Correcting Error

[scooter318]

Hi Everyone

I recently had a C&P exam on the 9th of July, the examiner told me that it would take 30 days for her to do her research and come to a decision about my claim. So the 9th of September was the 30 day mark and the case is still open as of today. I checked my blue button records and she actually made a decision on my claim the same day she said it's less likely than not. So my question is has any one seen results take this long and why would she lie to me and say it's going to take 30 days for her to find results and she made a decision the same day.

[Berta]

Just to add, the examiner failed to consider this search of how PTSD veterans have migraines and headaches due to their PTSD:

https://www.google.com/search?q=PTSD+in+veterans+affecting+or+causing+migraines&rlz=1C1CHBF_enUS695US695&ei=j5sfYd3zC42PtAaLg5mICQ&oq=PTSD+in+veterans+affecting+or+causing+migraines&gs_lcp=Cgdnd3Mtd2l6EAw6BwgAEEcQsAM6BQgAEJECOgsILhCABBDHARCjAjoOCC4QgAQQsQMQxwEQowI6DgguEIAEELEDEMcBENEDOgsIABCABBCxAxCDAToICC4QsQMQgwE6CAgAEIAEELEDOgQIABBDOggILhCABBCxAzoFCAAQgAQ6CAgAELEDEIMBOgUILhCABDoHCAAQgAQQCjoHCAAQsQMQCjoECAAQCjoKCAAQsQMQgwEQCjoECAAQDToECC4QDToHCCEQChCgAToICCEQFhAdEB46BQgAEM0COgUIIRCrAkoECEEYAFD2LVihiAJggJ0CaAJwAngGgAGwFYgBjuoCkgEMNS0xLjI1LjguOC4xmAEAoAEBsAEAyAEIwAEB&sclient=gws-wiz&ved=0ahUKEwid95bbyL_yAhWNB80KHYtBBpEQ4dUDCA4

And here is an excellent article by CCK- great lawyers for veterans claims:

https://cck-law.com/blog/migraines-secondary-to-ptsd-va-disability-benefits/

[Berta]

I just picked up on this:

"I actually already did a supplemental before I did the HLR and that one was denied as well, so could I go back and do another supplemental or do I have to go to the BVA?"

Can you scan and attach a redacted copy of the HLR decision? And the Evidence list-

Sorry- I didn't catch this sooner----I had PC work done recently and it seemed to change everything----

but it is  me- as well- I am extremely depressed over the Afghanistan situation-how are those people waiting at the gates ( or Americans who have not even gotten to the airport yet)- getting water and food- there are innocent children there-in his book "The Gallic Wars"- Julius Caesar surrounded a large fortress on a hill and waited for them all to die of thirst and starvation ,  as they could not get any supplies they needed, after they exhausted their food/water supply.

History repeats itself. 

The American Legion, DAV etc has sent me their statements on Afghanistan. There is help out there for veterans affected by this catastrophe- and for survivors of veterans as well.

The VA was more prepared for this then our Gov was. Sorry-----I am so angry----

 

[broncovet]

Your c and P exam was signed by a PA.  While a PA certainly can be both competent and qualified, this leaves the door open to your IMO being an MD, and should put you in a good position.  

"Competent" medical professional, however, does not necessarily mean "MD".  

For example, an Audiologist, with a Masters Degree (not a phd) who has significant experience and training can render an opinion that would be a "competent medical opinion".   

I think you need to "get this out" of the VARO and to the BVA.  This means to not do any more HLR's...but instead appeal to the BVA.  Sure, I know you want to save time, but it does not save time to get denied again and have to start over and then go the the BVA>. 

The BVA has to give a reason as to "why" they favored one exam over another.  

Or, it can be appealed to the CAVC and you can get an attorney who's fees would be paid by EAJA>. 

As stated, your IMO is important, maybe critical.  

To suceed, your IMO has to have several things going on here:

1.  THE IMO must state he reviewed your records.  

2.  The IMO doc must show his CV demonstrating competency, that is, training and experience in the field. 

3.  The IMO must "use language" the VA understands, and that usually means "at least as likely as not" in there somewhere.  The terms

"probably" related to PTSD, or "maybe" related to PTSD, or "could be" related to PTSD are deal killers, usually because the IMO doc is not familiar with VA.  (happens a lot).  

4.  The IMO doc must give his medical rationale as to "why" he rendered his opinion.  This often means citing medical studiens which link PTSD and migraines, for example.  

In my opinion a independent medical exam (IME)  is better than an IMO.  An exam suggests the doc saw you, while a doc can render an opinion based solely on what other doctors wrote down.  

An IME is new evidence, for sure.  "New evidence" can neither be cumulative nor redundandt to qualify for 38 CFR 3.156's special early effective date benefits.  

[scooter318]

Hi Berta

I've attached a copy of the IMO 

migraine IMO.docx

[Berta]

I see a problem with the IMO -unless you claimed the other conditions. If so have you gotten any C & P exams on them regarding this claim?

The IMO is very well done but it is what you actually claimed----- as cause or aggravating the Migraine condition.

The IMO PA-C stated:

"I have personally reviewed his service records, VA records, and private medical records. I have also reviewed and have noted the circumstances and events of military service with the Navy.

Veteran is seeking service-connection for migraine headaches secondary to chronic pain that he experiences from his service-connected orthopedic conditions. He is service-connected for lumbosacral intervertebral disc syndrome with spondylolisthesis and degenerative arthritis, left lower extremity radiculopathy, and right lower extremity radiculopathy with sciatic nerve involvement. His condition is further aggravated by his service connected post-traumatic stress disorder with adjustment disorder, anxiety, and depressed mood."

She gave excellent references from the internet to bolster the opinion.

BUT I thought you were seeking the NSC migraines as secondary to your PTSD.

Did you claim all of the above conditions in addition to the PTSD?

 

he states:

"After a review of the pertinent records and current literature, it is my professional opinion that it is at least as likely than not that Veteran migraines have been aggravated by his service connected conditions. Specifically, his chronic pain and PTSD with anxiety and depression. Veteran began experiencing episodes of migraines triggered by pain episodes last year that have progressively worsened. This caused him to isolate himself from friends, family, and necessitated working from home. This has caused his PTSD with depression and anxiety to worsen and further aggravate his migraines.  The medical literature supports his worsening condition through activating the hypothalamic and brainstem pathways in activating the pain response or lowering the threshold of the pain response. The evidence clearly shows that PTSD patients have a much higher incidence of suffering from migraines and its associated disabilities than migraine suffers without PTSD. There is a common pathophysiology through autonomic dysregulation. The evidence clearly shows that depression can aggravate migraine headaches, and vice-versa, and that research indicates that depression can be a causal factor in the development of migraine headaches. He will likely continue to experience difficulty with migraines and controlling them due to his service-connected conditions."

She gave excellent internet references for the opinion.

But in my lay opinion I feel the migraines might well stem from the "lumbosacral intervertebral disc syndrome with spondylolisthesis and degenerative arthritis" to possibly  include the other 

Sciatic nerve problems, as listed in the IMO.

I feel you can definitely get the migraines SCed as secondary but I hope others chime in, because there might be an easier way, then if the claim solely rests on the PTSD as causing the secondary.

What I mean is this-the VA could read the opinion and then order C & P exams unless you might have had recent ones on the other conditions-

BUT I dont expect the VA to do that ( it would be great) if you did not formally claim them as aggravating or causing the migraines.

There is no VA case law or regulation that tells the VA to use Common Sense.

 

 

 

Edited August 20, 2021 by Berta
added more

[scooter318]

Berta

I was rated for the back issues back in 2014 and I was recently rated for PTSD in September of 2020. So in your opinion my IMO should have been geared toward the PTSD and not the other conditions.