MEB for migraines but rated 0%

Rpgmer97

Rpgmer97

PEB Forum Regular Member
Registered Member
I don't know where to start but the just of what I got from a phone call from my peblo is that even tho my migraines were service connected I got a 0% rating. Mentioned that the PEB is using a statement of mine saying I had a headache as a kid as grounds for it not being aggrivated by service. I will get the full scoop tomorrow when I go in to see him, but how can they use me havinga headache as a kid as a medical diagnosis? If they can do that why can't I say I have everything under the sun and get 100% no problem? Really don't know what to do or where to go from here. Any help would be greatly appreciated!

Did the PEB state your migraines preexisted service? What does your VA rating state? If the VA is rating the condition higher than DoD there is a problem. Are you by chance be adjudicated by the Lewis PEB?

Mike
 
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I think there may be an error in communication. The VA would rate you on the criteria based upon 38 CFR Book 3 (VASRD).

Here are the standards:

8100 Migraine:

  • With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability 50%
  • With characteristic prostrating attacks occurring on an average once a month over last several months 30%
  • With characteristic prostrating attacks averaging one in 2 months over last several months 10%
  • With less frequent attacks 0%
By rating you at 0%, they are basically stating that the evidence that they have seen states that you are having migraine attacks less than one per every two months over the last several months. Have you been keeping a migraine log, or have you seen a physician for migraines more than once every two months?
 
I have been to several neurologist over the past 3 years, I have migraines 2-3 times a week some lasting for several days, no medication has helped yet. I have been told by several neurologist that when I have the migraines I don't need to go in to the ER every time if nothing is helping it. They said to go to a quite room and lay down. I even have a paper written up from legal that a neurologist stated my migraines are different then any headache I would have had as a kid.
 
I have an appointment with my peblo later this afternoon to get all the paper work and see what was said. So I will have more information to give after that.
 
@Mike - Yes I am being adjudicated by the Lewis PEB.

--------------------------------------------

4. Proposed entitlement to service connection of migraine headaches [Headaches,
Hemicrahia continua, Occipital neuralgia] for Department of Veterans Affairs (VA)
benefits.

Service connection for migraine headaches [Headaches, Hemicrahia continua, Occipital
neuralgia] is proposed as directly related to military service.

Your examiner indicated that your diagnosis of "migraine" appropriately covers the current

manifestation of the symptoms of all the claimed conditions listed (Headaches, Hemicrahia
continua, Occipital neuralgia).

We have assigned a noncompensable evaluation for your migraine headaches [Headaches,
Hemicrahia continua, Occipital neuralgia] based on:
• Less frequent attacks
A higher evaluation of 10 percent is not warranted unless there are characteristic prostrating
attacks averaging one in 2 months over last several months.

------------------------------------------------------

From day one I have told all the doctors, sick call, and neurologist that the headaches are consistent for days on end, occurring at least 2-3 times per week. no medications have helped at all. the only thing I could do was go to a silent pitch black room and wait for it to pass. When the migraines would spike any sound would make me recoil in severe pain and I couldn't open my eyes for any more light then a small nightlight in the corner of the bed room. After the first 3 or so months of the onset of my migraines the doctors told me I didn't need to go to the ER if it wouldn't help. wasn't worth the misery of waiting and being seen compared to finding a pitch black room.
 
I can understand why you are having a hard time understanding where to start.

My guess, for the 0% rating, not having any medication is probably the biggest problem. They seem to like to compare the frequency of abortive medication refills to the reported frequency and have them match up. Something to document it outside of your own reports. I would consider having someone else, a co-worker maybe, write up something about how often you have to do the silent/dark room for treatment.

Not much to go on with why the PEB is saying not service connected. I would probably insist they explain why the VA is wrong in their determination.
 
There has been a problem, especially with the Lewis PEB, of stating a condition is EPTS w/o aggravation without overcoming the presumption that any condition, not listed on your entrance physical, is service connected And or servic aggravated. Did the PEB provide clear and unmistakable evidence that the condition preexisted service and was not aggravated by service? Probably not, at least not to standard. The VA must follow the same standards and they declared you condition service connected. I will link yo to a site that has an appeal I wrote for a soldier, adjudicated by the Lewis PEB, that had a similar problem.

You also have the issue of the VA not rating the condition correctly. You will also need to ask for a VA reconsideration and provide evidence your headaches are prostrating and that they occur a least monthly.

Keep me apprised on your case.

Mike
 
my Peblo simply said the PEB has the right to go against the VA... "they dont have to agree with the VA"


iv started to look deeper through my paper work, guess i was too naive to check earlier, but all over in the paper work are things written in that are not true... they say that medications have helped but none ever have, they say "with less frequent attacks" even tho they are several times a week, it is written in the paper work that they are prostrating but that was not taken into consideration for my ratings it looks like, they are using a statement to a neurologist that i had a few migraines as a kid to say its the same thing i am having now even tho i have a letter from another neurologist that states they are very different, when i challenged the MEB they refused to seperate out the headaches i had as a kid and the migraines i am having now even though migraines and headaches are very different things...

i have an appointment with legal next tuesday to go over everything and hopefully try to straighten out everything, but it just seems like we are getting nowhere with anything we have done to try to correct it.
 
forgot to add in for the migraines being different, i have a triggering event with an ER visit, cat scan, MRI, blood draw, and spinal tap to go along with it. the triggering event is nowhere to be seen in the DA3947, but it is clearly in my medical records as i have them in my hand.
 
The PEB and the VA must follow the same rules when it comes to presumption of service connection and service aggravation. This issue is a known problem but you must appeal early and often to get them to follow the rules.

Mike
 
Thank you for the link, i briefly read through it and it is very well written. i will make a copy and take it with me to Legal.

This will be the 3rd time that i have tried to fight this process, so i am hoping that a history of issues will in a way help show that there is wrong being done.
 
Do you think providing my medical records from pre military and showing that they have a lack of diagnosis for headaches or migraines would do anything to help me?
 
It is up to them to demonstrate the condition preexisted. Make them do their job.

Mike
 
Rpgmer97 said:
Do you think providing my medical records from pre military and showing that they have a lack of diagnosis for headaches or migraines would do anything to help me?
Click to expand...

First things first, were you referred to the MEB for Migraines? Is this one of your "unfitting" conditions?

Second, please do not take this as disrespect, but it does not matter what anyone tells you or you tell anyone else, what matters is what documented. So if the PEBLO tells you that the PEB is not granting service connection for the condition of migraines, have you seen this in writing? Is this on your DA-199?

Third, if the condition of Migraines was a referred condition (unfitting), you can address the rating percentage by submitting a "one time VA Ratings reconsideration" (VARR). A VARR can only be requested for unfitting conditions. You will need your lawyer to help you with the VARR request. You will want to provide to the VA evidence which substantiates the next higher rating of 10% or 30% (I'd try to submit evidence that shows "characteristisc prostrating attacks occurring on an average once a month over last several months" to meet a 30% rating which will get you a medical retirement) The VA tells you what you need to submit for the next higher rating of 10%.

Rpgmer97 said:
We have assigned a noncompensable evaluation for your migraine headaches [Headaches,
Hemicrahia continua, Occipital neuralgia] based on:
• Less frequent attacks
A higher evaluation of 10 percent is not warranted unless there are characteristic prostrating
attacks averaging one in 2 months over last several months.
Click to expand...

Fourth, if the PEB is indeed claiming that the condition existed prior to service (EPTS), then you need to look once again at what @maparker wrote about "clear and unmistakable evidence" that the condition was not aggravated by service. I do not think that the PEB can overcome the burden of proof, however you cannot take this for granted. It is going to take a strong argument from a good lawyer to make your case.

Fifth, I think you are being set up for a raw deal, you need an advocate on your side. The soldiers counsel at JBLM may not be the best choice to present your case. You may benefit greatly from private counsel from a lawyer such as @Jason Perry (www.peblawyer.com). Private counsel such as @Jason Perry can look through you existing medical records, find the evidence that you need to submit a successful VARR (or FPEB) and ensure that you receive the correct benefits that you are entitled to.
 
1. Yes I was referred to the MEB for my migraines, and it is my only unfitting condition.

2. yes in my DA-199 it says the PEB is not granting service connection.

3. from day one, 3 years ago, I have been telling the neurologist that it is nearly every day. some days not as bad as others, but more often then not its hitting me at 8/10. I have no clue how it was rated at 0%. im trying to read thru the paperwork to see where they would get that.

4. I read thru the paper he linked and will be taking a copy of it with me to legal when I go next Tuesday.

5. I too feel like im getting the raw end of the stick. I think I would benefit from private counsel, would I even be able to get anything done in my time frame tho? I have to elect by next Friday if I want to do a IPEB.
 
From VA Ratings:

Proposed entitlement to service connection of migraine headaches [Headaches,
Hemicrahia continua, Occipital neuralgia] for Department of Veterans Affairs (VA)
benefits.

Service connection for migraine headaches [Headaches, Hemicrahia continua, Occipital
neuralgia] is proposed as directly related to military service.

Your examiner indicated that your diagnosis of "migraine" appropriately covers the current
manifestation of the symptoms of all the claimed conditions listed (Headaches, Hemicrahia
continua, Occipital neuralgia).

We have assigned a noncompensable evaluation for your migraine headaches [Headaches,
Hemicrahia continua, Occipital neuralgia] based on:
• Less frequent attacks
A higher evaluation of 10 percent is not warranted unless there are characteristic prostrating
attacks averaging one in 2 months over last several months.

From 199:

Migraine including migraine variants (DoD Non-Compensable)(MEB DX 1)

Onset of Soldier's headaches began at age 10, and was seen in May 2010, within 2 months of entry. IAW DoDI 1332.18, App. 3 to Encl3, 7.b.(2),(3), Soldier developed symptoms with clear and unmistakable onset indicating that this condition existed prior to service (EPTS-YES). Soldier has since been treated with an array of prophylactic and abortive agents and other measures, but failed to achieve sufficient remission of symptoms to allow return to unrestricted duty. IAW DODI 1332.18, Enc. 3, App. 2, para. 2a., condition is unfitting because it reduces Soldier's occupational efficiency to such an extent that it places an unreasonable burden on others, compromises the mission of the unit, makes him unable to reasonably perform duties as is required by the PMOS of 19K- Armor Crewmember, and prevents performance of DA 3349, Physical profile, block 5 functional activities, such as 5j. live in austere environment with out worsening the medical condition. in accordance with AR 635-40, B-10, the EPTS rating for this condition is 0% as this is the lowest rating for an EPTS condition. The Soldier's current level of disability is 0% based on VARSD 8100 per VA Rating dated 07 January 2016. Therefore, for compensation purposes based on no permanent service aggravation of an EPTS condition, Soldier is rated at 0-0% = DoD Non-Compensable. (DA 3947, NARSUM, C&P Exam, DA 3349, DA7652, and VA Rating Decision.
 
I would like to note that they never scheduled me to see a Neurologist with the C&P Exam, and when I asked about it "the va decides who you need to see, they probably said they had enough to work with."

sorry about all the ranting here, but this is very overwhelming...
 
There is a dicotmy between the VA stating it is compensable and DoD stating it is not as they both have to follow the same standards. Those standards require clear and unmistakable evidence that the headaches preexisted service and clear and unmistakable evidence that the headaches were not aggravated by military service. I note the DA 199 does not seem to mention the clear and unmistakable evidence overcoming the persumption of service aggravation. There other clear and unmistakable evidence seems week if you previous headaches were not migraines.

I VA reconsideration is in order if your migraines are prostrating and more frequent.

Mike
 
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