Secondary Service Connection for Migraine

[Duster4-60]

I am rated at 50% for PTSD. I would like to file for "Secondary Service Connection for Migraine Headaches"

I am thinking about doing this myself. I see lots of ads from Law Firms. Just wondering if anyone had any thoughts on the best way to file.

Thanks

[brokensoldier244th]

You don't need a law firm for an initial filing, and most won't take it, anyway- there is little incentive for them because the backpay will probably not cover the filing, and you can do it yourself anyway and get all the money. Save the legal stuff for if you have to file an appeal to either VA local or the Board.

 

File a 526ez for migraine and put that you are claiming it secondary to whatever you think its secondary to. Make sure that you have either kept up with treatment at VA or private, and if private, fill out a 21-4142/4142ez at the same time to send in so we can have release to request your private provider records (or request them yourself and send in the relevant parts- its faster and not all doctors respond to our requests- they aren't required to). The VA or Tricare stuff we can request already because they are federal.

 

It will help if your doctor/PCP/Neurologist, whoever you see can write up something either in your medical notes, or to you (preferably both) so that you can submit it or know that its in there when we request those records that says that 1. they are familiar with your military service and PTSD condition, 2. have been treating you for X long, 3. note how many  headaches a month you have and what symptoms accompany them and what you do to mitigate them, and 4. if they can link any literature citations RE: PTSD and Migraines and YOU all the better. Its pretty common that migraines are a subset of PTSD but if you just link some random study that you weren't a part of that study doesn't have much value unless your doctor can say "yeah, this study says migraines and PTSD, and my patient fits the criteria. 

 

Also, the wording helps if you can mirror what is on the DBQ that the examiner for VA/Vendor will be using- that language is "At least as likely as not" (meaning 50% or greater chance that your X is connected to Y). "Less likely than not" means less than 50% chance. While the exact wording does not have to be word for word, It does make it easier to find when we search your evidence to include with the examination request and it mirrors the DBQ form and opinion that the examiner will write. A nexus letter contains a definitive statement AND some rationale as to why. I see a lot of nexus letters that say X is connected to Y and no explanation tying the two together, whether its observation, study evidence, whatever. Sure, it may be buried in your medical notes, but if you have 1000 pages of notes its a lot harder for me to find and cite/highlight so the examiner and ultimately the rater sees it.

 

Even better if you can get them to fill out the attached DBQ for migraines and write a letter together that you submit. 

 

https://cck-law.com/blog/will-va-doctors-write-nexus-letters/

https://www.benefits.va.gov/compensation/docs/Headaches_Including_Migraines.pdf

Edited December 2, 2021 by brokensoldier244th

[pacmanx1]

3 hours ago, Duster4-60 said:

I am rated at 50% for PTSD. I would like to file for "Secondary Service Connection for Migraine Headaches"

 

I am thinking about doing this myself. I see lots of ads from Law Firms. Just wondering if anyone had any thoughts on the best way to file.

Thanks

You are going to need an IMO/IME (Independent Medical Opinion/Independent Medical Examination) that states that your migraines are as least likely as not caused by or the result of your service- connected PTSD. It should have a good medical rationale that relates the two disabilities. You only need a lawyer for appeals to the BVA or higher. The IMO/UME should come from a psychiatrist or a neurologist. 

Edited December 2, 2021 by pacmanx1

[pwrslm]

Lay statements carry significant weight in claims. You experience migraines, so you can testify to the severity and duration. You can also explain when they started, as your experience can identify if they began in service as mild and then got worse, or if they were mild before you joined active duty and that active duty service made them worse. The PTSD award provides you with evidence that can be used also, did you mention headaches in C&P exam when they awarded you PTSD? That should be used.

 

I always prepare myself for secondary conditions by taking the issue to my VA PCP. Let them diagnose the issue, refer you to specialists, whatever it takes. You do not have to mention you are going to claim this, just bring them the issue to deal with and let them handle it.  If you were exposed to TBI, get that documented as well. When all of the VA PCP eval is finished, then submit the claim.  

[broncovet]

Read your medical file before spending money on an IMO/IME.  The evidence "may" already be there!  

You dont know until you read what the doctors have said about you.  

"Just file".  (for migraines).  My advice:

"Im filing for migraines "to include" secondary to PTSD or other conditions.  

Dont burn down any bridges.  You dont know what your doc may say.  He may say, possibly, 

"your migraines were not caused by your PTSD.  Instead your migraines were because of trauma you had in the military service"

Primary, secondary..you dont care..you also do not have to be an expert on origins of secondary/primary/presumptive va conditions in order to get benefits.  Just file, let them figure out whether to grant it primary secondary, presumptive etc.  

 

[brokensoldier244th]

You can get your local VAMC records off of MyHealthVet, going back 3-4 yrs I think. VA pulls that stuff anyway but at least you'll know what's in there. 

[Dot09]

I was just recently awarded migraines at 50%. If you file it as a secondary you will likely be denied. You need to file it as a supplemental claim. Claiming that your service connection of ptsd aggravates your non service connection of migraines. They will determine a baseline which they can’t.  This can Only be done in person. On line does not have the option for aggravation. I would also recommend that you take a peek at the ratings in title 38 for a rating. Also try to get a migraine specialist to fill out a DBQ migraine form whether va or private. 
 

good luck