MEB For Migraine Headaches (A/D Navy)

J

jbartow

PEB Forum Regular Member
Registered Member
Hi, first time poster and long time reader.
I was diagnosed with migraine headaches in August of last year (2013) and my first LIMDU period was initiated. After exhausting all of the resources she could (Between 2 neurologists, due to their rotations), I went to my LIMDU re-eval expecting to be referred to MED board. She pushed it off to the last minute (Re-eval's are scheduled 5months into the 6month period, so that you can go back to work right after the 6 months is done if found fit) and refered me out to several different places to explore different options. One of them was mental health, where I was diagnosed with Depression, Anxiety disorder, and panic disorder w/o agoraphobia. At my re-eval (about 2 weeks ago, the last week of January), she said that she thinks I'm doing better and was very reluctant to refer me to MED board as I requested.
Some background on my case: I have approximately 2-3 migraines per week, which on average I end up in the hospital once a week due to them (Sick call at Family Practice if its during the week, or the ER if its during a drill weekend since I work at a reserve center). The other times I'm "lucky" enough to have them when I'm already home from work or on off days, since more or less most of them come on in the afternoon. The big issue is that my doctor does not support the headache logs (Which I have seen suggested here, especially for VA claims) which I keep anyways but she will not endorse with her signature. Without these logs it's my word against my medical record. My command is mainly SELRES and FTS personnel, so their mentality (Nothing against SELRES and FTS here) for my NMA is that I would be perfectly fine to go back to work as well (Keep in mind that I miss 1 day of work a week, and leave early at least 1 other). My headaches do not respond well to abortive medication (even Maxalt Disolve tabs only work ~25-30% of the time).
I guess my concern is this: The VA I'm sure will come back with an unfavorable review from their appointments (I have scheduled next week), I am concerned about my NMA (Which I have read is VERY important in their decision if this goes to PEB) and my doctor's MEB report. Am I able to rebute any of these? The NMA I am assisting in writing so I may be able to fight for an unfavorable light on that, but I'm really worried about my doctor's MEB report.
 
Be sure you give your log to the VA doc. I wouldn't sweat the write up too much until you get it. It should be written by another doc instead of your normal doc from what I understand, and it should be written based on all records presented. You will have the ability to disagree and request another evaluation from what I understand. You should be inquiring about MEB/PEB JAG representation if you have not already spoke to them.
 
Thank you for the reply. And I apologize for the scatter-brained post, it has been a very stressful couple of weeks. I'll bring my logs to my VA appt and contact legal tomorrow (Monday) since I was told I would have legal representation during the PEB, but nothing was mentioned about legal help during the MEB. Not that anyone cares, but I'll keep you all updated :p
 
Just saw your post. I hope I am not to late. Like the other post pointed out don't worry to much about the nma or Meb report. Yes they are important but they are not the only things that go into getting your rating. I had a very unfavorable NMA from a commander who had been at my unit for 2weeks and a not so great write up from my neurologist who refused to put me on a MED BOARD because he didn't believe I was that bad off because he has seen worse ( his words ). I even went to see the JAG office where all 6 lawyers told me I would never be found unfit for migraines and if I pushed the issue I would be med step with only 20%. Still I went for it. It took 9 long months but I was found unfit for service solely based on migraines and rated at 50% for migraines DOD. VA rated me at 90%. So it is possible. Few words of advice. I know it's time consuming and you may not want to do all the work but no one else will so here it is. First thing I'm sure you already know. Get copies of all your medical records. ALL of them. I even went as far as scanning them (all 5k plus pages) into my iPad so I didn't have to carry paper copies. Second. You need to make sure you are seeing a doctor the days you leave work instead of just going home. I know I know. Who wants to have a migraine and go in there and be tortured by those people for hours. I sure don't but you need documentation for lost time. And if you intend to file for SSDI you will definitely need it. Third. Always tell the truth. Not your truth. But gods honest truth. I know as people in the military are taught to be tuff and suck it up but when it comes down to medical documentation you need to let them know how you feel. I have been curled up in the fetal position throwing up and crying from migraines before and I let them know just that. Fourth. Stop saying that medicine works 25% of the time. It either works or it doesn't. Ask for different Meds that do work and stock pile them that way you will have them. You will be able to learn what Meds will work with what migraine. Just don't mix them and read all the cautions first. This way you have something that will always work. Last. Keep logs of headaches and all that It's easy now with apps and what not. They will come in useful. Anyway. Good luck.
 
@jbwood. Thank you for the advice. Like many of the other posts I've read on here I ended up "assisting" with my NMA so the write up is going to support my case. I'm very frustrated with the medical system at the moment (They currently have half paper records and half electronic records) and after talking to my neurologist it seems that she was not seeing my paper records. About the percentage comment, it's difficult to do because that's how they've taught me to treat all the headache medications, all of them are something along the lines of "this medication has a chance to reduce the overall number of headaches that you would have possibly had in a month" for preventatives and the navy treats abortives the same way. The advice was MUCH appreciated during the VA evaluation appointments though. My typical attitude towards everything is "it's not that bad", but between you and my first doctor, I was informed that I needed to treat it more like a human being and tell it like it was. Currently completed all of my VA evaluation appointments and I am a little confused on what happens next, but I assume that it is the med board decision (when the VA makes their initial yay/nay)
 
Update:
Today I receieved the evaluations from QTC, along with the write-ups from both my neurologist and my pyschologist. I agreed with both of their write-ups, and after a good read-through I signed them. I was given a copy of the QTC evals and sent on my way ("Take these home and grab a cup of coffee or something"). As I was looking through them, I noticed that there are quite a few things that I most definately do not agree with, mainly that they are trying to get away with saying that I have 1 prostrating attack every 2 months (0% rating) when I have documented proof that it is more than once every month. I guess my question is, how do I change this? Do I call my MSC, or is this a PEBLO issue?
 
I figured I would continue to keep all of my posts relating to my situation here on this thread as not to clutter. I was checking my NSIPS today and saw a MILSPERMAN 1910-120 on my record from 16JAN. I was refered to MEB on 28JAN, and the 1910 remains unverified. I was never actually given the form, and when I look at it online it isnt filled out, like the others are. My guess is that it is a place holder, and that the command preparing to route one because my condition had worsened to the point that it was significantly affecting my work. I guess my question is, why is this still on my record if I am currently in a PEB status for the only condition that it could be referencing?
 
*UPDATE*
As of 3/28, according to my PEBLO, my case has been forwarded to the VA rating office for a rating decision. Is there any way of finding out what they found to be unfit conditions, and what conditions they are currently in the process of determining the ratings on? Also (this probably sounds silly, but I just want a second opinion), am I safe to assume I was found unfit?
 
If you have been referred to the VA, you have something to rate, which means they found you unfit for something (unless something screwy has happened). In my case (Army) the PEBLO gave me a copy of the memo that was sent to the VA asking for the ratings on the unfit conditions. Ask your PEBLO. If that goes nowhere, you can try the MSC. If that goes nowhere, try a VSO through one of the vet organizations and see if they can get any info. Best of luck...Bob
 
4/23 Ebenefits has been updated to "Pending Decision Approval". I emailed both my MSC and my PEBLO and my MSC gave me the expected response of "Ebenefits status changing really doesn't mean much". My PEBLO said that the status change means that most likely the VA is sending my package to the PEB for them to review and approve, and then finally to myself. How correct is this in everyone else's experience?
 
5/8:
Just finished up at the PEBLO's office with my proposed ratings. For my refered condition, Migraine Headaches, DoD rated 50%. For the other 3 conditions (Major depressive disorder, generalized anxiety disorder, panic disorder) they found exsisted PTS and didn't rate (So I was told). The VA on the other hand rated everything and totalled up to 90%, though I won't pretend to know how their math adds up.
I won't bore with the specifics unless asked, but I was rated at:
50% for Migraines
70% for Major depressive disorder (also diagnosed as generalized anxiety disorder and panic disorder without agoraphobia)
And 10% for a knee injury. A couple other things were claimed but not rated due to severity (i.e. Hypertension was diagnosed and is being treated with medication, but the medication is mainly used as a preventative medication for headaches).

I'm going in today (5/9) to accept the findings of the IPEB and set my date for seperation at 30JUL (about 80 days out). A few concerns remain for me, and if anyone can help I'd be much obliged. I don't know much about having the ability to sell leave (I am about to take 10 days of paternity leave, and I have 20 days of house hunting/job hunting leave for free coming up, along with 26 days on the books, and 4-5 more days by the time I seperate), which totals to about 55-60 days of the 80-85 remaining days I have left in the Navy of leave. I still have TAP class to attend (command dropped the ball and would not schedule me). And my final concern has to do with the PRT. I have failed 2 in the last 2 years, and I'm coming up on what may be my third. I will already have a seperation day selected and will already be "getting out" due to my PEB, would a third PRT failure affect my situation at all?
 
Are you TDRL or PDRL? If they Navy PEB found the other conditions unfitting but EPTS, and they were not noted on your entry physical, did the Navy provide clear and unmistakable evidence that these conditions preexisted and clear and unmistakable evidence these conditions were not aggravated while on active duty?

Mike
 
I was put on TDRL. My PEBLO had said something about EPTS, but upon my own inspection of the actual reports the conditions that were not rated by the DoD were just not found unfitting (The 3 mental health issues I stated above) so were not rated by the board.
 
It has been a long battle but after a couple of months (and some fighting with my command over taking house hunting and job hunting leave, and leave period), the end is finally in sight! Last day of active duty is 28JUL and transfer to TDRL 29JUL. For anyone else in the Seattle area that put me at approximately 6 months from the beginning of the process until the results of the IPEB were accepted (2XJAN - 09JUN). I had a friend recently go through the Seattle area with only mental health issues (he only had a couple VA claims) and his was done in about 4 months. Our cases may have been faster than usual, but that is the experience I have seen. Does anyone have any information on switching from active duty doctors to VA docs? I was on a pretty hefty treatment regimen (1-2 scheduled visits/month with 1-2 weekly SIQ type visits to my PCM for my Migraines) and I was curious how the changes would be as a retiree compared to during the MEB/PEB. My Neuro had no idea how anything was going to be, and my Psych just loaded me up with 3 months worth of psych meds and said good luck.
 
Go to your local VA and get registered now. It may take a while to get an appointment. My local VA has a team just for OEF/OIF vetsv - I would guess most VA's do also. I have had pretty good experiences. With tricare, you can also get your own doc either at a military clinic or on the economy - my VA doc told me just have that doc send over the poresciptions and he would put them in the VA system and get them filled that way (so no copays). Hope this helps. Happy retirement. Bob
 
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