&P exam results below are a little contradictory.  If I go by the questions then it will probably be 30% because the C&P doctor marked "no" for severe economic inadaptability but he also marked "yes" for affects my ability to work - further sating that I miss several days a month and work with out pay due to migraines.  So if some one could please give me some guidance?  I know this is just your opinions based on your experiences and I need to wait for the big brown (white) envelope but it's just so confusing.  Please see c&p exam below

Headaches (including Migraine Headaches) Disability Benefits Questionnaire Name of patient/Veteran: Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No 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 1. Diagnosis ------------ Does the Veteran now have or has he/she ever been diagnosed with a headache condition? [X] Yes [ ] No [X] Migraine including migraine variants ICD code: G43.009 Date of diagnosis: 1993 2. Medical History ------------------ a. Describe the history (including onset and course) of the Veteran's headache conditions (brief summary): She noted the onset of headaches during basic training in 1993 after striking her head against a tree limb on a physical training exercise. Headaches are mainly left-sided and posterior with throbbing pain, accompanied by nausea, vomiting, photophonophobia, worse with movement. Headaches occur about 4 per month and last 1-2 days. She has used up all of her sick leave due to work absences due to headaches. She takes sumatriptan, which can be helpful, and also topiramate 100mg bid for headache prophylaxis. b. Does the Veteran's treatment plan include taking medication for the diagnosed condition? [X] Yes [ ] No If yes, describe treatment (list only those medications used for the diagnosed condition): Sumatriptan for acute headaches and topiramate 100mg bid for headache prophylaxis. 3. Symptoms ----------- a. Does the Veteran experience headache pain? [X] Yes [ ] No [X] Pulsating or throbbing head pain [X] Pain localized to one side of the head [X] Pain worsens with physical activity. b. Does the Veteran experience non-headache symptoms associated with headaches? (including symptoms associated with an aura prior to headache pain) [X] Yes [ ] No [X] Nausea [X] Vomiting [X] Sensitivity to light [X] Sensitivity to sound c. Indicate duration of typical head pain [X] 1-2 days d. Indicate location of typical head pain [X] Left side of head 4. Prostrating attacks of headache pain --------------------------------------- a. Migraine / Non-Migraine- Does the Veteran have characteristic prostrating attacks of migraine / non-migraine headache pain? [X] Yes [ ] No If yes, indicate frequency, on average, of prostrating attacks over the last several months: [X] Once every month b. Does the Veteran have very prostrating and prolonged attacks of migraines/non-migraine pain productive of severe economic inadaptability? [ ] Yes [X] No 5. Other pertinent physical findings, complications, conditions, signs, symptoms and scars ----------------------------------------------------------------------- a. Does the Veteran have any other pertinent physical findings, complications, conditions, signs or symptoms related to any conditions listed in the Diagnosis Section above? [ ] Yes [X] No b. Does the Veteran have any scars (surgical or otherwise) related to any conditions or to the treatment of any conditions listed in the Diagnosis Section above? [ ] Yes [X] No c. Comments, if any: No response provided. 6. Diagnostic testing --------------------- Are there any other significant diagnostic test findings and/or results? [ ] Yes [X] No 7. Functional impact -------------------- Does the Veteran's headache condition impact his or her ability to work?[X] Yes [ ] No If yes, describe the impact of the Veteran's headache condition, providing one or more examples: She misses several days per month from work due to headaches and currently has used all of her sick leave and has had to borrow sick leave and work without pay. 8. Remarks, if any: ------------------- No remarks provided. ****************************

Thanks in advance folks. KiKi

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Of course, we dont know what the decision maker will decide.  

Before you go into figuring out disablity percentages, first make sure you have Caluza elements documented.  Many Vets, including myself skip the caluza elements then wonder why they were denied.  

Of the 3 Caluza elements, I saw a "diagnosis" (1), and possibly (2) an "in service event" (struck by a limb in boot camp).  However, I did "not" see a nexus.  (statement by your doctor that your migraines are at least as likely as not due to you being struck by a limb in bootcamp).  Your docs statement of the struck in limb in bootcamp should be verified by your service records.  Is it?  Otherwise, your "in service event" is in jeaprody.  Your doctor can not provide an "in service event", that needs to be documented in your service records.  

Absent this nexus, you are likely to get denied.  Of course, your nexus could be elsewhere, and, I may have missed a nexus.  

However, IF you have the magic nexus, your percentage may be determined from 0 to 50 here:

https://cck-law.com/news/how-does-va-rate-migraine-headaches/

Your doc did mention "prostrating" headaches.  

If you dont already have your cfile, order it.  Did your Service records confirm the trauma to your head??  Remember, if its not documented, it did not happen.  

 

Edited by broncovet
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6 hours ago, KiKi said:

currently has used all of her sick leave and has had to borrow sick leave and work without pay.

I don't understand this. I can see not getting paid because you aren't working, but why would you be working without pay?

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Bronc is correct; you never know how a rater will work his/her magic, so there is no purpose in guessing what they will do. That said, you probably should expect that if there is any gray area, they will chose the the lower level. But really, what do you have to show there was an incident in the service and more to the point, how can your doctor connect it with what your medical condition is now. Do you have str showing the event and treatment? A Buddy letter could help substanctiate the event if you had someone that witnessed the event. But that still probably won't be enough to say that that event caused your current disability if you don't have record/diagnosis  of your original injury. If your doc has nothing to review from your incident, he can't compare it to what you have now. No nexus. Maybe there is info in your c file. As Bronc said, order it and see.

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I would look in your service records for any complaint of headaches.  I was granted migraines following a heat stroke because I went to sickbay complaining of headaches due to my injury.  Otherwise proving service connection can be difficult.  I would also expect them to low ball you on migraines, I had to go from 0% to 10,30, and then 50%.  The VA is way behind the times on migraines and how deeply serious they can be.

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Vetquest is correct   expect a low rating.

However I notice these raters are not just only going by theses C&P Exam Notes ,but more as to what the Dr's opinions/reports are saying.... believe it or not.

let us know what they rated you on this.

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On 6/27/2019 at 3:26 AM, Buck52 said:

Vetquest is correct   expect a low rating.

However I notice these raters are not just only going by theses C&P Exam Notes ,but more as to what the Dr's opinions/reports are saying.... believe it or not.

let us know what they rated you on this.

Update:  ok according to ebenifits they apparently approved the migraines at 30% today.  They have an effective date of 11/1/2018 but my previous claim that was denied was back in 2002 and I reopened the claim in January 2019. So I’m a little confused. Anyway This combined with previous ratings makes me 100% effective 11/1/2018 according to ebenifits today.I have not received the BBE.. in fact I am quite confused because my claim was in PRep for notification this morning after lunch I see 100% confirmed in the ab8 and a new ab3 for commissary but my claim went back to gathering evidence and now wont be complete until December 2019. Yes I had other contentions but I have gone to cp  exams for them already so I dont understand what is occurring. Any thoughts would be helpful. Does this mean they will hold out on the retro pay until December too?  So confused. Thanks in advance. 

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