Question concerning hearing loss and other claim issues

S

Stealthmanx2

PEB Forum Regular Member
Registered Member
I'm thinking this is the right section for this. I recently retired and this VA stuff is confusing because you ask 5 people a question and you get 5 different answers. So I know some of the problem with my overall claim was the VA guy on base had me fill out my 526EZ wrong. For instance, I suffer from migraines and he told me to put headaches. In the box where you put what causes he said put unknown which I should have put brain tumor. The VA denied because I put on my MEPS paperwork I had previously had frequent headaches. Needless to say I resubmitted and changed to migraines.
Anyway, the tumor cause hearing loss in my right ear and what I can hear comes in distorted (like I have a plug in my ear). The VA denied my claim for hearing loss so like my migraines I challenged it. I got my letter back and it said my speech loss was 52% and puretone was 59%. My claim for hearing loss on left ear was denied due to my job. Funny thing was I never asked for hearing loss in my left ear, and the letter never gave the results of the left ear. My question is I understand the VA takes the results of the good ear vs the bad to get a possible rating. Because of this I am trying to get the results of my left ear to see where I truly fall. I was under the impression though that if the hearing loss was due to a disease (tumor) that it was treated differently than say if it was due to normal loss.
The doctor's don't know when I got the tumor, but I believe it was some time in 2006 because that is when I started getting the migraines, having hearing issues, and vertigo. I know there are thousands in the same boat as me and it is very frustrated when I can by lying in bed with my left ear on the pillow and my wife can be literally less than two feet away from me say something and I can't hear what she says. Then to have the VA say that you get nothing for it.
 
I strongly recommend getting a VSO to help you with this claim as I can tell you will need a clear strategy to prevail.

The reason for the migraine denial is very weak as you can win here with a aggravated claim, now you are not consistent with the tumor and its side effects. You claim you think you got it in 2006 because thats when you first started having headaches that is technically not true since you self-reported that you have headaches before you entered service. 2006 is fourteen years ago when did you leave service? When was the tumor found? Did you see a doctor in service for the headaches in 2006? or anytime in service?

The resubmitting the migraine claim was a big mistake there is no difference between headaches or migraines as the VA treats them both the same for rating purposes, yes among neurologist they may claim their is a difference but to the VA not so much.
 
The VSO really can't help me, she said basically she just files the claim. Actually you're wrong, the VA doesn't rate headaches, only if you have "migraine" headaches which is what I changed my claim to. I put on my MEPS form that I had "previously" had frequent headaches. There are two options for that form, Have or Previously Had. Like I said, when I filled out the form in 1989 I had not suffered a frequent (and that is subjective as to how many) headaches since about 1985. So I was "headache" free up until 2006 and I started getting migraines (not headaches) in the back right part of my head to the point where it felt my head was in a vice and it lasted for up to 8 hours. NOTHING I did helped and believe me when I say my worse headache on a 1-10 scale would be like a 4, these were 15. ALL of these migraine attacks are in the exact location of this tumor which was discovered by accident in 2011. I say 2006 because I started having the migraines, dizzy spells, vertigo, hearing issues ALL in or around 2006 and ALL are documented in my medical records.

Code 8100: Migraine headaches are a type of headache caused by the swelling of the blood vessels in the brain. They are often more severe than other kinds of headaches (stress, sinus, etc.), and so interfere more with the individual’s ability to work and function in daily life. If another kind of headache interferes significantly with daily life, it can also be rated here.


Two things are taken into account when rating migraines: frequency (how often they occur) and severity (how bad they are). To receive a proper rating, it is essential that the physician records these clearly along with how they affect the individual’s ability to work and function.


The term “prostrating” means that the individual must stop all activity, take medication, and either seek medical attention or seclude himself for the rest of the day. The individual is unable to perform any occupational or daily activities either because of the migraine itself or because the migraine medication makes him too drowsy, etc.


The ratings for migraines only go up to 50%. The Rating Authorities, however, can give a higher rating if the case is so severe that 50% doesn’t truly reflect the disability. It is completely up to the Rating Authorities, however, exactly what makes a condition severe enough to warrant a higher rating.



Frequency​
Severity​
Rating​
2 or more times per month​
Prostrating​
50%​
Once a month​
Prostrating​
30%​
Once every 2 months and prostrating​
10%​
Once every 3 months or less​
Prostrating​
0%​


If the condition does not make occupational activity impossible, then it cannot be rated more than 0%.
 
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The VA does rate headache, analogous to migraines. Meaning your headaches must meet the same requirements as migraines, a doctor would have to diagnose you with headaches and be treating them , then you just replace the word "migraine" with "headache" in the VASRD. I know this because I had a rating for "new daily headaches" along with migraines. They just rolled into the same rating. My diagnosis of "new daily headaches" is different than my migraines because I have a new headache everyday, that requires medication that doesn't help with migraines.

Also just a word, instead of flat out telling some one they are wrong, I would look for a more tactful way of saying you respectfully disagree. We are all volunteers here, trying to help our brothers and sisters, and if I got told flat out that I was wrong, then I would just ask the person why they need help if they have all the answers already.
 
In respect to your ratings, you are going to need more concrete evidence and diagnosis. Without hard dates, evidence to support claims and treatment plans, you are not going to get rated as there is not enough information to rate against.

What are your service dates, what are your diagnosis dates for starters. Your timeline is confusing since you don't mention these.
 
I agree with @heathro1281 you already have a denied claim so will need to file a supplemental claim with new and relevant evidence apparently you just refiled reclassifying the headache with a migraine that claim will most likely be denied unless a duty to assist error was found.

I suggest finding a different VSO to help you most NGO's can assist you as well. We cant jump ahead here arguing over what a headache is and its effects on you the VA is claiming your headaches are EPTS given how long you were in I am not sure how they are getting away with this. Maybe you have a break in service have you reviewed all your medical records yourself?
 
Maybe I should work on my tact, guess you can say it's how one interprets. You are correct in the sense “Analogous” means the condition that is closest to the overall condition, that best describes the main symptoms, or that has the same treatments. How I read it is the only way to code out a headache is to have it so severe to classify it as a migraine headache. Going over oddpedestrian's post again I can see it from different angles and no need of ruffling feathers on here. As for when I entered service in 1989 I like pretty much everyone that went through MEPS didn't remember what they put down. In 1985 there was a small period where I would get a headache maybe once a month that all I needed was aspirin. Right there was a four year gap where I didn't have frequent headaches and I shouldn't have put anything, but being where I was and being told to be truthful I was. Anyway, in 2006 I started getting these migraines to the point where if slamming my head in a car door would stop the pain I would. I also started having bouts of vertigo, dizziness and hearing issues in my right ear that would come and go. I have multiple places in my medical records where I was seen for from 2006 until I retired in 2019, I had gone off base for the vertigo in 2006 and complained to my PCM at other times, but since it would come and go the doctor didn't do anything. Same thing with the hearing, the tumor would mess my hearing up and then it would come back. Other than getting the acoustic neuroma removed in 2012, the only other "treatment" I have and will ever have for the migraines are the 3 different types of medicine to help reduce the frequency of the migraines. I know we're talking VA, but doesn't take a rocket scientist to put two and two together as far as why I am having the migraines since it the epicenter is always where the tumor was. The dizziness, hearing loss, and vertigo are all 100% related to the acoustic neuroma. Not sure what other documentation the VA needs. Hell, one of my medication's has caused me to lose taste of carbonated drinks. I haven't had a soda or a beer in a year and a half because of it.
 
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VA needs a doctor to diagnose the condition, and link it to service connection by showing that your service is the primary reason for your conditions to exist or become debilitating. This is usually as easy as providing evidence that your conditions began after you entered service through examination or found it after you left service but can provide evidence that service created or exacerbated the condition.


Its harder once the VA concludes your conditions existed prior to service "EPTS". Now you have to prove that while the conditions may existed prior to service, it is undeniable that your serving caused the condition to regress to a state so severe that it is debilitating and would not have reached this state if you never served. This seems to be the path you are travelling. You would now need to prove that either your headaches are a new condition that didn't exist prior to service by :
1. having a doctor prove that you never were diagnosed with headaches prior to service, and now your service precluded this new diagnosis of headaches.
2. you have 2 separate issues, normal headaches prior to service but now you have a worse more debilitating diagnosis of headaches such as "new daily headaches", headaches caused by TBI or some sort of new finding that could have only resulted from service.
3. The headaches have always existed but your service has exacerbated the headaches to a degree that is ratable comparable to migraines

How do you compare headaches to migraines? Migraines are not headaches even though normal everyday descriptions have limped these two together but migraines are usually precluded by a physical manifestation, I know the day before a migraine happens because I will be euphoric, will have neck pains and will get nauseated the day fore I am bed ridden with the "migraine" which includes pain so bad behind my eye that I see flashes in that eye, the pain makes me throw up and then the day after I have back spasms. Migraines are a problem with the nervous system and requires neurology to diagnose and treat. Headaches normally do not have indications that you are going to have a headache until the pain hits and can be diagnosed and treated usually through your primary care physician.

Buy your headaches can still follow the debilitating descriptions: the headaches need to be so bad that they are prostrating which means they require some sort of intervention and removal from society to cope with the headache such as requiring ER or medical assistance to deal with the pain, bed riddance or self isolation until symptoms subside. And the frequency most be at least once a month to multiple times a month to receive a rating greater than 0% . I have Migraines rated as 30% with NDH (new daily headaches) of 0%. I get 2-3 migraines a month that require me to actually go to the hospital for shots 1-2 times a month. I get 26 botox injections every 3 months and take daily medication to lessen the severity of migraines and daily medicine to combat headaches. I think I was shorted , I appealed for a ratings increase to 50% based on severity and frequency but was denied because I only go to the hospital on average once a month and not "2 or more times", even though I have to self isolate every time a i get a migraine 2-3 times a month.

Where do you start? Begin a pain journal, describe everything you can prior, during and after your headaches such as triggers, how you find relief and after effects of the headaches, and find a treatment plan that requires medical assistance and get all of this diagnosed and documented by your doctor at least, if not to include specialist visits.
 
According to the VA I am on hold to have an exam done for my migraines, but COVID has everything on hold. I am in the same boat with you, I can tell when the migraine is going to hit as 12-24 hours ahead of it I start feeling tightness in my neck and slowly having pain progress to the point where it feels like I have my head in a vice and every time my heart beats I feel it behind my right ear. This is constant for anywhere from 8 to 10 hours and I would like to say I just go into a dark room and it feels better, but it doesn't. Luckily (if you call it that) the peak of my migraines usually hit around 1900, problem is I am up all freaking night and dead tired the next day.

I don't have anything in my records before I joined that stated I had frequent headaches and would be willing to hire a lawyer to fight the VA if necessary. I say this because I am confident what the military considers frequent versus what I had are two different things. Granted it was 35 years ago, but I'm talking a span of a few months where I had a couple of headaches month. As far as I know there are no triggers, I do know the topomax I am on has lessened the amount of attacks, but I still fall into the more than 2 a month category. I also will tell you that if I forget to take my topomax one night it's pretty much a guarantee the next day I will get a migraine. As far as relief, so people say going to a dark room and putting a cold cloth on their head helps. I did have rizatriptan benzoate prescribed which is taken at onset, but it is hit and miss as far as how long it takes to take affect. My neurologist recently prescribed me a nasal spray, but I'm not too sure about that. He did talk about botox shots. So you are saying the VA says considers the 2 or more attacks only if you go to the hospital? That's pretty dumb if that's the case. Granted I understand we are talking about the VA. I mean, why would you or anyone who is in pain go to the hospital and deal with the paperwork and everything to be seen and essentially get nothing more done than what you would have gotten at home. SMH.
 
For the visits, it needs to be verifiable removal from society, so documentation you were sent home from work or called in, a trip to the hospital, that kind of nature to verify the amount of attacks.

It sounds like you could eb diagnosed with migraines as I take rizatriptan also, there are many -triptans …. sumatriptan is another, they all have varying amounts of side effect vs relief. I tried 3 types and to me , the worse the side effect, the faster and more aggressive the relief from the migraine. I had to find a happy medium, the triptans to me make my face, scalp and inside nostrils feel like its sunburnt, the worse the sunburn feeling, the faster the migraine subsided.

You are going to need some help. I don't know how long you have to try to connect service to ailments. But I think we have you squared away for what to say and prepare for, now its making sure you can create the connection to receive compensation.
 
Thanks for the info on the removal from society stuff. That may be hard because like I said, only a very few episodes were during the day so I didn't miss a lot of work. The days that I felt the migraines coming on I just stuck it out, maybe that was a mistake, but figured it was coming whether I was at work or not. I have no set hours with my current job as I am basically my own boss. I don't know, maybe that's a good thing. LOL I first started out with sumatriptan but that stuff made me feel way bad, even after the migraine was gone. That's when I went to the riza which worked really well, but then not so much and then the doc gave me the nasal spray.
 
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