Monomelic Amyotrophy

[DonH]

ALS Variant?

 

I'm a Vet Wife. I post on behalf of my husband, I'm his note taker at doctor's appointments and consults.  I'm his support system and all around cheerleader. Lord knows we have had our VA battles. All these years after Vietnam, the onset of my husband's emerging illnesses, obviously percolating internally has emerged  one after another. We've seen subtle signs and some not so subtle. But didn't; know what those sign meant. The VA didn't do a very good job of educating the older veterans about what to be aware of regarding SC disabilities,

My veteran husband's a Purple Heart Vietnam Veteran  served in US Marine Corps. My husband  has several service connected disabilities. My husband diagnosed with Monomelic Amyotrophy recently; it is a Motor neuron (MND) disease that is the umbrella covering all type Motor neuron diseases and variants. To which ALS/ Amyotrophic Lateral Sclerosis and variants falling under the same umbrella as being classified as Motor Neuron Disease (MND). As exhibited in cases of muscle loss: Monomelic Atrophy.

ALS causes degeneration of nerve cells in the brain and spinal cord that leads to muscle weakness, muscle atrophy, and spontaneous muscle activity. The VA Doctors pondered whether my husband had ALS or MS. Yet, the Neuromuscular Head Physician conceded that my husband's illnesses was an ALS variant because his illness fell under the umbrella of Motor Neuron Diseases as did ALS......is a Motor Neuron disease. ???? We don't know how VA will decide.

Other complicating issues:

*Spinal issue (S Curve of spine)

*Multi focal motor neuropathy associate with Diabetes 2 is a part of the mix/entwined as well. 

 

However, most severely is the inability of identifying the exact reason for the monomelic atrophy.

Although it was hoped a more exact finding will be determined when all results of updated blood tests were in.

On May 2017: *Blood test are in; determination that no immune diseases are present

Possible treatment of an intravenous treatment once every three months or medications with steroids would be beneficial. No effective treatment available.

 

MMA

Diagnosis. 

Inflammatory Arthritis is Part of the neuropathy (Special kind of neuropathy)

As well as severe spine problems. Very rare complicated illnesses intersecting and exacerbating primary and/or secondary with veteran's service connected disabilities.

 

Monomeric atrophy......Veteran has lost the use of his right hand and right forearm weakened and wasting away.

One limb atrophy

See notes…..described as one limb muscle atrophy

 

Spinal cord (S curve of spinal cord) compression on top on addition the monomeric

 

Toxic agent like Agent Orange could more likely than not" a contributor for neuropathy.

 

Immune diseases (no)

 

Deterioration. Of bones on vertebra

Spondylosis...inflammatory arthritis 

Acts like spinal cord injury 

 

(Findings of EMG) EMG to confirm the diagnosis ( Neuromuscular VA Physician at Michael E. DeBakey VA Medical Center, Houston, Texas)

Table of Rated Disabilities
Disability	Rating	Decision	Related To
Peripheral Neuropathy, Left Lower Extremity		Not Service Connected	Denied as…. early as 2011… Yet, D to pinpoint as severe symptomatic complexities of Monomelic Amyotrophy variant of ALS in 2017….should be cued.
Peripheral Neuropathy, Right Lower Extremity		Not Service Connected	Denied as…. early as 2011…  Yet, ID to pinpoint as severe symptomatic complexities of Monomelic Amyotrophy variant of ALS in 2017….should be cued Agent Orange - Vietnam
Neuropathy, Left Upper Extremity		Not Service Connected	Denied as…. early as 2011…  Yet, ID to pinpoint as severe symptomatic complexities of Monomelic Amyotrophy variant of ALS in 2017….should be cued
Bilateral Hearing Loss (claimed as diminished hearing)	0%	Service Connected
Tinnitus (claimed as ringing in both ears)	10%	Service Connected
headaches		Not Service Connected
depression		Not Service Connected
skeletal arthritis aching of the joints (unspecified)		Not Service Connected	Arthritis denied as…. early as 2015…  Yet, ID to pinpoint as being symptomatic complexity of Monomelic Amyotrophy variant of ALS in 2017….should be cued
post traumatic stress disorder (PTSD, also claimed as depression and anxiety)	30%	Service Connected	PTSD - Combat
Hypertension	0%	Service Connected
Neuropathy, Right Upper Extremity		Rectal carcinoma claimed as rectal cancer, a soft tissue cancer)   Not Service Connected Agent Orange - Vietnam Still on since  12/11/14 appeal Remand 5/15 scar, shrapnel right knee 10% Service Connected   09/18/2013 diabetes mellitus type II 10% Service Connected Agent Orange - Vietnam 07/06/2015 prostate cancer 100% Service Connected Agent Orange - Vietnam 07/06/2015 erectile dysfunction 0% Service Connected   07/06/2015	Neuropathy, Right Upper Extremity Denied as…. early as 2011…  Yet.ID to pinpoint as severe symptomatic complexities of MonomelicAmyotrophy variant of ALS in 2017….should be cued Agent Orange – Vietnam

Edited June 26, 2017 by DonH
adding more details

[Berta]

This link holds  the PTSD rating schedule:

 

[DonH]

"Has the letter from the doctor ever been prepared and sent to the VA?"

 Yes, Dr. Williams submitted letter.

"It seems to me that the July 2015 award letter should have taken note of the "helpless child" claim".  No, the July 2015 did not mention our son. Actually when my husband had some earlier encounters with the  VA in mid to late 1990's regarding his PTSD, our son was referenced way back then.

No action to address the claim was taken by the VA. That's why it was apart of the Appeal. To that effect, why do you think (your insight) the July 2015 letter should have made note of the claim about our son?

[Berta]

Yes.

As I interpret the May 2015 remand, and then what was posted here regarding the VARO 2015 award letter,

I felt this is still an open issue and for some reason the VARO failed to address it.

But the BVA caught the error.

A good tip on Remands....whenever the BVA remands a claim for something...that is the time to make sure VA has the "something"...or gets it.

The BVA remand says the son is on SSI-telling VA to get those records.

But this is something you could do yourself, as I believe SSI would have to release them to his father.

I have seen many remands asking for SSA or SSI records, Voc Rehab records, and other pertinent evidence, which the RO failed to obtain, even after years had passed. 

 

 

[DonH]

Thanks for great insight!

[DonH]

My husband was eventually rated from from 30% PTSD to 50% PTSD, effective December 18, 2018....actually....it should have been retroactive to 2006. And, he was granted  individual unemployability as of December 18, 2018; actually though, this was due retroactive to 2011. Our Representative is extremely methodically planning to address at a later date...hopefully soon. 

Regarding Monomelic Amyotrophy, VA Physician doesn't think it falls exactly squarely under ALS. Just remaining in a watchful state. Dr. still admits it falls under ALS variant.  

Remand still failed to Address my husband's first cancer Rectal Cancer as being presumptive to AO (Also referred to as Colorectal Cancer).  Still unresolved.

Edited April 9, 2021 by DonH

[Berta]

If you want us to assess the decision, please scan and attach it here- to include  the evidence list- 

cover the C file #, name ,address prior to scanning it.

When did he file the claim?

"Our Representative is extremely methodically planning to address at a later date...hopefully soon. "

I hope so too.

 

"Regarding Monomelic Amyotrophy, VA Physician doesn't think it falls exactly squarely under ALS. Just remaining in a watchful state. Dr. still admits it falls under ALS variant.  "

Did the VA deny this claim, and did you submit a formal IMO/IME with it?

"Remand still failed to  Address my husband's first cancer Rectal Cancer as being presumptive to AO (Also referred to as Colorectal Cancer).  Still unresolved."

That too would need a strong Independent medical opinion.