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Battling for Migraine Headaches VA Disability Claim in Higher Level Review
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- Опубликовано: 23 янв 2024
- VA Disability Claims for migraines can cause more migraines and headaches. It's one of the most common 0% service-connected disabilities that are fought with an appeal. Whether that appeal is a Higher Level Review (HLR), a Supplemental and the Board of Appeals (BVA), migraines and headaches are commonly misunderstood by RVSRs (VA Rators). The most commonly won appeal is for migraines being increased from 0% and the reason being...medical evidence.
#va #vadisability #veteran #migraines
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Im happy you briefly mentioned it.
I think, definitely, you should always if possible, get the higher level review with the phone call, you be surprised how much you can learn from that.
If it’s still denied, you will know exactly where you stand.
Then file the supplementary to give you time.
Then do what you need to do,
If the supplementary falls short, do another HLR, and so.
You are basically keeping ur claim alive which is important if you eventually win for sure.
I was denied migraines secondary to tinnitus. I requested a HLR, and 11 errors were found. My case was sent back for to be rated. I’m hoping it will be granted this time.
Hello @jadavis1000 I'd like to here more more about your HLR and what was found. I was denied secondary to Tinnitus even though i provided a diagnosis, migraine log, buddy statement, and statement from my supervisor for missing work. When i went to my C&P the examiner said the VA wanted her to ask certain questions. After the appointment she mentioned in so may words that she can't find the connection for the migraine. I'm waiting on my FOIA to see what the examiner wrote. Did you have a nexus letter? I'm trying to get one. I'm already connected for Tinnitus and SSD. Going to appeal for the migraine denial and for pain due from my SSD.
@@RogerChin-nm8dq I'm sorry for the late reply. The nexus letter in my opinion is a must. I paid for one and it was definitely worth it. I used telemedica for a nexus and DBQ letter.
@@RogerChin-nm8dq I'm now at 60%!
I was denied for migraines secondary to tinnitus as well. I had a nexus letter, DBQ, buddy statement, migraine buddy log, etc. I only received an ACE exam and was denied. I just received a letter saying they found an error and will be correcting the error…whatever that means. There are some terrible VA raters.
I've been denied an increase from 30- 50% 5 times, and I exceed the requirements, have records from multiple providers, and they dont care.
Thanks Guys!
Got it, thank you Jason
They can change it on the spot, however, it still may take even after the rater calls you, many months before the decision is changed.
You can get, and error occurred, n they can retest you if something wasn’t done properly. They can also have a professional look at the proof (i.e. an mri that was done but not professionally reviewed or something like that).
In any case, it will still be a little while before something is completed.
I requested an informal conference for an HLR. I never had a conference and VA determined duty to assist error and probably another c and p.
For real, if there are people out there that need a nexus, a worst case scenario, use a company that specializes in that.
Not one that will do ur claim because they will take too much.
One thing most advocates have missed is VA modifying/VA updating the headache DBQ to remove severe economic inadaptability consideration. Shifting that decision from the examiner to the RVSR/DRO. This likely will result in more 30% type ratings being assigned than those that may have been 50% in the past. Very important to document completely prostration attacks too as the updated DBQ distinguishes a difference between prostrating and completely prostrating. You might consider making a video to discuss the updated directives shown by M21-1 V.iii.12.A.3.a.-h.
Solid and thank you!
Good info to have for sure.
Is there a direction or phrase or term I should use when filing?
@@todtalk3912 the Manual reference from M21-1 i shared above provides the definition for prostrating and completely prostrating. Seeing which one you fall in and being able to describe those limitations to coincide with the frequency should help your doctor in documenting it or completing a DBQ.
Awesome!!! I am currently in the process requesting a higher level review for my migraines secondary to tinnitus. My decision letter was sloppy and rushed, only VA evidence was identified. I submitted a IMO, FMLA, migraine log, personal statements, all was absent on the denial letter as evidence. I reviewed VES DBQ and IMO the DBQ was correct for the symptoms to qualify for 50%. But VES nurse practitioner one sentence negative opinion out weight my IMO by a PA-C with supporting medical literature but since none of my evidence was used it was the raters only evidence to use and was denied. I believe since the VA did not use my evidence at all that a HLR would be the correct option. I hope this situation would be a good example for a HLR.
Any update?
@@BanksBandzsubmitted for HLR. Now waiting game.
Add that nexus letter and then if their doctor says it’s a no go it’s still 50-50 which is all you need to get it man. I got denied once by a VA RN opinion I submitted supplemental with a nexus letter from an actual doctor who said at least as likely than not in the nexus letter and they granted me 10% doing supplemental now to get up to 50% once I get my DBQ and letter back from doctors
Exact same issue here
I just had my higher level review for migraines. My first time around I was denied I feel like I aced my latest telephone review I didn't use any medical terms I just told it like it was I guess I'll find out in the coming weeks
How’d it go? I have a HLR next week, I’m 2nd to Tinitus/insomnia.. I got a migraine log, nexus, letters, etc.
I am from the 1980s Cold War era. Nobody told us anything about "VA benefits." There was no internet and no information. Foljs went to the doctor for serious stuff, not for migraines or sleep apnea. The new generation is 100% better informed. I have 10% for tinnitus (M1 tank crewman) and I have severe migraines and sleep apnea. I doubt I can do anything about it at age 60.
All you can do is submit a claim.
I'm turning 65 in couple of weeks, STILL awaiting HLR results.
I discharge in 1989, everyone told me I have no disability even though my Tinnitus is getting worse as I age.
Finalky, a co-worker(before I retired from that company) pushed me to at least try.
So, at 62, I filed my 1st Tinnitus claim.
First got denied because the C&P examiner said there is no service connection WITHOUT my military medical records.
Filed a HLR in Dec 23, STILL waiting for VA to "correct an error"...😂
@@kodiak536kodiak536 Yup. We are from the old days where nobody told you anything. But this new generation knows how to get money from the government. I cannot prove it but I have met some where I believe that the only reason they signed up was to get a 100% rating, and many did. They know what the VA looks for. Have a little "accident." Keep going back to the Dr and getting it documented incessantly. Start "acting up" demonstrating issues because of the "injury" and there you have it.
I was in the same period. In the past years, I have had service connections for migraines and tinnitus. You'll be able to do it. Could you make sure you have current symptoms( you have seen doctor recently for conditions)? and doctor visits or secure messages describing your symptoms. Migraines are secondary to tinnutis. also any depression, injured knees, feet, or back? sleep apnea will be tough. Give it a try and don't give up
I filed my migraine secondary to my sleep apnea and was denied. I filed an appeal but what can I say to get it approved?
I’m rated 30% migraines. I’ve been under the care of a neurologist because I have been getting 1-3 prostrating migraines a week for several months. He has increased my prescription of sumatriptan to 100mg. But did not work so I’m currently taking Riaztriptan 10mg in hopes it helps. Is this information enough to apply for increase? I have an intent to file for increase in March
Luckily for me migraines were being taken care while active duty and beyond.
Evidence is king!
Got a Nexus letter and was connected at ZERO percentage. Makes no sense based upon the evidence submitted. I filled a supplemental claim. Hopefully I get an increase
@runthemdawgz good luck on your supplemental. I was outright denied secondary to Tinnius. Waiting on FOIA to see what examiner wrote.
@runthemdawgz Where did you get your nexus letter. Was it established well? I've reached out to my neurologist but, they never heard of a nexus letter and don't know how to write one.
I got 10% for Tinnitus. I get anywhere between 2- 4 migraines a week, and I am prescribed SUMATRIPTAN. Should I file Migraines as a secondary or primary?
I believe the best course of action would be to file it as a secondary
If i am awarded 20% and I submit a HLR, will they stop or continue paying 20% during the process?
I just got denied for this exact thing. I had a nexus letter, current diagnosis, buddy letter and personal statement. They used two different contractors for my exams and they never even called. When asked the contractors said the examiner had all the info and didn’t need to ask me anything. So they filled out two different DBQ and idk what they even filled out. Rater just denied my service connection for migraines, even though I filed as a secondary to tinnitus
Same here man
Foolproof🙂
Let's say a person was denied for migraines secondary to tinnitus. However, soon after, they were awarded for MH. Would it be best to submit a supplemental claim connecting the migraines to MH instead?
I was thinking this…. Following.
I would suggest gathering evidence that shows cause from YOUR mental health causing YOUR migraines. It's not a 1 size fits all and evidence is king.
Check reponse@@JrFrOmDaBx
I got denied migraines raise using cck lawyers, have diagnosis, 100mg sumatriptan and 200mg topiramate.
Did you ever go to sick call?
I have a real problem with migraine (headache) denial when there is firm diagnosis, a sinus and or a rhinitis rating, a service connected TBI, medical evidence of current treatment and especially clearly documented Gulf War/ burn pit exposure.
The VA is the enemy. Expletives...
Like the Bellichik say, or used to say Do your job already😂😂😂
Too bad the raters and the DRO-s don't use the 38 CFR (use it very selectively). Sometimes I trully wonder if these guys can read at all...They know one word, deny,
deny, deny
My P&T for migraines was a psych eval. Dude didn’t believe me or take me seriously. I have 10 years of severe migraine treatment and proof of prostrating migraines the entire time. I even git a VA neurologist to add an addendum to my chart saying the other PTSD symptoms are triggering migraines. But the QTC guy didn’t care. He didn’t ask much about the migraines and focused on the PTSD instead. I wasn't filing for PTSD, just Migraines secondary to it. It almost never came up. At best they'll give me 0%. But I fully anticipate a downgrade. This shit is such a waste of time. It is impossible to be approved even with VA treatment. You're wasting everyone's time and lying to them getting their hopes up like this. High level reviews don't exist. I requested one and they ignored it. All I can do is wait a year for my deinal. You people need to stop doing this. It's so disingenuous and exploitative. The VA hates us and would rather we all died. You people are telling us we have mkney and additional benefits coming. No we don't. They have no obligation to accept us, let alone give us more. They don't owe us an explanation. Everything you say is a lie.