Full of questions.

[Whodat]

I know that this is a site for education only and I really do need to be educated a lot on claims procedures. Lots of you all have been a great help to me and I thank you all. Most of you are better help than my attorney.

This is what's going on and I am aware that I have went about it the wrong way and now I am trying to clean it up.

1. I filed a claim in 2018 for migraines secondary to tinnitus and other service connected conditions. I know now that I should have filed for headaches.

2. C&P exam completed 2019. Examiner stated tinnitus don't cause migraines. Did an HLR had another exam in 2020. Came back with a DTA, another exam was ordered. 2021 denied.

3. Assuming that my attorney appealed that decision, that didn't happen.

4. I have now lost my eed but it's ok.

Now I want to readdress this issue but uncertain on how.

If I file a new claim for headaches, VA will kick it back and probably say that I have open a claim for headaches and I need to do a supplemental which isn't true. I opened up a claim for migraines.

This is where I am lost.

Now my thoughts which I have the proof of a bad exam. Do I open up a supplemental claim for migraines and challenge my last exam?

Thank you all.

Merry Christmas

 

 

 

[broncovet]

File a supplemental claim for the desired benefit.  (headaches, migraines, etc.) My advice is to never burn down bridges.  Instead file for headaches "both primary" to the head trauma, and "secondary" to tinnitus or other SC conditions.  

Its the VA raters job to determine whether its primary, secondary, presumptive, etc., not yours.  So, dont take their job away!  

If this supplemental claim is denied (again), this time appeal it timely within a year, this time.  Or, if awarded, but at the wrong effective date, appeal that, too.

The Veteran is not responsible for diagnosing his own illnesses.  You probably are not competent to determine if its a "migraine" or a "headache" or even trauma pain from your TBI.  Thus, an application for "migraines" should also be an application for "headaches", but you may need to argue that on appeal, if necessary, on the effective date.  Once SC, your effective date should be the later of the claim date (the first time you applied!) or the facts found, which is the date the doc said your headaches began.  You may need this if you need to appeal the effective date, later.  You can argue, or your representative can argue, that your application for headaches would include "migraines" or, perhaps, pain from head trauma (TBI). 

Yes, you will have to have a Tbi diagnosis, and you should check your records for same.   

You can point out "supplemental information" which may have been missed by previous decision makers, such as the date(s) of exams where your doctor provided favorable exam reports.  

[Whodat]

Thank family for the education. Wish I had known all of this sooner 

[Rattler]

You file for what you can prove. I would file for the TBI. You stated, "I do have favorable findings such as vehicle rollover, explosion etc. while in service. I do have CT scans of the head shows what could cause my headaches." That would be form 21-526ez. Open it as a new claim if you haven't filed for it before.  Make sure you submit the medical evidence with the claim. You know the VA will send you for a C & P so make copies of the records that shows you had the accident above and take them with you to the exam and give them to the doctor your self don't give them to anyone else.  

[brokensoldier244th]

29 minutes ago, Rattler767 said:

You file for what you can prove. I would file for the TBI. You stated, "I do have favorable findings such as vehicle rollover, explosion etc. while in service. I do have CT scans of the head shows what could cause my headaches." That would be form 21-526ez. Open it as a new claim if you haven't filed for it before.  Make sure you submit the medical evidence with the claim. You know the VA will send you for a C & P so make copies of the records that shows you had the accident above and take them with you to the exam and give them to the doctor your self don't give them to anyone else.  

You dont want to give them to the doctor, they can't do anything with them.  If you know your STRs are in VBMS (the 'claim' file) then you give him a list of the approx dates, or even just years. They can ctrl-F search and do the rest. They aren't going to pour over paper records. They, for the most part, don't get paper records anymore, even from us. I send them a list of links or attachments directly attached to the exam request and it all comes out on their end as 1 thing. Contractors, especially. VHA can see the same things we can, with limits, even within our systems. Same with us and VHA- within some limits. 

[Rattler]

On 12/24/2022 at 11:10 AM, brokensoldier244th said:

You dont want to give them to the doctor, they can't do anything with them.  If you know your STRs are in VBMS (the 'claim' file) then you give him a list of the approx dates, or even just years. They can ctrl-F search and do the rest. They aren't going to pour over paper records. They, for the most part, don't get paper records anymore, even from us. I send them a list of links or attachments directly attached to the exam request and it all comes out on their end as 1 thing. Contractors, especially. VHA can see the same things we can, with limits, even within our systems. Same with us and VHA- within some limits. 

In my experience with the exception of one. The C & P doc's don't read what the VA sends them.

Edited January 2, 2023 by Rattler767

[Vync]

On 1/1/2023 at 9:25 PM, Rattler767 said:

In my experience with the exception of one. The C & P doc's don't read what the VA sends them.

I have had this happen so many times. In my initial claims from 20+ years ago, the C&P examiners failed to fully follow BVA remand instructions. Just a few years ago, the NP contractor failed to even opine on the correct claimed disability. I have only had a few who got the job done thoroughly and correctly the first time...