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How i won my migraine claim

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USMC_VET

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My story is alot like other veterans, i had an issue and didnt go to the doc in service to deal with it and didnt go to doctors after because i was just going to tough it out.

I had migraines off and on in service and after and got worse in the years after my discharge.  I was finally to the point where i was missing work on days because of them and eating tylenol and 800mg IBprufen like candy.  I went to a local NP who gave me a Rx and didnt like it and went to a neuro specialist after.  I made a claim at the same time and was denied.

So i decided to do it right the second time and got a NOD ready to file and started to work.

1) i started keeping a diary of all my symptoms of ANYTHING that was going on with me from PTSD to migraines. I realized not only for my migraines but there may come a day i need to defend against a reduction for something like PTSD or pes planus (already fought one for PTSD).  Alongside that phsyical diary about once a month i would go into myhealthevet and transcribe it into a symptoms/diary on there, mostly because it was then in my health record more than anything else. I recommend this to all vets, you dont need to keep a physical and digital diary like me but at least do the digital one.  If they try and hit you with a reduction at some point you can point them to the myhealthevet system and tell them to look at the timestamps to show months, years or decades or inputs.

2) i went to a specialist through private insurance (i know not everyone can) which helped to create more of a paper trail with a medical system that wasnt trying to leave stuff out.  Most if not all hospital systems of moderate size allow you to look at the notes after the visit a few days or so later, if not you can request in person, fax, etc a copy of the visit notes and your record.  Do so, check to make sure they also noted down everything and contact them to update the record if they didnt write something important down, they are usually receptive to this, just let htem know that you need certain things you talked about mentioned so when you share your files with teh VA they can approve Rx's etc. without having to visit them as well.

3) this is somewhat along with #2 but i didnt get a IMO for this claim, i just had a couple of detailed medical visits to private practicioners that painted the picture the VA raters needed to see. It was very detailed in terms of Rx's given, how many incapacitating episodes i had per month, the lights bothering me at work, headaches at work (severity & #'s) as well as how it affected my work performance.

4) i had sworn declarations from myself, wife and some buddy's at work along with sick time off from work that helped to put the personal & work effects in context.  they were very detailed in how it affected me, my work & my family life and the burdens it placed on them, relationships, etc.  the more detail the better.

5) I was lucky in that both of my post deployment questionairres had headaches listed on them, but i dont think thats a must have just a really helpful piece of evidence. without medical record info i think you need to track down a bunch of friends from your unit and have them write down about all the times they saw you have headaches, like every occurence and when you visit a private practicioner show them these and make sure they not in their visit notes that the onset was in whatever years those statements mention so that its a MEDICAL record thing and not a BUDDY statement thing as well.

6) I also in every claim go through my cfile and va/military medical records and search myself for what they need to see.  I dont trust raters to find things so i go through pull the pages i want, HIGHLIGHT the sections they need to see and submit that with my evidence.  they will still look for stuff to support AND DENY your claim, but at least they cant pretend they didnt see it, you submitted it!
 

7) when i submit evidence i do so first online through ebenefits while ALSO submitting it in paper via fax and certified mail WITH RETURN RECEIPT to the evidence intake center.  certified mail/receipt is key. the certified part guarantees that the VA cant deny you didnt send it, the return receipt guarantees they cant deny they didnt receive it.  This doesnt mean they CANT screw up your claim but on appeal after seeing your cfile and what the rater looked at you can make a airtight case that X,Y,Z evidence was provided but not considered.  I know its expensive but all important correspondence i send to the VA regarding claims is sent certified.

😎 The evidence i send ALWAYS has a cover sheet, where i list that i want this evidence considered for my claim(s) for _____ and then i list every piece of evidence, a brief synopsis of what it is and how many pages that piece of evidence contains. I also spell out that i am submitted X numbers of pages of evidence in total and this way it covers the bases of if i submit a cover sheet saying i have 100 pages of evidence and theirs only 67 listed in my cfile, someone along the way after i sent it screwed up. now this hasnt been an issue yet, but maybe it might.

I was eventually, 6 months later granted 30% for migraines, retro back 13 months and EED back 3 years to 2012.

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  • HadIt.com Elder

USMC_VET Way to go! I think somewhere along the line, most probably after your initial denial, that you figured out something that is repeated here on Hadit time after time. That my friend is the fact that nobody, but nobody wants that claim to be approved more than you. So take charge, do what you gotta do. If it makes sense, do it. Evidence is evidence. At lot of work? Overkill? Not if you win your claim. Nice job Marine.

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I agree, I recently won an EED back to 1998 by loading my CD C-file in my computer and doing a search and then copying most of the documents and  making sure that I noted them on my form nine and statement in support of my claim.  My claim did have to go to CAVC and they even further went through my C-file and listed even more evidence that VA either overlooked/omitted or just tried to hide in order to deny my claim but now it is all on record. I not only won my CUE claim where VA did admit to and granted my claim but BVA found that my original claim was still open and pending.  It is good to hear that a veteran can still win his/her claim after everything that VA does not to grant his/her claim.  The new comers need to hear that evidence is evidence and if the veteran feel that he/she should be service connected then the one true thing to do is to fight for their benefits.  Never give up.

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I totally agree . You have given very good advice here  as honestpete 552 and as pacmanX1, and I want to thank you, and the other members,  for helping the recent widowed member ,Lisa.

As many here know, I am preparing a complaint, in the form of a legal brief , and have gathered the Evidence I need, and only have yet to access Pacer for more info on a court case the member had, the link is here at hadit to the apology , but that case has 11 more pages I need to read , that might have  bearing on my complaint, and this limits my time here,

(plus the fact that Spring in NY only lasts a  few days and then we get very high temps and I need to finish my garden and flower beds. It has been a glorious month for me- but sad as well, due to Memorial Day ( I am a Gold Star Wife and honor every day, my deceased husband's service, as well as the 7 years my daughter was in the Military, and she makes Every Day Mothers day for me) 

Evidence as you said is Evidence and Evidence is everything! And the newcomers should also be aware of current VA case law and regulations, to the best of their ability- that control their claims. And not overlook M21-1MR or any OGC Pres Setting decisions, or those from the US CAVC.

But certainly not every claimant has to go through all of that, as and as a successful 'Cuerino 'yourself, you know

VA might fight over even a prime facie CUE, and we must aggressively fight back!

I am still ticked that my prime facie SMC CUE took 8 years ,until it was set for BVA transfer, where I knew it would succeed, but the Nehmer VARO-since it was filed prior to my Nehmer claim, and contingent of a proper CUE resolve- took them a mere 3 weeks- which all of my other CUes took,within the appeal period, to be resolved....

sort of....they did grant SMC S under bother theories of S"...but

I have 2 CUEs pending on that same issue.....I was going to let it go, but realized how much they still owed me, based on a highly erroneous statement from the director of my VARO, so I filed a CUE again (actually 2 CUES) because,

YOU are Right on this Too:

the one true thing to do is to fight for their benefits.  Never give up."

 

 

 

 

 

 

 

 

 

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Forgot to add....Reading BVA decisions every week, since the BVA went online has been a Great help to me and hopefully to others her who have read them, either in my posts or on their own.

BVA's denials are as important as awards, especially on CUE claims. However a CUE with the appellate period does not involve BVA CUE regulations. That type of CUE involves Basis VA 101 regulations-to include the M21-1MR change due to my letter to former Sec. Secretary Shulkin, and a call from his office.... a point I have stressed here many times.

I hope Lisa returns . I also hope the VSO used the correct forms for her claim. DIC and accrued claims are completely different from regular veteran claims. The prime witness,in essense,  to a DIC claim is the dead veteran, and we widows have to 'speak' for them, with the right Evidence the VA requires, and they might even need an IMO as well.

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Thanks Ms. Berta for the kind words. I still say that most of us should be tipping our hats off to you, and many of the Elders.  I like most feel that the things that I had to go through to get my benefits, no one should go through and I would like to try to help in any way I can. Times are hard and getting even harder. We need one another to help overcome these small littler hills.

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