ACE C&P Exam for migraines

[Rallen]

The Veterans Board of Appeals granted me service connection for migraines. The claim was sent to the regional office for rating and I was granted a rating of Zero. A NOD was filed within days of the decision with a selection of Decision Review Officer review appeal under the legacy appeal system. The appeals management center requested a opinion from the regional office and one day I looked on Ebenefits and saw a C&P exam scheduled on July 1, 2019 at 13:00. I was looking at this on Ebenefits at around 17:00 and was amazed to see that I showed up and completed the exam! I was totally confused, and around three days later the ACE C&P exam showed up in Ebenefits and here are the results:

 

Jul 01, 2019, 01:00 PM	OFFICE CONSULTATION	GENERAL INTERNAL MEDICINE	Encounter for other administrative examinations ICD10 Z02.89 with Provider Comments: MEDICAL C&P ACE CHART REVIEW		OLD EAST POINT VA CLINIC
	Encounter Notes The included Outpatient Encounter Notes are available 3 calendar days after completion and include a maximum of the 5 most recent notes associated with the Outpatient Encounter. The data comes from all VA treatment facilities. ·           Date/Time Encounter Note Provider Jul 01, 2019, 03:09 PM C & P EXAMINATION NOTE :  LOCAL TITLE: C&P EXAM  STANDARD TITLE: C & P EXAMINATION NOTE  DATE OF NOTE: JUL 01, 2019@15:09 ENTRY DATE: JUL 01, 2019@15:09:12  AUTHOR:  URGENCY: STATUS: COMPLETED  See CAPRI for ACE completion. NURSE PRACTITIONER Signed: 07/01/2019 15:09   Jul 01, 2019, 01:00 PM C & P EXAMINATION NOTE :  LOCAL TITLE: C&P EXAM  STANDARD TITLE: C & P EXAMINATION NOTE  DATE OF NOTE: JUL 01, 2019@13:00 ENTRY DATE: JUL 01, 2019@15:08:26  AUTHOR:   URGENCY: STATUS: COMPLETED  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] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. 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: G 43.9 Date of diagnosis: established 2. Medical History ------------------ a. Describe the history (including onset and course) of the Veteran's headache conditions (brief summary): The following contentions need to be examined: Migraine headache b. Does the Veteran's treatment plan include taking medication for the diagnosed condition? [ ] Yes [X] No 3. Symptoms ----------- a. Does the Veteran experience headache pain? [ ] Yes [X] No b. Does the Veteran experience non-headache symptoms associated with headaches? (including symptoms associated with an aura prior to headache pain) [ ] Yes [X] No 4. Prostrating attacks of headache pain --------------------------------------- a. Migraine / Non-Migraine- Does the Veteran have characteristic prostrating attacks of migraine / non-migraine headache pain? [ ] 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? [ ] Yes [X] No 8. Remarks, if any: ------------------- CPRS/medical records are silent for any c/o of headaches for past 2 years. NURSE PRACTITIONER Signed: 07/01/2019 15:08 SELYN

 

I have been under care by a board certified neurologist for close to the last 40 years for migraines. I requested my neurologist to complete the DBQ for migraines, which was faxed to the intake center in WI. The appeal has been running for over 2 years for the rate increase and a earlier date. Two questions: 1. Does the neurologist DBQ carry more weight than the DBQ completed by the nurse practitioner ? The DBQ completed by the neurologist is impossible to post because of technical problems.  2. Embarrassing  question! My phone broke and I lost my contacts-Does anyone have the number for the appeals management center?  

[Rallen]

Just now, Patton said:

I should have included the website, which is: https://www.bva.va.gov/CustomerService.asp

Thanks for the information.  A lot of information .

[Rallen]

Just now, Patton said:

At least they Service Connected your migraines, that's half of the battle. Wait for the rating letter. If they rate it at 0%, then submit a Supplemental Claim. Include all new documentation (emergency room visits, etc...). 

The VA as a whole has made the claim process a lot more difficult than it needs to be. Many Veteran just give up and that is a win for the VA. Never give up! 

Doing a google search, I came up with this: 

Once the Board issues a decision (including a remand), we no longer have the authority to act on the appeal. Please review "Your Rights to Appeal Our Decision" included with your Board decision.  You may also contact the Appeals Management Office (AMO) via email or phone at 1-800-827-1000, your local RO or your representative (if you have one to advocate on your behalf). 

The DRO appeal for a increased rating and a earlier effective date has been in the pipeline since October 2018. The ACE DBQ was completed July 1, 2019, and my private physician completed a DBQ, Which  showed up August 15, 2019 at the Appeals Management System, and August 23, 2019 according to the national call center. The Board of Veterans Appeals decision for service connection picked up on VA records dating  March 2007, and the board sounded frustrated in that I had put in a claim around 1997 that was denied and I did not appeal. But I filed a claim to reopen in 2009, Which was not even addressed by my regional office because the regional office wanted new and material evidence which the was already in the VA's possession as Stated in the Board of Appeals decision. When the Board sent the migraine decision to the regional office for rating that land me at zero percent I was taken aback. Fingers crossed  that I will get a fair shake from the DRO and if not back to the Board of appeals.

[Patton]

Hopefully they will do what's right! Please let me know what the outcome.

[Rallen]

Just now, Patton said:

Hopefully they will do what's right! Please let me know what the outcome.

I most definitely will. Thanks for your insight.

[Rallen]

Found the number and the Appeals Management center informed me that the have the ACE C&P exam and the DBQ that my neurologist completed. My appeal for migraines is past development and is now with a rating specialist and I should hear something soon. A NOD requesting a DRO review of effective date and increase from zero with neurologist DBQ supporting a 50 percent. I hope for the best and expect  something to give me a migraine!

[Patton]

You should hear something very soon. You should be able to check eBenefits to see what they gave you once a decision is made.