Cluster Headache/Migraines

[KenDawg]

I have a question concerning headaches.  I am rated for cluster headaches(10%).  I have been having migraines 2 to 3 times a month and have been prescribed medication so it is now documented in my records.  I have recently received my rating for PTSD and I am trying to figure out should I apply for and increase for my cluster headaches since I am already service connected or do I apply separately for migraines and s/c it to because of my PTSD?  From what I have read all they fall under the same category.
 

I am working my headache log.  Is there anything else I need to do?

Any help is appreciated

[blahsaysme2u]

good call on migraine meds...if you are on metformin some migraine meds can interact harshly and put you in acidosis and land you in the ER as well....be careful out there...i had to request a change from metformin for this very reason bc dummy pharmacy didnt notice the drug interactions

 

side note/question:

if you are on meds and your migraines decrease- can the va decrease your SC%? even if i ran a log now i would barely hit the 10% mark bc the meds work so well...off them im at 30%(altho i probably could have fought for 50% if i wanted but i was already at 100% and didnt feel like fighting the va anymore over it) i have worried about this for a while bc in my yearly checkups with the doc he always asks me how the meds are doing and i been telling him how great they are and how much a difference its made in my migraines, but now getting worried that might bite me in the ass later...

thoughts?

[Vync]

@blahsaysme2uYep, I learned about that one the hard way. After the heart attack, the cardiologist who treated me told me to stop taking any NSAIDs daily, but never mentioned anything about migraine meds. After I got my records, I found sumatriptan (the migraine med) listed in the meds I had taken that day. Another tip for everyone to consider is to keep a medication list in their wallet or purse. I was so drained, I couldn't remember so I just handed the list to them.

When I filed my claim, the C&P examiner (also a cardiologist) asked which meds I thought might have caused my heart attack. I told her the only thing I was instructed to stop was NSAIDs, but verbally asked for all VA-prescribed meds to be considered as I am not a doctor. Of course, they denied it. After posting here on Hadit.com, Berta (former member) and I discussed the sumatriptan and she told me that it was a very strong medication. She posted a link to the FDA insert which contained all the contraindications, risk factors, and special diagnostic testing info. After reading the stereo instructions, I thought back and remembered the VA -never- did any of the specified tests nor did they tell me that it was a strong med. Berta advised to follow up with a neuro doc, who reviewed everything, and concluded it was "more likely than not" the cause.

26 minutes ago, blahsaysme2u said:

side note/question:

if you are on meds and your migraines decrease- can the va decrease your SC%? even if i ran a log now i would barely hit the 10% mark bc the meds work so well...off them im at 30%(altho i probably could have fought for 50% if i wanted but i was already at 100% and didnt feel like fighting the va anymore over it) i have worried about this for a while bc in my yearly checkups with the doc he always asks me how the meds are doing and i been telling him how great they are and how much a difference its made in my migraines, but now getting worried that might bite me in the ass later...

thoughts?

That is a very good question. I can't look up the law/reg right now, but vaguely recall from memory that "it depends". If the rating criteria specifically mentions the impact of medications as to a percentage tier, then a reduction can legitimately happen. However, if it does not mention that, then the VA is not supposed to reduce.

A great example of this is asthma ratings. As an alternative to the FEV/FVC1 breathing ratings, a vet can get 10% or 30% rating depending on the type and frequency of inhaler they use. However, the 60% level also includes systemic steroids (ingested or injected) three or times a year to meet the 60% threshold. If it is a fresh increase to 60%, the VA tends to state it is temporary because the condition is expected to improve. They will follow up in about a year to re-evaluate the situation.  If the vet sought that treatment from a non-VA source, they would need to provide proof of that to the VA otherwise the VA will issue a proposal to reduce.

Additionally, some conditions might yield a higher %, such as prostate cancer. However, once the prostate is removed, the VA could then rate on any residuals from the removal.

Please keep in mind that much of this is from memory, so please double-check any references as necessary...

[blahsaysme2u]

RIGHT! just like blood pressure too - i was going to file a secondary claim for my HBP and cholesterol but now that i am on meds and numbers are looking good(since i am taking it properly) i was told i would be denied- even tho if i miss a dose or if i manage my meds poorly in general things go haywire! very frustrating. 

i just wondered if Migraines were the same. thanks for your help and anyone else that might have input on...if this needs to be seperate post please move it or ill make a new one- just let me know.

thanks yal

[Vync]

@blahsaysme2u It might be worth considering filing for those as secondary also. Your medical records show a diagnosis when they initially started giving you the meds. However, you would not currently be taking those meds if your diagnosis was normal. With the appropriate nexus, they might grant secondary SC. Although it is still possible they might grant 0% SC, consider if things get worse. At that point you can definitely consider filing an increase.

It might be worth splitting the secondaries out to a new topic, but I would assume the same might apply to migraines, too. The migraine criteria I posted makes no mention at all of the impact of medication. It's just the type and frequency.

[KenDawg]

Hey guys, thanks for the help.  Just checked my claim for an update and my letter was updated on the VA app.  I got my 100% P&T.  
 

I don’t know my rating yet for migraines and I also submitted for Asthma based on the the PACT Act Burn Pit presumptive service connection.  Don’t have that rating either but based on math they both had to be 30% or better.   Looks like they gave me 30 for migraines and increased my sleep apnea to sleep apnea with asthma from 50 to 60.
 

Again, thanks for the advice and I’m so happy the site will stay active.

Edited December 5, 2022 by KenDawg