Hi, another one for you here. Denial of entitlement to an evaluation in excess of 0 percent for migraine headaches, Jan 2020. Reason for denial by De Novo review as follows: "We have reviewed the evidence and found it does not support you experience prostrating attacks that would warrant an evaluation in excess of 0 percent. While your testimony is credible, the probative evidence does not show your reported symptoms cause extreme exhaustion, powerlessness, debilitation or incapacitation with substantial inability to engage in ordinary activities, or result in substantial work impairment."
With that, I submitted new material evidence Nov 2020 by rehabilitation hospital M.D. who reported I have 5-7 headaches a week that require me to lay down for over an hour and take medication. He also noted aura and vertigo and my headaches where hard to control. In my supplemental statement of case, I requested them to review my ER visit for Migraine and the following day I presented as a walk in to Primary Care because it came back. I also noted in the original C&P exam in which the examiner stated they were not prostrating, but he also mentioned that I have weekly headaches where I have to lie on the ground for an hour or two affecting my work. All notes, ER visit 2016, C&P exam dated 2018 and new material evidence dated 2019 provides consistent periods of prostrating events and asked them to review as such. I also provided evidenced-based clinical literature showing productivity and impairment, and financial impact due to migraine but also requested VA to consider whether the migraines where at least capable of producing severe economic inadaptability and not just actually produces as the court has held they need to assess both.
With that, just as of today, I get a call from LHI stating they need to schedule me a C&P exam for headaches. However, the last exam was just done 2018. Why would they do this and what is my course of action? Thank you taking the time to help!
These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.
Service Connection
Frost v. Shulkin (2017)
This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected.
Saunders v. Wilkie (2018)
The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.
Effective Dates
Martinez v. McDonough (2023)
This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.
I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful. We decided I should submit a few new claims which we did. He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims. He said that the VA now has entire military medical record on file and would find the record(s) in their own file. It seemed odd to me as my service dates back to 1981 and spans 34 years through my retirement in 2015. It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me. He didn't want my copies. Anyone have any information on this. Much thanks in advance.
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.
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Recondo@53
Hi, another one for you here. Denial of entitlement to an evaluation in excess of 0 percent for migraine headaches, Jan 2020. Reason for denial by De Novo review as follows: "We have reviewed the evidence and found it does not support you experience prostrating attacks that would warrant an evaluation in excess of 0 percent. While your testimony is credible, the probative evidence does not show your reported symptoms cause extreme exhaustion, powerlessness, debilitation or incapacitation with substantial inability to engage in ordinary activities, or result in substantial work impairment."
With that, I submitted new material evidence Nov 2020 by rehabilitation hospital M.D. who reported I have 5-7 headaches a week that require me to lay down for over an hour and take medication. He also noted aura and vertigo and my headaches where hard to control. In my supplemental statement of case, I requested them to review my ER visit for Migraine and the following day I presented as a walk in to Primary Care because it came back. I also noted in the original C&P exam in which the examiner stated they were not prostrating, but he also mentioned that I have weekly headaches where I have to lie on the ground for an hour or two affecting my work. All notes, ER visit 2016, C&P exam dated 2018 and new material evidence dated 2019 provides consistent periods of prostrating events and asked them to review as such. I also provided evidenced-based clinical literature showing productivity and impairment, and financial impact due to migraine but also requested VA to consider whether the migraines where at least capable of producing severe economic inadaptability and not just actually produces as the court has held they need to assess both.
With that, just as of today, I get a call from LHI stating they need to schedule me a C&P exam for headaches. However, the last exam was just done 2018. Why would they do this and what is my course of action? Thank you taking the time to help!
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pacmanx1
First, the 2018 C & P exam in way to old. Second, it seems that you filed a claim, and it was rated and denied in Jan 2020. You recently filed a supplemental with new medical evidence Nov 2020 and
pacmanx1
VA will do whatever VA will do, with that said, I think you really know the answer but here I go anyway. Yes, VA can make your effective date the date of your original claim. You posted that you miss
El Train
I think you will probably be increased to the date of your NOD with additional evidence. At least that's the way it worked for me. And yes, I had C&P's requested by the VA after I filed NOD's wi
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