Migraines

[Wise Guy]

I have a current claim for several injuries to include PTSD. I did some research and found out the best way of getting a rating for migraines is to have a diary through the VA of the migraines. For my PTSD which I got diagnosed through the VA in February, I'm taking Doxazosin (Nightmares), Hydroxyzine (Anxiety), and Sertraline (Mental Health). All of the medication causes headaches. However, the Sertraline only causes headaches within the first 2 weeks. I was going to wait until the claim was complete before filing for Migraines because I wanted to already have the rating for PTSD first so I can claim the migraines as secondary. But is there a way to still file for it now to still say it's because of the medication for the PTSD? Which route should I go or is there a better one? And should I talk to my VA counselor/medication doctor to get him to state that my migraines are caused by my PTSD and medications? I heard every time you file for a new claim, then everything gets re evaluated so it would be ideal if there was a way to get everything done now. 

 

Also, I did get diagnosed through the VA for Sleep Apnea back in February,. So, can I say that the migraines was also caused by the Sleep Apnea?

Edited May 12, 2020 by Wise Guy

[GBArmy]

Wise Guy It usually is a safer route to get the first disability granted before trying to get another one as secondary. You could do both at the same time but it is riskier. Sleep apnea is not a slam dunk as you might think because of the high rating (0% or 50%.) I would suggest that you go and get an outside sleep study done by a specialist and be sure that if you are  found to require a CPAP machine, your specialist says it is absolutely necessary for your health NOT just "recommended."  Just because you are diagnosed with SA by the VA DOES NOT mean you absolutely need a CPAP machine, or that it is s-c.. Do research and find out if any of those prescribed meds by the VA can cause sleep issues. Look at the cautions on the prescriptions. If you find the link, you can provide that info to your sleep doc. He/she has to write an IMO that says the headaches are caused by the meds, provide back up medical justification from med articles, research, journals etc. and have a statement that in their opinion t is "ast least as likely as not" that the meds caused your SA. If all you do is say (in your opinion, this med does so and so, it doesn't count. You are not a medical professional.) Same routine for headaches. Research. Get a log and record time, duration, effects of your headaches ex. had to lay down for 2 hours in a dark place, frequency, what may have caused ex.  had coffee, drove 50 miles for dr.'s appointment and traffic bad, etc. There are apps also available. Submit that as record on secure messaging to your doc  so it is on record. If you can show your MH doc your research and he can put in his notes that X,Y, or Z for meds can cause migraines that wold be great, but don't count on him doing it.IMO I would go for the the PTSD first and get that approved. Then go for the migraines, then the SA. Remember that just because you have a VA diagnosis, it doesn't mean that it is recognized as a s-c condition. Get the PTSD first.

[pacmanx1]

IMHO, I do agree but you will have to decide what is better for you.  As stated it is never advised to file claims directly and secondary simultaneously due to the fact that VA could deny them all in one quick denial.  Now if you have the in-service accident or event, a current diagnosis and a nexus of each condition then by all means you can file all claims as directly related to military service but not secondary.

Yes by filing a claim for directly service connected and then waiting for it to be granted then filing claims for secondary will take time but it is better for the veteran not to put the horse before the carriage. By filing directly and secondary claims simultaneously would add more years on appeal compared to filing a claim for directly and then waiting for it to be granted and then go from there.  I also agree that PTSD should be first then sleep apnea and then migraines in those orders.  It is well known that PTSD can cause sleep apnea and it is also well known that sleep apnea can cause migraine headaches. Keep in mind that this is the only and correct order.  You will still need medical opinions that one is as least as likely as not the cause of the other. 

[Wise Guy]

@pacmanx1 I had an appointment with my sleep apnea doctor today just to see how my CPAP machine was coming along. In the appointment, I asked him if sleep apnea is caused by PTSD (so he can state that in my record) and he said absolutely not and explained why. He then stated to me for compensation I'm good because in his very first sentence he typed in my record, it states that "Patient has had Sleep Apnea x 5 years". He said this would put it back to 2015 since the time I was in so all I had to do was file and I was good. Some VA doctors are cool I'm glad he helped out

[pacmanx1]

9 hours ago, Wise Guy said:

@pacmanx1 I had an appointment with my sleep apnea doctor today just to see how my CPAP machine was coming along. In the appointment, I asked him if sleep apnea is caused by PTSD (so he can state that in my record) and he said absolutely not and explained why. He then stated to me for compensation I'm good because in his very first sentence he typed in my record, it states that "Patient has had Sleep Apnea x 5 years". He said this would put it back to 2015 since the time I was in so all I had to do was file and I was good. Some VA doctors are cool I'm glad he helped out

Not sure why the doctor disagreed/lied about link between PTSD and sleep apnea. He could be just ignorant of the fact that many veterans are getting service connected that way.  https://cck-law.com/blog/sleep-apnea-secondary-ptsd-va-disability-benefits. 

Never the less depending on what he wrote, the evidence in your file and his medical rationale you should be good in filing a claim for both PTSD and sleep apnea as directly service related.  Please don't take this the wrong way but you have your records and you can  see what he wrote compared to what he said. The writing in your records are most important and relevant to your claims.