C&P exam for migranes

R

RogerDayton

Member
PEB Forum Veteran
Registered Member
Hello all,

I had my general medical C&P exam the other day and the examiner did not go over migraines with me. Which is one of my big claims because I consistently get them weekly. She told me they told her not to go over them in the notes.

I then did my mental health C&P exam the following day and the examiner did not go over them as well. I now only have my eyes C&P exam and TBI exam left.

For those of you who have claimed migraines before at what point did they go over migraines? I'm assuming at the TBI appt? Or should I bring this up to my PEBLO or someone. I am currently in the MEB process. This is not a post service claim.
 
RogerDayton said:
Hello all,

I had my general medical C&P exam the other day and the examiner did not go over migraines with me. Which is one of my big claims because I consistently get them weekly. She told me they told her not to go over them in the notes.

I then did my mental health C&P exam the following day and the examiner did not go over them as well. I now only have my eyes C&P exam and TBI exam left.

For those of you who have claimed migraines before at what point did they go over migraines? I'm assuming at the TBI appt? Or should I bring this up to my PEBLO or someone. I am currently in the MEB process. This is not a post service claim.
Click to expand...
If you claimed migraines the examiner needs to do a DBQ for migraines. If they missed it you will need to come back in for another exam. I would first reach out the contractor that did the exams. Tell them they missed one and they can schedule it. If you do nothing they will eventually figure it out a when there is now DBQ for a claimed condition with the VA.
 
Provis said:
If you claimed migraines the examiner needs to do a DBQ for migraines. If they missed it you will need to come back in for another exam. I would first reach out the contractor that did the exams. Tell them they missed one and they can schedule it. If you do nothing they will eventually figure it out a when there is now DBQ for a claimed condition with the VA.
Click to expand...
I brought it up to my C&P examiner during the exam and she said she was told not to go over the migraines. So I am confused because my only C&P exam left is the one for TBI
 
RogerDayton said:
I brought it up to my C&P examiner during the exam and she said she was told not to go over the migraines. So I am confused because my only C&P exam left is the one for TBI
Click to expand...
TBI may be combined with migraines. that's probably why. There are several conditions that are combined. For example sleep apnea and asthma are conditions that are combined for rating purposes.
 
I have a TBI exam coming up and on the Optum Serve website, it lists which DBQs they are covering. Migraines is listed under TBI for me. I did the general exam already and it was the same deal. I asked about migraines and the NP told me it was not part of the general exam. I checked the website when i got home and thats where i saw it was listed under the TBI exam. Hope this helps.
 
blackbeard31 said:
I have a TBI exam coming up and on the Optum Serve website, it lists which DBQs they are covering. Migraines is listed under TBI for me. I did the general exam already and it was the same deal. I asked about migraines and the NP told me it was not part of the general exam. I checked the website when i got home and thats where i saw it was listed under the TBI exam. Hope this helps.
Click to expand...
Okay that puts me at a little more ease. I have a TBI exam a little later this month just did not want the migraines to be missed.

How can you see what your exams are for? Mine are contracted through VES and I cannot see what my exams are for and what they are covering.
 
It appears that the two claims are being combined, but I suggest you keep a migraine log anyway. Ensure you document in the way you will be compensated.
 

Attachments

  • IMG_0127.jpeg
    IMG_0127.jpeg
    139 KB · Views: 14
RogerDayton said:
Okay that puts me at a little more ease. I have a TBI exam a little later this month just did not want the migraines to be missed.

How can you see what your exams are for? Mine are contracted through VES and I cannot see what my exams are for and what they are covering.
Click to expand...
I'm not sure. With Optumserve, when i log into their portal, it shows my appointments that are scheduled and the details under the appointment list the DBQs involved.
 
blackbeard31 said:
I'm not sure. With Optumserve, when i log into their portal, it shows my appointments that are scheduled and the details under the appointment list the DBQs involved.
Click to expand...
Even if combined they can be rated separately in the sense that they each get a rating. The higher of the 2 ratings is used. So read the VA percentages for each condition and make sure you know what your symptoms are and how they correlate to a %. My wife had 50% sleep apnea and 10% asthma and so her rating was 50%. So its important to make sure the DBQ is filled out correctly so that you have the correct ratings. If you are 40% for TBI and 50% for Migraines but don't communicate the symptoms correctly at the exam you could get 30% for Migraines and since 40% was for TBI you would get 40% instead of 50% for the combined ratings etc.
 
chaplaincharlie said:
It appears that the two claims are being combined, but I suggest you keep a migraine log anyway. Ensure you document in the way you will be compensated.
Click to expand...
Is that a bad thing that they may be combined? I do keep a log of all my migraines dating back to January of this year
 
blackbeard31 said:
I'm not sure. With Optumserve, when i log into their portal, it shows my appointments that are scheduled and the details under the appointment list the DBQs involved.
Click to expand...
Wow so lucky to have that. VES you get nothing. Besides a location and time and date. I'm not even sure my general med examiner used a DBQ. All she did was go down the list of claims ask me about it and that's it moved on to the next claim. Didn't even do ROM test on me either. So I'm worried she didn't properly fill out the DBQ
 
RogerDayton said:
Is that a bad thing that they may be combined? I do keep a log of all my migraines dating back to January of this year
Click to expand...
The VA does not allow overlapping conditions to be rated twice. It is impossible to attribute which disease contributes to the symptoms. The process when followed; treats you fairly.
 
chaplaincharlie said:
The VA does not allow overlapping conditions to be rated twice. It is impossible to attribute which disease contributes to the symptoms. The process when followed; treats you fairly.
Click to expand...
I am a little confused by this statement. Shouldn't they do a specific dbq for migraines alone? I claimed migraines
 
If your TBI rating clearly meets or exceeds the migraine maximum, what would be the point?
 
You must log in or register to reply here.
Top