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]

Thank you Patton,,

1. One step closer regardless the outcome . I  am just wanting the appeal to go forward in that I can either get paid or learn more, Both are priceless.

[Patton]

Rallen,

I failed a number of times before learning how to successfully submit a claim. The key is to educate yourself and never give up. You have taken the first step in being successful. I am still fighting the battle but one day I will win the battle.

Best of luck,

Patton

[Rallen]

Thanks Patton, Will you keep us updated on your appeal also? We all can learn from your experience, and maybe it will help some of  the Veterans that have served our country that say the hell with the VA- They can take the claim and shove it.