If the Com & Pen doesn't give you enough to work with to suggest the severity of the symptoms, have the veteran complete a Statement in Support of Claim (VA Form 21-4138) that says:
I have reviewed the previous Comp & Pen exam dated
[date of Comp & Pen Exam], and the[doc/nurse/clown]failed to document all of my symptoms. I have enclosed a headache log indicating the frequency and severity of the symptoms, which have remained consistent since I filed this claim.
<aside> <img src="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/3f95d6aa-e910-4ff6-bc23-c39b53f24bfe/Siren.png" alt="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/3f95d6aa-e910-4ff6-bc23-c39b53f24bfe/Siren.png" width="40px" /> TRACKING THE VETERAN’S SYMPTOMS
Ask veteran to track his symptoms using:
or by downloading the migrainebuddy.app (QR Code below)
The migrainebuddy app allows you to track your symptoms and export a report directly to your OSDRI representative to submit as evidence of your symptoms!
@Kailey - need to create a .pdf for “Evidence Plan for Migraines”
</aside>
If you STILL lose on Supplemental, appeal in HLR and copy and paste the following legal argument:
*Prostrating, as used in 38 CFR 4.124a, DC 8100, means “causing extreme exhaustion, powerlessness, debilitation or incapacitation with substantial inability to engage in ordinary activities.” Headaches are rated under DC 8100, and a 50% rating is granted when the headaches are completely prostrating and productive of severe economic inadaptability. The M21-1 defines severe economic inadaptability as denoting: “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.” M21-1.V.iii.12.A.3.e. “Completely prostrating” as used in DC 8100 means “extreme exhaustion or powerlessness with essentially total inability to engage in ordinary activities.” M21-1.V.iii.12.A.3.c.
The VA should not rely entirely on the Disability Benefits Questionnaire, and whether the medical provider checked the “completely prostrating” block in Question 4B. Rather, “A claimant’s own testimony regarding symptoms and limitations when having those symptoms can establish prostration as long as the testimony is credible and symptoms are otherwise competently attributed to migraine headaches through medical evidence.” M21-1.V.iii.12.A.3.d.*
Go get 'em.