Migraines Statistics in the US
One of the most debilitating medical conditions of our modern age is migraine headaches. From a medical standpoint, migraines are described as moderate-to-severe headache pain that can last a few hours to a few days, accompanied by physiological symptoms, such as nausea, vomiting, and sensitivity to light and sound. Functionally, migraines can be crippling and completely debilitating. Often people who suffer from migraine headaches must lie down in a dark, quiet room for the duration of the attack, and are unable to work or tend to the needs of their families.
The Migraine Research Foundation provides surprising statistics on the prevalence and implications of migraine headaches in the U.S. and worldwide:
- Migraine is the 3rd most prevalent illness in the world and the 6th most disabling illness in the world.
- Nearly 1 in 4 U.S. households includes someone with migraines.
- 12% of the population – including children – suffers from migraines.
- 18% of American women, 6% of men, and 10% of children experience migraines.
- 85% of chronic migraine sufferers are women.
- About half of female sufferers have more than one attack each month, and a quarter experience 4 or more severe attacks per month.
- Migraine is most common between the ages of 18 and 44.
- More than 90% of sufferers are unable to work or function normally during their migraine.
- More than 157 million workdays are lost each year in the US due to migraines.
- More than 4 million adults experience chronic daily migraines – with at least 15 migraine days per month.
- Migraine sufferers, like those who suffer from other chronic illnesses, experience the high costs of medical services, too little support, and limited access to quality care.
- Having migraines increases the risk of other physical and psychiatric conditions.
- The vast majority of migraine sufferers do not seek medical care for their pain.
- Only 4% of migraine sufferers who seek medical care consult headache and pain specialists.
Migraine Ratings for Veterans Benefits
The Veteran population is no stranger to migraine headaches. In fact, a recent study found that 36% percent of Veterans who had completed a 12-month deployment to Iraq were either diagnosed with or exhibited symptoms of migraine. Notice that the study only discussed deployments to Iraq. One can imagine that those statistics, if true for Iraq deployments, must also hold true for deployments to other areas as well.
In spite of its acutely disabling effects, migraines take up a very small section in the VA diagnostic rating code and are rated at a maximum of 50%. Migraines are principally rated according to the frequency of the migraine attacks.
- 0% – With less frequent attacks
- 10% – With characteristic prostrating attacks averaging one in 2 months over the last several months
- 30% – With characteristic prostrating attacks occurring on an average once a month over the last several months
- 50% – With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability
The magic word for an increased rating, therefore, would appear to be “prostrating.” We find that this is exactly the case. The Disability Benefits Questionnaire for headaches, which the Compensation and Pension examiners use to conduct their exams, includes a whole section on “prostrating attacks.” The questionnaire prompts the examiner to ask the Veteran if the migraine attacks occur:
- Less than once every two months
- Once in two months
- Once every month
- More frequently than once a month
- Very frequent prostrating and prolonged attacks of migraine headache pain
What are Prostrating Migraines and What Are Their Ratings?
While the rating code itself is vague, the VA’s internal adjudication manual, the M21-1, provides clarification for these terms for the decision-makers:
Prostrating: causing extreme exhaustion, powerlessness, debilitation or incapacitation with substantial inability to engage in ordinary activities.
Completely prostrating: means extreme exhaustion or powerlessness with essentially total inability to engage in ordinary activities.
Severe economic inadaptability: denotes a degree of substantial work impairment. It does not mean the individual is incapable of any substantially gainful employment. Evidence of work impairment includes, but is not necessarily limited to, the use of sick leave or unpaid absence.
Very frequent: Duration of characteristic prostrating attacks, on average, are less than one month apart over the last several months
Less frequent: Duration of characteristic prostrating attacks, on average, are more than two months apart over the last several months.
When you add the adjudication manual definitions to the rating criteria language, you will find that the Disability Benefits Questionnaire questions translate to this:
- Less than once every two months = 0%
- Once in two months = 10%
- Once every month = 30%
- More frequently than once a month = 50% AND
- Very frequent prostrating and prolonged attacks of migraine headache pain = 50%
The magic word “prostrating” holds even more weight, as the adjudicators tend to look only at Section IV – Prostrating Attacks of Headache Pain (as shown below) in making their determination. The examiner does not check the “Yes” box under 4A or 4C, the adjudicators will not award a higher rating.
However, the adjudication manual cautions adjudicators that even if the term “prostrating” does not appear in the Veteran’s medical record—or in the C&P examination, for that matter—equivalent symptomology would warrant that rating. For example, the manual states that if a Veteran provides testimony that he/she 1) experiences severe headaches and vomiting when exposed to light; 2) does not engage in any activities when this occurs; and 3) must rest or sleep during these episodes; and if there is medical evidence that the claimant’s description of symptoms is in fact symptoms of migraine headaches, a determination that the headaches cause prostration can be made.
What does all this mean for you?
With the fate of your migraines rating essentially in the hands of the C&P examiners, there are a few things you can do to boost your case for an increased rating:
- Complain, complain, complain!
As with most other medical conditions, documentation is key for your claim for an increased rating. Tell your doctor about your migraine headaches, even if you do not take prescription medication for them. Let them know your symptomology, limitations, frequency of headaches, and precautions you must take during migraine attacks. That way, even if the C&P examiner does not accurately represent the severity of your migraine headaches, the medical record will support the criteria for a higher rating.
- Don’t downplay your symptoms.
This goes hand-in-hand with the first point. A good rule of thumb, especially for C&P examinations, is to describe the symptoms of your most severe migraine attacks. The headaches might not always be that severe, but the point is for the VA to compensate you for functionality that you lose due to your service-connected conditions. However, this is not to say that you should exaggerate your symptoms, as this could cause problems later on.
- Write a statement.
You are your own best historian. You know your migraine condition better than anyone else—so write about it. As with the first point, describe your symptomology, limitations, frequency of headaches, and precautions you must take during migraine attacks. Statements from family members, friends, and/or coworkers who witness you during migraine attacks are also very beneficial. Statements are a strong piece of evidence, especially if you do not see your doctor very often.
TDIU Requirements: Part 1, Schedular Requirements
Many disabilities can leave a Veteran unable to maintain employment. The VA awards 100% disability ratings if they find that the Veteran’s service-connected disability inhibits them from being able to work. But, 100% ratings can be rare and hard to achieve. Alternatively, one condition may not render you unable to work, but rather a combination of several conditions. The VA recognizes that Veterans without a 100% rating still may not be able to get and keep a job. Because of this, there is another option known as Individual Unemployability which has its own requirements. Disabilities differ in effect and severity for each individual. Those Veterans with a disability rating of less than 100% may need that extra compensation in order to combat the lack of income and stability full-time employment provides.
Are there Unemployability Requirements Veterans Must Meet?
The VA provides an opportunity for those in that category to obtain compensation called Total Disability Rating Based on Individual Unemployability (TDIU or IU). If you are granted TDIU, the VA has conceded that your disability makes you unable to get and keep a job, and they will pay you at the 100% rate.
TDIU compensation exists to allow those Veterans with disabilities that render them unemployable to be able to support themselves and their families. Unemployable according to the VA standards is to be incapable of maintaining substantial and gainful employment.
According to 38 CFR § 4.16, the VA allows Veterans with ratings less than 100% can be eligible for TIDU by adhering to the following guidelines:
- If you have only one service-connected condition, the condition must be rated at least 60% or higher.
- If you have two or more service-connected conditions, you must have at least one condition rated 40% or higher, with a combined rating of 70% or higher.
Do I Need A Specific Disability for Unemployability?
The VA does not have any sort of guideline as to what type of disability you must have in order to be eligible. Both mental and physical conditions are considered. And while the VA does allow combining ratings, they do have a requirement as to what counts as a single disability. The requirements are as follows:
- Disabilities of one of both upper extremities, or of one or both lower extremities, including the bilateral factor of application
- Disabilities resulting from a common etiology or a single accident
- Disabilities affecting a single body system (ex: orthopedic, digestive, respiratory, etc.)
- Multiple injuries occurred in action
- Multiple disabilities occurred as a prisoner-of-war
Other Important Factors About Unemployability Requirements:
- The VA only recognizes disabilities that are already service-connected when assessing a TDIU claim. If you have other pending claims, they will not be considered in your TDIU decision.
- Disabilities that are not service-connected will not be considered in your TDIU decision.
- The age of the Veteran is not a factor the VA will take into consideration. The decision will be based solely on the service-connected disability.
Receiving TDIU compensation can be life-changing for a Veteran. If you are unable to maintain substantially gainful employment but do not meet these requirements, do not fear. The VA provides more exceptions to TDIU requirements that will be outlined in Part 2. And if you need help with a TDIU / Unemployability claim, click here!
How the New VA Appeals Process is Addressing “Hurry Up and Wait”
Every service member knows the famous motto, “Hurry up and wait.” Unfortunately, this motto has taken hold in the VA system so much so that many Veterans think the VA is waiting for them to die just to get out of deciding their claim. Wait times for initial decisions have often taken over a year, and if you need to appeal the decision, it can be multiple years before you begin receiving monetary benefits. But…..the Appeals Modernization Act (AMA), which was signed into law on August 23, 2017, promised reduced wait times and faster decision. Has it happened? Let’s take a look at some of the changes and what the current wait times are with the new VA appeals process.
What is the Difference Between AMA and Legacy?
The Appeals Modernization Act (AMA) was officially implemented on February 19, 2019. Every new claim filed after that date is under the new program, referred to as AMA. Claims filed before that date are now referred to as “Legacy” claims.
Where Does My New VA Appeals Claim Go?
Originally, when a claim was filed it went to the RO servicing the area the Veteran lived. Under AMA, only two ROs,, St. Petersburg or Seattle, will handle all initial claims. The other 57 ROs are handling all appeals and Legacy cases. Yes, 2 offices are handling all claims and 57 ROs will be handling appeals.
I Filed My Claim, Now How Long Will It Take?
The good news is that things are speeding up. For initial claims, the wait time has been cut by 60%. However, it does not look like Board appeals are speeding up much faster than the rates from the year before. In fact, filing a Notice of Disagreement (NOD) is actually incurring a longer wait time than before AMA.
Number of days pending
Initial Claim Decision
NOD Appeal to BVA
VAF 9 decision
Remands to RO
Should I Appeal to the BVA?
Not if you can help it! Under Legacy, if you got an unfavorable decision at the RO, you could appeal that decision once, then you had to appeal to the board. Now, with the new system, you can continue to keep your claim at the RO as long as you continue to submit new and relevant evidence.
Once you get a decision on your initial claim, either a grant of the conditions with a rating percentage and the benefits you will receive, a denial of your claim, or an incorrect effective date; you may want to appeal. If you appeal, you will still start to collect the current benefits awarded.
At this point, you have three options to appeal your claim: Supplemental Claim or Higher Level Review from the RO or you can file an NOD to the Board. There is now a one year limit to file any type of appeal. Board level appeals currently have an average waiting time of almost 430 days, over a year and a half.
Now, of the three options; you have to make sure you meet the requirements of each:
Type of Appeal
Is Evidence Required?
Yes, must be submitted with Appeal
Higher Level Review
No – will not look at any new evidence
Yes/No: you can submit new evidence within 90 days of Appeal but not required
Why Stay At the Regional Office Level?
With the Supplemental Claim, you can keep appealing as long as you submit new and relevant evidence within one year of the last decision to keep your original effective date. You can reopen a claim with a Supplemental Claim after the one-year deadline with new and relevant evidence and the new effective date.
Benefits of the New VA Appeals AMA System:
If you received a favorable finding, no one can reverse that finding. You will get a decision that should tell you exactly what was missing to grant your claim. For example, if you claim service connection and had an injury in service but no current diagnosis, the decision must state that you are missing a current diagnosis.
Is AMA Good for Veterans?
Yes and No. There are many aspects that are more favorable towards the Veteran such as:
- the initial wait times are shorter,
- the decisions have to show what the Veteran needs to get a favorable outcome, and
- everything is electronic so records and paperwork are expected to move much faster.
However, there are also drawbacks as well:
- it is not very user-friendly towards Veterans
- even the VA is not very clear concerning the expectations and rules they have designed
- there are a lot of issues that the VA is not sure how to handle yet.
Unfortunately, this new VA appeals process can become a long circle of decisions and appeals until you receive the benefits for which you are entitled. These long wait times can become extremely frustrating and may even deter you from filing a claim, or appealing the decision, but in the end, the outcome can be worth the wait. The effective date for which you will start receiving benefits for your granted disabilities will go back to the date of the original claim. For example, if you filed your original claim in 1998 and after the entire appeals process you received your rightful decision in 2004, you would receive six years of back pay, plus recurring monthly benefits!
Is There Any Way to Expedite My Claim?
Sure, there are a few ways to help speed up the process and move your claim at a faster pace even with the new VA appeals process. Show the VA proof of age (over 85 yrs old), a terminal illness, or financial problems such as foreclosure or evictions that can lead to homelessness. These are the only ways so expedite a claim.
We will keep you informed of the new developments and statistics surrounding AMA and how to make it work for Veterans in the best way possible.
What is Urinary Incontinence? Urinary Incontinence is essentially a loss of bladder control. The severity can range from leaking urine when coughing or sneezing, or a sudden urge to urinate that does not always allow you to make it to a bathroom in time. Urinary Incontinence is typically service-connected as a secondary issue. For example, you can develop incontinence due to a back condition, or even a disease such as Parkinson’s or diabetes.
The VA’s Rating Criteria for this voiding dysfunction:
- Rate a particular condition as urine leakage, frequency, or obstructed voiding:
- Continual Urine Leakage, Post Surgical Urinary Diversion, Urinary Incontinence, or Stress Incontinence:
- Requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day 60
- Requiring the wearing of absorbent materials which must be changed 2 to 4 times per day 40
- Requiring the wearing of absorbent materials which must be changed less than 2 times per day 20
Based on these criteria, a Veteran that requires the use of absorbent pads and changes those pads once per day is going to receive a rating of 20%. If the pads are changed two to four times per day, the Veteran will be given a 40% disability rating. If the absorbent material needs to be changed more than four times per day, the Veteran is rated at 60%. These ratings add up considerably, especially when paired with their primary conditions. For example, if you claimed urinary incontinence due to your back condition and your back condition is service-connected at 20%, you can receive an additional rating of 60% if you change your absorbent pads more than four times per day.
Proving your urinary incontinence claim
The first thing you will need to do is file a claim for urinary incontinence secondary to your service-connected disability. Next, you will need to provide a link between your current disability and the development of your urinary incontinence. Be sure to submit any medical records documenting that the incontinence was caused by your service-connected disability. If there isn’t anything specific in your medical records linking the two, see if your doctor would be willing to write a statement indicating that your disability led to the development of urinary incontinence.
Next is to document how often you need to change your absorbent pads. It would be beneficial to write a statement on a VA Form 21-4138 attesting to the number of times per day and per night you are required to change the absorbent material. Do you require a waterproof mattress cover? Have you ever had any accidents? How often? Have a witness, such as a spouse or a roommate, do the same. If you can provide a buddy statement to back up your claim, that is a great way to substantiate your case. Urinary incontinence can be an embarrassing topic to discuss with a friend or a doctor, nonetheless a VA examiner; be sure that you do not downplay your disability. There is nothing to be ashamed of. If you require absorbent pads, let them know. If you have had accidents due to urinary incontinence, make sure you tell them. You deserve compensation for all of your military-related disabilities, and urinary incontinence is very common in Veterans, but not often claimed.
>>Veteran and Hawaii real estate agent Bernard Edwards talks with VA loan expert William Doom about what makes the VA loan so special and a benefit no Veteran should pass up.
The Military VA Loan is one of the best, if not the best, lending options available to military families. We have launched “The Military VA Loan Dot Com Show” with guest host Bernard A. Edwards to learn firsthand from real estate professionals that serve Veterans, military members, and military spouses about what it’s like to use a VA loan to purchase a home in today’s market.
In this episode, Bernard sits down with mortgage lending professional William Doom to find out just why the VA Loan is such an amazing benefit for military Veterans and families. If you want to learn more about obtaining a home with your VA loan, this is an interview that you don’t want to miss!
Breaking Down Myths about the VA Loan
Veterans and military members have no shortage of options when it comes to securing financing for a home. Along with conventional and FHA loans, Veterans also have exclusive access to VA loans.
There are a lot of myths surrounding VA loans, ranging from questions about rates to how difficult it is to secure financing with the program. But many Veterans have found success with the program and go on to use it multiple times to buy a home.
So, when picking a mortgage option, should Veterans always use a VA loan?
“I’m in the camp of the Phil Knight world, so I would just do it,” says William Doom, Loan Consultant in Honolulu, HI. “There really are no negatives about purchasing using your VA.”
Doom works with home buyers that have access to VA loans as well as buyers that don’t. He’s seen the benefits of the VA loan program first hand and believes that Veterans should always look to use their VA eligibility when they can.
Here are some of the benefits of a VA loan, according to Doom:
Before anything else, Doom says that the biggest benefit of VA loans is the 100% financing.
“That means you’re putting zero down,” he explains.
With home prices rising across the country, affordability has become an issue for many would-be home buyers. By avoiding a downpayment, Veterans can become eligible to buy a home that a non-Veteran in their situation would be unable to afford.
“A lot of times, depending on the lender that you’re working with, you’re going to have zero closing costs,” says Doom.
VA loans allow the home buyer to avoid some closing costs and include others in the financing. Some of the closing costs can even be assumed the by the home seller.
As Doom explains, the amount of closing costs Veterans pay – if any – are dependent on the lender. When shopping for a VA loan, it’s a good idea to get multiple quotes from different lenders. Also, it’s worth it to find a lender that has VA loan experience. This keeps things going smoothly throughout the process.
The third big benefit of VA loans is the low interest rate.
“A lot of people don’t realize that the rate is far better than what you’ll normally see on conventional lending,” points out Doom.
VA loan rates are often the lowest available. Rates are always changing, and the rates available to each Veteran will change depending on their personal situation. But when compared to other products like conventional and FHA, VA rates are often the lowest available.
Securing a loan
Most Veterans are eligible for VA loans, as are some active duty military. Active duty military will likely have to go through more paperwork to prove their VA eligibility, says Doom, so it’s best that they bring their DD-214. Aside from that, experience VA lenders should be able to help with all the other paperwork.
“If you’ve been out of the service for a while and you’re like, ‘Oh, I’ve misplaced that. I’ve moved five times, I don’t know where I can get that.’ Most lenders will have the ability to help you,” says Doom.
Along with paperwork, Veterans should be prepared to prove their income. This means bank statements and verification of employment. But if Veteran buyers are not making a down payment or paying for closing costs, bank statements might not be necessary.
Full Video Transcript
Bernard Edwards: Hey everybody, welcome to the MilitaryVALoan.com show. I’m your host Bernard Edwards, CEO of Troopstoagents.com. And I’m here with my friend, Will Doom.
William Doom: What’s up?
Bernard: What’s up, brother? Good to see you. On this show we interview real estate professionals that service the Veteran community, help Veterans get into homes, secure homes, create investments for themselves, and we also interview Veterans who have used VA loans in their lifetime. Some of them more than once. Without further ado, I’d just like to get started asking you our first questions. Some of our viewers have chimed in and they want to know, what’s the number one piece of advice you’d give a military family that’s looking to purchase their first home?
William: Number one piece of advice, I’d say, I’m in the camp of the Phil Knight world, so I would just do it. There’s really no negatives about purchasing using your VA. I think it’s an awesome tool the VA offers, and it’s something that every Vet should take advantage of.
Bernard: What makes it, because you work with a lot of Veterans, but you work with folks who are not Veterans. What are some of the things about the VA loan that standout, that make you say, just do it?
William: Number one, 100% financing. That means you’re putting zero down. A lot of times, depending on the lender that you’re working with, you’re going to have zero closing costs, that’s number two. Number three, which a lot of people don’t realize, the rate is far better than what you’ll normally see on conventional lending. You’re getting an awesome rate. There’s this old myth that VA loans are bad, they’re hard to do, the rates are high. That’s all a fallacy. It’s not true. I believe, truly, that the VA loan is probably the best loan out there. If you have the ability to take out a VA loan, it’s something you should definitely do because you get that leverage of 100%. You’re putting zero down, if you’re working with a good lender they’re going to do hopefully zero closing costs, so you’re not paying anything out of pocket. And again, you’re going to get an interest rate that’s pretty awesome and pretty amazing.
Bernard: Love it. Love it. I’ve definitely used VA loan a few times in my deals where I can. It’s all been amazing experiences. And you’ve serviced a lot of my clients, which has been great. What’s some of the biggest surprises your Veteran clients have when, let’s say they’re a first time homeowner, and I know one off the top of the head is probably paperwork, right?
William: Yeah. It depends. If you’re active duty versus civilian, the biggest thing is the DD-214. Making sure you’ve got that, and most lenders will have the ability to help you get that.
Bernard: This if they’re active duty, separated, retired, doesn’t matter. They’re going to have to produce a DD-214.
William: Correct. Just to show their eligibility. And again, if you’re working with a VA, a lender who knows the VA product, they’ll be able to help you get that. If you’ve been out of the service for a while and you’re like, “Oh, I’ve misplaced that. I’ve moved five times, I don’t know where I can get that.” Most lenders will have the ability to help you.
Bernard: Nice. Any other surprises that some of these Veteran clients have had? That they didn’t realize was a necessity?
William: It really comes down to, VA loan at the end of the day, too, it’s just like any other loan where you’re going to have to provide income. Bank statements, verification of employment. Just be prepared that, “Hey, I’ve got to verify my current employer. I’ve got to have a pay stub that’s recent.” In most cases, you potentially have to have a bank statement if you’re putting money towards closing costs. A lot of times they’ll, again, if you’re not paying any closing costs, you might not have to verify your bank statements. Just be prepared. Bank statements, employment information, and pay stubs.
Bernard: All right. There you have it, guys. Go head over to MilitaryVALoan.com, where you can get much more of this great content. Will Doom, thank you so much for coming and providing value to the Veteran community.
William: Definitely. Thank you for having me.
A trio of Democratic senators are pushing to overhaul transferability rules with the current GI Bill benefits program in response to a pending Defense Department policy to limit troops’ ability to share those education payouts with their spouses and children.
Sens. Jon Tester of Montana, Sherrod Brown of Ohio and Richard Blumenthal of Connecticut introduced legislation this week which would guarantee that that all service members with 10 years of service are eligible to transfer their benefits to dependents at any time, either before or after they leave the military.
“The law should make it easier, not harder, for service members to use the benefits they’ve earned in a way that makes the most sense for them and their families,” Tester said in a statement, adding that the new plan would get rid of “unnecessary hurdles” in the current program.
It’s unclear how many families could benefit from the change. More than 773,000 individuals have used Post-9/11 GI Bill benefits since the program began in 2009.
GI Bill Currently, troops must register all eligible dependents in Defense Department systems before separating from the military in order for them to be able to receive Post-9/11 GI Bill benefits in the future.
That means the children born after individuals retire from the service are not eligible for the education payouts, which include 36 months of full in-state tuition and monthly living stipends. Same for the spouses of Veterans who get remarried after leaving the ranks.
Last year, military officials announced plans to refine the Post-9/11 GI Bill program even further, in the interest of maintaining it as retention benefit. They would shift the deadline for registering dependents up even earlier, blocking troops with more than 16 years of service from adding any new names to their accounts.
Advocates argued that change amounted to punishing troops for having long, productive military careers.
House Democrats in June included language in their chamber’s draft of the annual defense authorization bill to block the change, which was set to go into effect last July. That measure is still pending before Congress.
However, on the eve of that deadline, Defense Department leaders announced they planned to delay the controversial change until January 2020.
The three senators backing the new legislation say they want the issue settled once and for all, and believe that the military’s approach to the benefit is flawed.
“The Department of Defense’s confusing new policy moved the goalpost for transfer eligibility, breaking our promise to military families,” Blumenthal said in a statement. “Disqualifying service members with more than 16 years of military services penalizes the men and women who have served this country in uniform for the greatest length of time.
“This policy change is fundamentally illogical and unfair.”
The legislation would be retroactive to 2001, meaning that thousands of Veterans’ dependents who were previously ineligible could take advantage of the program if the measure becomes law (provided the Veteran has not already exhausted all available benefits).
No potential price tag for the Senate legislation has been released.
A joint House and Senate conference committee is currently negotiating the final draft of the defense authorization bill, to include whether the GI Bill policy repeal will be included. That work is expected to finish in coming weeks, with full chamber votes on the compromise measure sometime this fall.
1. VA did not have proof of your injury in service
You must show that your disability is related to an in-service incident. If VA said that there was no proof of what happened in service then you need to find something to back up what you say happened. The most common evidence to prove your incident in service is service records. These can be either medical records or records of your duty stations or performance evaluations. If VA said it could not find these records and you believe that they exist then it is worth writing to the National Personal Record Center to obtain them.
Even if the records are missing, proof of an in service incident can be found through other means. Find others who served with you and have them write buddy statements describing the incident. These statements count as evidence. Also, you can look for unit records through the National Archives or records of your base, ship or unit on the internet.
2. VA says you do not have a disability
To obtain service connected disability benefits your disability must have a diagnosis. Pain is never a diagnosis. Exposure to deadly substances like Agent Orange in Vietnam or TCE in Camp LeJuene is not enough if the exposure does not result in a current diagnosis. So if a Vietnam Veteran, exposed to Agent Orange, develops Diabetes then that is a diagnosis.
Two common areas where this is a problem are back problems and mental illnesses. Often Veterans will treat for back pain but the doctor will not give a diagnosis. With mental illness you might be treating with a doctor for mental health problems but VA will deny benefits because VA’s doctor will state that you do not meet all that is needed for the diagnosis. This problem happens a lot with PTSD cases. It is important if you are treating with a doctor that you ask for them to give you a diagnosis. If it is a mental health case like PTSD, then you need to ask the doctor to lay out all the elements of the diagnosis in the medical record.
3. VA says that your illness is not related to service
To get service connected benefits, you have to show that there is a link, or nexus, between what happened in service and the current diagnosis. If VA says that they are not connected then it probably did so based on an exam from its own doctors, a C&P exam. If the C&P doctor says that there is no connection then you should go get an opinion from your doctor or an independent medical exam from outside doctor. You should give them the service records and medical records that they need to not only say that your disability is related to service but to explain why it is.
4. VA says you did not show up to your C&P exam
It has recently come to light that VA was setting C&P exams, the exams VA uses to determine of a Veteran’s service connected compensation benefits, and not telling the Veteran. Then VA would deny the benefits and say that the Veteran did not show up to the C&P exam and that is why it was denied. VA gets an automatic denial if the Veteran does not attend the C&P exam. Unfortunately, VA has been denying on this reason when it never told the Veteran about the exam.
In this case, you should write VA and state that you were never informed. If you were informed and did not attend then you should also write and state why you could not attend. If you do not hear back from VA after a couple of months then you should file an NOD and appeal the case.
5. VA doesn’t believe your doctor
If you got your doctor to write a favorable opinion for your claim and VA rejected it then you need to go back and look at the opinion to see if it is thorough enough. VA routinely rejects opinions from treating doctors—both VA and private doctors. There are certain areas that VA always looks to in dismissing your doctor’s opinion:
- Your doctor did not review your C file. The doctor does not have to review the whole file, just the part relevant to your claim.
- Your doctor must review everything in the C file and outside of it that relates to your claim and state he did so in the report. An opinion that states the doctor discussed the claim with the Veteran and nothing else will be rejected.
- Your doctor must use VA’s language—that the disability is ‘it is likely as not’ to service
- Rational: the doctor must state why he believes that they are connected
6. How do I know that VA got the evidence to prove my claim?
VA has a duty under the law to get the evidence needed to prove your claim. This duty includes getting medical records, service records, Social Security records and medical exams. But how do you know that VA did this? You need to request from VA your C file. This is the folder that the VA benefits section keeps on you. It will have all information about every claim you have filed since getting out of service. Most importantly, it will show you the evidence VA used in its decision on your case. You want to check this to make sure that all the favorable evidence you sent, or asked VA to get, is in the file. You don’t know what VA is using against you until you review your file
On Sept 10, the U.S. Department of Veterans Affairs (VA) exceeded its goal, three weeks ahead of schedule, to deliver 90,050 appeals decisions regarding disability benefits and services to Veterans in fiscal year 2019, approximately 9,000 more decisions than the previous year.
The Board of Veterans’ Appeals (Board) also hit a record, by providing more than 21,000 hearings in FY 2019, 5,000 more hearings that past year.
“The Board of Veterans’ Appeals provided thousands of Veterans with critical, life-changing appellate decisions,” said VA Secretary Robert Wilkie. “The Board surpassed its goal for delivering results to Veterans and their families for the second year in a row. This reflects VA’s continued commitment to providing excellent customer service to Veterans.VA is committed to reducing the backlog of legacy appeals and ensuring that Veterans receive the benefits they deserve.”
This achievement in surpassing last year’s number of decisions comes while VA concurrently implemented the Veterans Appeals Improvement and Modernization Act of 2017. The act offers Veterans choice and control over their appeals and provides for a more timely and transparent process.
To aid in achieving this historic goal, the Board focused on hiring attorneys and judges, reorganized its structure, instituted various training and implemented modern technology changes. Utilizing modern technologies is one way the Board continues to adapt to the changing needs of the Veteran population.
For more information about the Board and its progress on appeals modernization, visit www.bva.va.gov.
U.S. military Veterans who served after 9/11 are more likely than those who served before to say their deployment had a positive impact on their financial situation when they returned home.
That’s according to new findings from the Pew Research Center, which conducted a study of nearly 1,300 Veterans 18 and older to gauge their feelings about money.
The results: A whopping 68% of post-9/11 Veterans with combat experience said their service helped them financially, compared with just 30% of pre-9/11 combat Veterans.
That could be due to their ability to find work, the research suggested. While only one in four Veterans, overall, said they had a job lined up after discharge, about half of post-9/11 Veterans found a job less than six months after starting their search.
Regardless of when they started looking, 57 percent of post-9/11 Veterans said it took less than six months to find a job. Another 21 percent said they found employment within a year.
What’s more, 61 percent of post-9/11 Veterans said serving in the military helped them get their first job after leaving, including 35 percent who felt it helped “a lot.”
“What it means to be a military Veteran in the United States is being shaped by a new generation of service members,” according to the report. "About one in five Veterans today served on active duty after the 9/11 terrorist attacks in 2001, in which terrorists toppled the twin towers of the World Trade Center in New York and flew an airline into the Pentagon.
“Their collective experiences — from deployment to combat to the transition back to civilian life — are markedly different from those who served in previous eras," the report found.
The differences are not all good.
Veterans, overall, who’ve had traumatic or distressing experiences while in the military, and those who’ve experienced post-traumatic stress, were more likely than those who didn’t share such experiences to face financial difficulties after returning to civilian life.
For example, 61 percent of Veterans who experienced post-traumatic stress said they “had trouble paying bills in the first few years after they left the military,” Pew noted. That’s compared with 30 percent who haven't had post-traumatic stress.
And post-9/11 Veterans were more likely than pre-9/11 Veterans to say that readjusting was difficult. About half of post-9/11 Veterans say it was somewhat or very difficult to readjust, compared with one in five Veterans whose service ended before.
Post-9/11 Veterans were also more likely to have been deployed, seen combat or experienced emotional trauma, the data showed. Roughly three-quarters of post-9/11 Veterans were deployed at least once, compared with 58 percent of those who served before them.
What is sleep apnea? Sleep Apnea is a common, potentially serious sleep disorder in which a person’s breathing is repeatedly interrupted, or ceases, during the course of a night’s sleep. These sleep disturbances can occur from tens to hundreds of times per night. The causes of these disturbances may vary depending on which form of the condition you have: obstructive, central, or a mixed form of both.
Obstructive sleep apnea is one of the more common forms which occurs when the upper airway repeatedly becomes blocked throughout the night. This blockage is caused when the soft tissue in the back of the throat relaxes, impairing the airflow. Central sleep apnea occurs when the brain either does not send signals to the muscles that control breathing or those signals are interrupted. The VA refers to mixed sleep apnea is a combination of the obstructive and central forms of the condition.
How Does the VA Rate Sleep Apnea
Sleep apnea is rated under 38 CFR § 4.97, Diagnostic Code 6847. This diagnostic code falls under the Sleep Apnea Syndromes. The VA assigns the following ratings for Veterans based on the severity of their sleep apnea:
- 100 percent: chronic respiratory failure with carbon dioxide retention, the need for a tracheostomy or the enlargement or failure of the right side of the heart due to lung disease. This is the most severe and the highest rating available.
- 50 percent: the Veteran requires the use of a breathing device, such as a CPAP machine.
- 30 percent: the Veteran is experiencing hypersomnolence, or excessive daytime sleepiness, that does not improve with sufficient sleep or even with naps during the day.
- 0 percent: the Veteran’s condition does not produce any symptoms but has a documented sleep disorder. This rating is a non-compensable rating, however, a Veteran may be entitled to other benefits, such as VA health care.
Establishing Service Connection
In order to establish direct service connection for sleep apnea, a Veteran must show that they have a current, diagnosis of sleep apnea, an in-service event or illness/injury, and a medical nexus or link that shows the Veteran’s sleep apnea is related to their in-service event, injury/illness.
A Veteran can also establish service connection for sleep apnea on a secondary basis. This means that a Veteran has an already service-connected disability that caused the Veteran to have sleep apnea. In this case, there must be a medical nexus to link the sleep apnea to their already service-connected disability. Some conditions that can be secondary to sleep apnea may include but are not limited to heart conditions, mental health conditions, and diabetes. If you have a service-connected condition that you believe is causing your sleep apnea, it may be a good idea to start to talk to your doctors about it.
How Does the VA Diagnose Sleep Apnea?
The VA will usually order a sleep study to be performed in order to confirm a diagnosis of sleep apnea. As a part of the VA’s duty to assist Veterans in obtaining evidence to help prove their claim, the VA has a duty to assist Veterans in scheduling the examination for a sleep study. For Veterans who have already been diagnosed with sleep apnea without a sleep study by the VA, the Veteran may have to undergo a sleep study done by the VA in order to confirm the diagnosis for benefit purposes.
Denied for Benefits?
If you have a previous denial for sleep apnea, please give us a call to see how one of our experienced attorneys can help you! Get started here!