I am about to file a claim for Headaches. Below is the information I will supply in the claim. Do you think it will suffice?

[Wico1337]

Hello all, below is what I plan on filing with my VA claim. Do you think it will suffice? I was sure to point out I have a current diagnosis by the VA. A convincing nexus along with how the condition has already been acknowledged as being secondary to my current rated condition. Backed by citation of another veterans review. And finally, criteria of my condition and how it falls in line with the 50% rating for headaches.

Beginning of claim

"Headache Claim

 

 

With a recent suggestion of my VA Primary Care physician to include daily intake of Zyrtec and Flonase to ease my Allergic Rhinitis symptoms, my headaches have began to occur less frequently and less severe since taking the Medications suggested by the VA. This has made it apparent that my Allergic Rhinitis has caused my Headaches for many years. The ENT specialist at the VA diagnosed me with Allergic Rhinitis and prescribed me medication so I do not need to continue buying Zyrtec and Flonase.

 

The VA has already ruled that there is a direct nexus between Allergic Rhinitis and Headaches.

 

According to VA Citation Nr: 1048433

 

https://www.va.gov/vetapp10/files6/1048433.txt

 

Quote “Service connection for migraine headaches as secondary to allergic rhinitis is granted.”

 

All headaches, including Migraine Headaches, fall under the same category of ratings which is 38 CFR 8100. 

 

I have a diagnosis of Chronic Headaches from the VA Primary Care physician on file.

 

The following VA Finding means that while I am describing my symptoms, I will refer to my symptoms for my condition as unmedicated, as medication is not mentioned in the rating schedule for Headaches.

 

In Jones v. Shinseki, 26 Vet.App. 56, 63 (2012), the Court held that the veteran is entitled to a rating based upon his unmedicated condition – that is, the higher disability evaluation – if the effects of medication are not explicitly mentioned under the applicable diagnostic code of the rating schedule.

 

My condition for Headaches occur very frequently, forcing me to assume the prostrating position which is where I need to lay down in a dark area and rest my body and mind. This can last anywhere from hours to days. This has caused severe economic inadaptability. Causing me to cancel meetings with people, miss hours or a day of work, miss spending time with wife, miss participating in my things in life. All because of the extreme head pain and overall extreme body exhaustion that my headaches cause."

End of claim.

With all of the information above. How should I present my symptoms to the examiner? The examiner will be asking how frequently headaches occur. Should I follow the guidelines of pre-medication? Or when they ask me questions about how often I get headaches, should I answer them how I feel currently with medication? If I answer with how I feel while medicated, I have a feeling that the Rater will see the symptoms as a 30% rating. And I would have to appeal for a 50% rating as I should have been rated for 50%. What would be the best way to approach? And do you have any feedback on my claim statement above?

[broncovet]

Yes, it can be sc secondary, "If" (and only if) your doctor opines that your (diagnosis of headaches) is at least as likely as not due to PTSD/anxiety/depression, etc. (SC conditions).  

[Whodat]

Thank you Bronco. I am not trying to be negative at all. But looks like he it trying to claim a secondary to something that he isn't service connected for. He is trying to get a Nexus or an IMO for something that hasn't been approved. He does an SC mental disorder. I would think that I would try to connect a secondary condition for something that's already serviced connected. Just me. 

[MilvetHD]

On 7/14/2022 at 8:27 PM, Whodat said:

Thank you Bronco. I am not trying to be negative at all. But looks like he it trying to claim a secondary to something that he isn't service connected for. He is trying to get a Nexus or an IMO for something that hasn't been approved. He does an SC mental disorder. I would think that I would try to connect a secondary condition for something that's already serviced connected. Just me. 

Bingo, he should take the path of least resistance and connect it to a condition already rated. I also highly suggest getting an IMO, unless he has a good working relationship with his VA provider. In my experience, and to my surprise even against VHA policy, I've had a primary care physician for whom I've been seeing for years refuse assistance. The focus should be on getting it documented properly and not who can opine the quickest. 

[pacmanx1]

Quote

I am not trying to be negative at all.

Don't look at our posts as being negative, these are simply the facts and try not to take them personally. We are here to try to help and not discourage. Post may sound insensitive, but they are not meant to be. It is better to be clear and to the point than tell a veteran that the VA should have granted his/her claim when we have already seen and experienced the reality of the VA taking the short cut of denying claims and secondary claims when in fact the claim should have been filed differently.