Nasal Bone Fracture Service Connected Could The

[mountain tyme]

I just need some insight into this claim...

This service veteran retired after 21 years of service...

in 1989 during desert shield he sustained a fractured nose...in his VA paperwork that was done at the time of his discharge...(yellow paper)

it states

"Service connection is warranted for a fracture of the nasal bone and a less than 10 percent evaluation is in order"

also...the same paper work states

"Service connection for muscle tension headaches"

Service medical records show initial complaints of headaches as early as 1983 at which time migraine was diagnosed. Subsequent service medical records show diagnosis of tension headaches or muscle tension headaches and this was the diagnosis at the time of the VA exam. A diagnosis of migraine headaches was not given, however. The veteran stated that these have been present for 15 years and are located in the posterior occipital area. They occur approximately every 10-12 days and last about 4-8 hours. However, they are not accompanied by nausea or vomiting and there is no vision change. Service connection is afforded as the headaches were chromic in service, However, as migraines were not involved a 10% percent or higher evaluation is not in order. (Which could be assigned with characteristic prostrating attacks averaging one in two months over the last several months).

Ok with the above said....this veteran applied for an increase for headaches...in 2006 and he received there dicison on Oct 19, 2007...

it stated " evaluation of muscle tension headaches, which is currently 0 pecent disabling, is continued.

The VA states...

"VA exam shows you reported that you have two to three headaches per week that are not prostrating. Your motor and sensory exams were normal.

The evalution of muscle tension headaches is continued as 0 percent disabling because the evidence fails to show this condion has worsened to a compensable level. A noncompensable evaluation is asigned unless there are characteristic prostrating attacks averaging one in two months over the last several months."

this veteran has been treated for headaches since he retired in 94...in Feb 2007 he was seen at the Family practice clinic on base (air force base he has tricare)

and the diagonis...was

1. Migraine headache: maprosys 500 mg bid for 2 weeks then PRN. Imitrex not aborting migraines so will switch to Maxalt consider prophylactic medicine.

Rizatriptan (Maxalt) PO 20 MG TAb PO@onset of HA

Napoxen (Naprosyn) PO 500 MG tab-1T TB PO BID WF

_________________________________________________________

This veteran and his wife told me that he works rotating shifts...and due to this he had and has been laid up in bed for two or three days at a time but ironically when he has these migrain attacks they seem to fall on his days off..or they begin at the end of a shift and by the time he arrives home it is a full blown migrain...that is why the doctor put him on the above medication...to help prevent the migrains from coming on or controling the serverity.

when I went through his medical records for the last year...he had gone to the doctor about once every 8 weeks for the migrains...and the appointments were in the middle of the week..(his days off).

so that is where we stand now...

I told him he should do a NOD...or perhaps a reconsideration...and have his wife write a statement that due to the serverity of the headaches that he was in bed for 2-3 days...and he had called in sick...I told him that he will need to get something from his employer as to days he called in...it won't say why because his employer does not require a doctor note unless they do not have any sick time left...

how would he go about putting in for a reconsideration or a NOD...the veteran states he told the C/P doctor at the VA that he did miss work...but on his C/P it does not state that...or is it marked occording...

any advice would sure help...or any help on how to write a NOD on this situlation...

also could a fractured nose cause sleep apena? and the fact during his enlistment he was on rotating shifts??

thanks in Advance

MT

[Rockhound]

Quick not: I am not saying to lie. But I would refraise my wording about when most of his migraines would come to him after work and on his days off.

I would say something like my mirgraines would come on after a hard day at work, and at times at the end of a siminly long week, I would then spend my time away from work suffering from and recouperating from the migraine. Had it been a work a work day I would have been force to miss work and spend more time having a physician document these episodes for the benefit of my employer. As it is, with the medication I am currently on I am able to mitigate the number of times these migraine episodes interfere with my employment. Even though I am able to be home for the most part and able to treat my migraines, I still must spend these times in bed at rest, since I am unable to do anything else during these times.

Something like that. Don't point out that they only happen after work, it should make it sound that they come on during or at the end of a work day or week.

Rockhound :)

[mountain tyme]

Rockhound wrote: "Quick not: I am not saying to lie. But I would refraise my wording about when most of his migraines would come to him after work and on his days off."

Dear Rockhound: I can say in all certainty that this vet is very honorable..and I have known his wife for many many years...I do know that most of the onset of his migrains are in the afternoon...not sure why...and they come on quite sudden...by all accounts his military service records indicate that he has gone from the work place right to the emergency to seek treatment and they would give him a shot to relieve the pain...at home he needs to be in a dark room and he becomes nausated as well.

He has called in sick a few times and his wife had to go pick him up from work because he could not drive home...

with that said...since only God has control as to when the onset comes he has no control...and if they happen on his day off all he has to support that statement is his family (wife) and notes from his doctor that he went in.

Since he is on medication for the migrains there really isn't much he can do except to ride it out...

since he keep a log on his migrains and headaches it would be hard to reframe from saying on his days off ect...because they happen to occure mostly when he is off...as I stated earlier he works 3 days on 4 days off...

but I see your point...it would look to someone who is of a sucpious nature that how convient that it only happens when he is not at work...I will print off this tread and let them look at it...

He is going to go to the base family clinic tomorrow and request any records he had after feb 07 since they prescribed him a new medication for migrains...

the good news is that the medication does help he is only experiancing the average of 3 onset of migrains per month compared to 4-6 per month...he still has headaches but the medication is doing it's job and it does not develp into a full blown occurance...

thank you for your insight...it helps to see differnt points of views...I sometimes forget to take off my rose color glasses...*grinning...

life is a never ending lesson is it not.

MT