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Headache letter

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So what do you understand from this? photo in the Link - https://ibb.co/5Wm84vD


I already got a diagnostic recently after the letter, So if I send the Diagnostic as a supplemental would they come back denying due to no nexus letter?

Or is the nexus already covered? 

Also 3rd paragraph - the medical evidence support the conclusion that a persistent disability was not present.
- would this be the next reason for a denial? how you overcome this?


Around November 2007 I was in Afghanistan in the process of being medically transported to Germany and then WalterReed for another condition, I believe I left WalterReed around January or late December and that part of the favorable finding. When I complained of headaches.

This last March 2021 I went to the VA Emergency Room due to strong headaches. I rarely go or complain I just pop some Tylenol or Ibuprofen and call it.

Now I am taking Migraines medication Sumatriptan given to me by the VA.


trying to get as much advise as I can before I send a supplemental claim.


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Welcome to hadit.  You have a valid point. 

     There is a "presumptive" here.  Let me explain.  

You enter military service, and were given a physical.  The presumption here, is that the doc did his job, and you had no maladies, other than those he noted on your physical.  

Then, you have an "exit physical".  If you have a malady on your exit physical, which was not on your entrance physical, then the presumption is you got that in service.  

However, VA can "rebut" that presumption.  Lets use an example.  Let's say you have "knee problems" now, but had none before service.  

But you got into a car accident AFTER military service, and records show a knee injury in a car accident post service.  The VA can "rebut" the presumptive, citing your car accident injury.  

      So, you are actually missing "2" of the Caluza elments described in the letter you posted. (allegedly).  

1.  You have no "in service event" or aggravation which was DOCUMENTED in military service.   Now, lets talk about this.  Ok, so you complained of headaches.  Ok.  Well what did you tell the doc that happened in military service that caused your headaches or, did you have headaches documented before and they got worse in service.  For example, did you hit your head on something?  Was it documented?  Did you have a "headache trigger" in service?  I can not answer those questions...I was not with you in service, and I have not seen your service medical records or cfile.  


2.  Nexus, or doc statement that your (in service event) "at least as likely as not" led to your current migraine diagnosis.  

3.  The "other" caluza element is that you have to have. a diagnosis by a dcotor that you have headaches, migraines, etc.  

     Normally, you get the caluza elements documented, you get service conneced.  

      A doctor "can not" invent an in service event.  It has to be documented in your records, OR, sometimes a buddy can send a letter documenting it .  

     Example:  (Lets call you "Joe Veteran" and your friend "Frank Veteran" for this example)

      I was with Joe, when we were doing drills and we were practicing hand to hand combat skills.  He fell off a truck and landed on his head.  

Later, he complained of headaches and went to sick bay.  However, the doc apparently did not treat his headaches.

     signed...Frank Veteran.  

      It usually needs to be an "eyewitness account", that he saw you fall on your head.  Or, he told you he fell on your head and he went to sick bay and complained.  

      My advice is to check your records, see if you have documentation of the caluza elements.  You will likely need to file a NOTICE of disagreement and go to the BVA arguing you had all 3 caluza elements.  

     If you have the caluza elements you should win service connection..then it will be down to symptoms (current).  


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  • 2 weeks later...


thanks, I did a search and found what happened it was due to a lumbar puncture headache.

So no way that is was causing my headaches now. Almost 20yr later.

i believe now what causing my headaches is my PTSD.

- Not sure if I should start a new topic or ask here.

But having headaches denied as a primary can I claim them as secondary or once you have a condition claimed as primary it can’t be changed to secondary?

That was added as part of the VA inferred claim I did not file for it, the rater or someone in the claim process added it because I mentioned I was having headaches in my statement for PTSD.

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Cloudbuster Sure, You can submit a disability claim for anything. I am assuming you have a VA disability for PTSD; what is your rating? Do you have any other disabilities also approved ? What you want to do is find out what the diagnosis was by the VA specifically; that is, for example PTSD with MDD and anxiety. Your looking to see if your headaches is part of the diagnosis for your MH condition. If it isn't called out in your decision letter, you should be able to get it by requesting your rating sheet from the VA. Call 800-827-1000. Tell them you want a confirmation of your disability ratings make-up. Or, just get copies from the VA of all the notes concerning your disability. If headaches are not called out as part of your diagnosis, you should be able to claim a new disability for them. (The VA is rating your disability based on your symptoms; kinda like the more symptoms, the higher rating.) Including headaches as part of your diagnosis means that they are including that symptom as part of your comp. It can be secondary to your MH condition. Veterans re-apply for disabilities all the time after being denied. Doesn't matter whether it is primary or secondary. In fact, when submitting a claim for the first time, it is often better not to call out whether it is primary or secondary. Let the VA decide what it is. And just to add, there may be other disabilities that can be secondary to headaches, like sleep apnea, complications from meds, etc. 

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