Would VA C&P recognize documented "Chronic headaches with nausea and fatigue, involving light sensitivity" as Migraines?

[Wico1337]

I feel like VA doctors refuse to give a proper diagnosis on anything. From my standpoint, I feel like I get migraines. The pain only occurs like once a month, but when it hits, I feel such extreme pain all around my head and am so fatigued that I literally have to lay down until it disappates or take Migraine Medicine. However, my doctor listed me as having "Chronic headaches with nausea and fatigue, involving light sensitivity".

My question is... If I file a VA claim for Migraines and this information is presented to a VA decision/rater, would they recognize it as Migraines? Or do I need a clinical official diagnosis for Migraines? I feel like any person who is being reasonable would look at the text written and safely assume they are describing migraines without saying it.

[pacmanx1]

On 6/25/2022 at 9:41 AM, Wico1337 said:

My question is... If I file a VA claim for Migraines and this information is presented to a VA decision/rater, would they recognize it as Migraines? Or do I need a clinical official diagnosis for Migraines? I feel like any person who is being reasonable would look at the text written and safely assume they are describing migraines without saying it.

The problem with a lot of claims for headaches/migraines is that VA raters look for the word prostrating which is not a word that the average person would use. Prostrating simply means to lay down, even the BVA and the CAVC has acknowledge that the word/term has not been defined by the VA, but a lot of veteran has to appeal their claims just to get service connected or correctly rated.

The average person goes to the hospital or doctor’s office and state that their head is hurting to the point where they have to lay down or they feel sick and dizzy or have nausea, but they do not say they feel prostrating. Now before this post is attacked, I am posting my personal experience in filing a claim for headaches/migraines and helping other veterans file claims for headaches/migraines. In any case the BVA/CVAC looks at headaches, migraines, sinus headaches, tension headaches, chronic headaches recurring headaches and any other headaches you could/would produce would all fall under the same 38 CFR 8100 criteria.

Accordingly, the DC 8100 Migraines VA Rating Criteria is as follows:

• 50 percent VA rating for migraines is warranted with very frequent, completely prostrating, and prolonged attacks productive of severe economic inadaptability.
• 30 percent VA migraines rating is warranted with characteristic prostrating attacks occurring on an average once a month, over the preceding several months.
• 10 percent VA disability rating for migraines is warranted with characteristic prostrating attacks averaging once per two months, over the preceding several months.
• 0 percent migraines VA rating is warranted with less frequent attacks than the 10 percent rating criteria.

 

Edited July 6, 2022 by pacmanx1

[Wico1337]

On 6/25/2022 at 5:57 PM, Dustoff 11 said:

Your doctor said therefore that your headache symptoms are basically same as those of migraines so I would file for Migraines and stress in your claim arguments/contentions that the doctor diagnosed you with "Migraine" and use only the term migraines in your claim, not headaches and list all your migraine symptoms.

First, I want to say THANK YOU to everyone in this thread for the amazing information. Dustoff11, I really think you have a lot of convincing points here and I really appreciate the in depth response. From your knowledge and/or experience, would you suggest I file two separate claims? One claiming headaches with all "headache" terminology and one other separate claim for Migraines while only using the word Migraine and migraine terminology? Is there any downside or upside to doing that? I feel like it may be able to double up on my raters, until I get lucky enough to have one correctly rate me?

[Dustoff1970]

I would under no condition file two separate claims for the very same medical issue as this confusion will give VARO raters an excuse to ignore your Migraine claim and give you a 0 or low or no rating for regular type cluster headaches that can even be more painful than migraines.  I always ask for the highest rating possible in every claim I file and also state very clearly my most severe recurring and long-term symptoms and use the term severe symptoms before and after taking medications for the migraines. Clearly list your most severe symptoms in the claim and how this in detail adversely impacts your daily life and employment abilities. Your doctor used the term chronic which is good for your claim, and you should repeat that word in your claim.

Pacmanx has also given you important good advice and listed the different ratings levels based on severe to mild symptoms.  Since you want the highest rating level possible for Migraine headaches then use only the term migraine and not headaches as I stated earlier.  If you have to lay down and try to rest and sleep due to migraine, then state this clearly.  If you suffer from nausea and vertigo during migraine episodes then state this clearly also, etc., etc,. 

Don't be lazy and do follow the procedures I listed in my first comment that does require extra work on your part for important to you claim.

Thanks for your comment as unlike some others such as I do not give abrupt short half answers to involved medical claim issues.  You should also consult with a paid VSO found at VARO offices and VA hospitals for additional advice and assistance.    Remember Medical record copies and prescriptions drug copies are your friends. Never leave home without them (Joke).

I am done here now.  Best of luck

My comment is not legal advice as I am not a lawyer, paralegal or VSO.

 

Edited June 28, 2022 by Dustoff 11

[flow1972]

On 6/25/2022 at 1:36 PM, Richard1954 said:

 Since it involves light sensitivity,  I am guessing it had nothing to do with your military servide, but that is just a guess, and I am not a doctor. 

Light sensitivity is just a symptom of a Migraine.  It has no bearing on whether the Migraine is related to service or not.

[flow1972]

My husband was just rated 50% on Migraines due to TBI in Service.  I agree with the advice to claim Migraines as long as you can give a reason for Nexus.  The diagnosis is already in your file by the definition of your symptoms.  Don't over think this stuff.  If you want to include the Mayo Clinic symptomology for Migraine, it doesn't hurt.  Also, I made my husband keep a headache journal for several months in preparation of the C&P as well as provided to his VA PC Doc.  He already had the prescriptions in history for the Migraine meds as well as emails to his PC requesting further evaluation due to frequency and severity.  He had started quarterly treatments of some kind of gel stuff that put in up his nose by the time the C&P came around.  The rater took all of that and granted the correct rating.

 

Items documented in journal:

Date, (approximate) Start Time,(approximate) End Time , Intensity 1-10, Medication Taken, Required Lying Down In Dark Room (Y or N)

[Whodat]

All had given great advice. This is one of those claims that are really tough to get nowadays. Not saying that it can't be done. 

I have been diagnosed with migraines. Prostrating, light/sound sensitivity all in my records. What causes my migraines? I filed for it as secondary to my serviced connected PTSD and other service connected disabilities. On that particular claim I had gotten a duty to assist error and had to do another c&p and that examiner stated that I have cluster headaches not migraines so I got denied. 

Someone mentioned about just claiming headaches. I think that it's great advice. 

We all have different experience with VA and all of us have different outcomes. But I wouldn't file migraines and headaches at the same time. Just my opinion b

 

All had given great advice. This is one of those claims that are really tough to get nowadays. Not saying that it can't be done. 

I have been diagnosed with migraines. Prostrating, light/sound sensitivity all in my records. What causes my migraines? I filed for it as secondary to my serviced connected PTSD and other service connected disabilities. On that particular claim I had gotten a duty to assist error and had to do another c&p and that examiner stated that I have cluster headaches not migraines so I got denied. 

Someone mentioned about just claiming headaches. I think that it's great advice. 

We all have different experience with VA and all of us have different outcomes. But I wouldn't file migraines and headaches at the same time. Just my opinion b