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    • Don't take the Claim Ltr to mean more than what it asks, you left info out that needs to be completed. As to your Dr's SISOC, marginal at best. No indication that he actually reviewed your 2002 SMR DX of SA. SC SA DX'd needing Cpap or Bipap is rated at 50%, even if you don't use the Machine, which would not be wise. If you also have a DX requiring supplemental 02 while sleeping due to P02's dropping below 90%, that does support a possible Chronic Resp Failure claim. Check out the 38 CFR 4, SA Rating for 100%. You'll notice that there are 3 or 4 DX "OR'S" listed, any (1) of which could get you a bump to SA 100%. That worked for me, this past 12/15. It took a VA Quality Review of a 07/15 increase Denial Decision, but the Sr Rater agreed with my position regarding my SA Request for an increase to 100%. Every thing regarding my 02 use and meeting another (2) of the 100% requirement was in my VMC records. The original Rater just didn't understand the significance of the "OR's" and the 02 Use. Got 100% Retro'd back to 01/14 with SMC S (1). Semper Fi  
    • Send her a black rose with a small card that says "Paid for by my VA Benefits" and then ignore her.   Unless you get information that she is trying to cause you a problem, you probably dont need a lawyer.  If she is calling up SS and the VA and all the other points of contact about your disability, then you might think about it if she is lying.  This would be defamation of your character if she is telling stories about you that are not true, in an attempt to cause you harm.  Then you would want a lawyer.    
    • Your worst enemy can't hate you like an X. How long has she been your X? I'd take her off your Christmas Card List. Semper Fi
    • Your Scheduler 100% SC for PTSD, not a combined Rating, right? NO IU Rating involved? Any mention in your Award Letter regarding a possible Fiduciary Appointment? I know you mentioned your $6K Retro Deposit, it's just that a 100% PTSD Vet, who may or may-not be homeless and may or may-not have RX or other Dependency issues, is usually a prime candidate for a VA Fiduciary Appointment. Semper Fi
    • At this stage of your PTSD Rating Decision, kind of the "11th Hour" so to speak, just try to relax. The VA PTSD Rating Decision won't move any faster or slower based on anything you could do at this point. You have a PTSD DX, it all comes down to the Raters Determination regarding your MST Supporting Evidence, it will either be Compelling or not. Keep in mind, the VA "Benefit of Doubt Doctrine." If for some reason, the Rater determines that your MST "Marker Evidence." doesn't quite Seal the Deal and the evidence for and against an SC rating is determined to be in "Equipoise," you get the Jump Ball and the SC is Awarded. At least in Theory. The only thing you can and probably should do, practice the Anxiety/Stress relieving exercises that you learned in Group Therapy. Get together with someone from your Group, it really does help to talk face to face. Semper Fi





ken1939

Spine - Secondary Condition - Headache

7 posts in this topic

Can anyone quote the exact reference in VA regulations where "characteristic prostrating attacks" is defined? I thought I had seen it somewhere in the forums but can't find it now. I have found many references to it but never a real definition. The best I could ever come up with is that a "characteristic prostrating attack" is a "characteristic prostrating attack". And I have read a lot of interpretations as to what that means but not the official VA definition. I sent an IRIS asking this question but haven't gotten an answer. Thank you. Ken1939

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There is no VA definition of "characteristic prostrating attacks," per se. It is a common medical definition that is specific to each parent condition that creates the prostrating symptoms. A prostrating attack is one that completely incapacitates the sufferer for a period of time. The word "characteristic" comes into play in regards to the parent condition suffered. In the case of headaches, this term would mean a headache so severe as to totally incapacitate the sufferer for a large part of the day due to common (re. characteristic) symptoms such as severe pain, vision problems, and nausea or vomiting. Imagine the migraine sufferer displayed on medical shows who is in such severe pain that he has to have the lights off, no noise, is banging his head on the floor, and puking all over the place. That would constitute a (severe) characteristic prostrating attack.

I'm not sure if that is what you were looking for, or if you were looking for a definite piece of VA literature that can prove that headaches is a secondary condition of cervical spine disorders. If that is the case, then the following from the 2002 VA Training Letter on IVDS should work:

a. Cervical IVDS

Pain

• Neck pain

• Pain radiating down the arm (brachialgia). The pain may be sharp, burning, stinging, or stabbing in the arm, elbow, wrist or fingers, depending on the disc site. It is the upper extremity equivalent of sciatica in the lower extremity.

• May be referred pain in the upper middle of the back.

Sensory abnormality - May be numbness, burning, or weakness in the arm and hand.

Motor abnormality - If there is pressure on the spinal cord, there may be weakness in the legs, shock-like pain down the spine, numbness, or poor coordination.

Other - Headache is common. Cervical problems tend to be less debilitating than lumbar problems.

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There is no VA definition of "characteristic prostrating attacks," per se. It is a common medical definition that is specific to each parent condition that creates the prostrating symptoms. A prostrating attack is one that completely incapacitates the sufferer for a period of time. The word "characteristic" comes into play in regards to the parent condition suffered. In the case of headaches, this term would mean a headache so severe as to totally incapacitate the sufferer for a large part of the day due to common (re. characteristic) symptoms such as severe pain, vision problems, and nausea or vomiting. Imagine the migraine sufferer displayed on medical shows who is in such severe pain that he has to have the lights off, no noise, is banging his head on the floor, and puking all over the place. That would constitute a (severe) characteristic prostrating attack.

I'm not sure if that is what you were looking for, or if you were looking for a definite piece of VA literature that can prove that headaches is a secondary condition of cervical spine disorders. If that is the case, then the following from the 2002 VA Training Letter on IVDS should work:

RG,

is that quote you listed stating that lumbar conditions are more debilitating for headaches than the cervical spine?

Edited by MRRRR5

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the quote means that generally lumbar IVDS is more debilitating that cervical IVDS. I'm not sure where they pulled that gem out from.

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Thank you rentalguy1,

I am interested in VA literature to prove headaches as a secondary condition. My current 10% SC for the neck is for "degenerative disease of the cervical spine". I guess I could assume that Intervertebral Disc Syndrome (IVDS) is the same thing but I have learned not to assume anything. I am also SC for a secondary condition, "headaches associated with degenerative disease cervical spine". The VA examiner diagnosis was actualy "Muscle Contraction Headaches". My rating is 0% because of no "characteristic prostrating attacks" averaging 1 every 2 months over the last several months.

I intend to appeal this but I need to know exactly what it is that I am appealing. I deal with headaches almost daily but about once every 2 to 3 weeks I have to lie down until the headache goes away.

I have an appointment with a private neurologist on 1/29/09 and hopefully I can suggest the right wording for his report that the VA will accept. I know prostrating attack is important but I'm not sure it is in the doctor's vocabulary. I have searched medical dictionaries and other medical journals and have yet to find a reference to that phrase. The only place it shows up is on VA web sites and there is never a definition or a reference to VA regs. Your definition is as good as I've seen but I never get that wiped out.

Thanks again, I really appreciate your input.

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This, so far is the best I've found on characteristic prostrating attacks.

It is from a BVA decision.

Hope this helps a vet.

carlie

http://www.va.gov/vetapp94/files1/9404239.txt

The medical evidence and the veteran's own testimony do not depict

characteristic prostrating attacks, as contemplated by Code 8100,

where the affected person is truly incapacitated for a substantial

period of time and must lie down and rest until headaches abate.

Rather, the evidence shows low-grade headaches that are readily

relieved and which have no major impact on the veteran's ability to

work. The aggregate impairment from these headaches does not exceed

that which would be found in a migraine condition with characteristic

prostrating attacks averaging one in two months over the last several

months (i.e., the 10 percent criteria of Code 8100). Thus, an

increase in the current 10 percent rating must be denied.

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