Migraines Deferred...

[My Monster]

I'm rated at 20% for cervical DDD at C5-6-7. I had put in a claim for Migraines and Radiculopathy bilaterally at the same time. No mention of radiculopathy in the decision letter or SOC and the Migraines were deferred.

For the Radiculopathy Claim will the following help my case?

The Surgical Notes following my fusion state "POST OP DIAGNOSIS: Cervical radiculopathy with cervical degenerative joint and disc disease." It goes on stating levels C5-6-7. 3 months after the Fusion, the surgeon set me up for an EMG/NCS. The notes from that state "Radiculopathic process affection the left lower cervical spinal root levels (C8/T1). Evidence is consistent with pathology that demonstrates acute axonal denervation and is preganglionic in nature. I also sent in an EMG/NCS from last June stating the same results but bilaterally in both my arms and legs.

For the deferred Migraine Claim will this help move the claim along? I've read the rating criteria and I'm not sure where this would fall.

Neurologist Notes: Improved tremor with popranolol. Head aches not improved, migraines 3 per week. May awaken with headache. May or may no have neck ache first, sometimes head aches start from top down, in the crown. Postive nausea, feels tense, sensitive to noise and light. Experiences visual auras, sparkling white lights prior to onset of migraine. Sleeping somewhat better, but may have problems falling asleep. Sleep is interrupted, may have problems falling back asleep. Reports that migraines significantly worsened after his neck surgery Sept of 2010. When he has full migraine, he has to stop all of his activities, and lie down in a dark, quiet room. This significantly impacts his ability to interact with his family. Assesment: 1. Essential tremor, improved 2. Migraines, non-responsive 3. Sleep disturbances 4. Cerivogenic headaches which may lead into a migraine.

I still have quite a few NODs awaiting a DRO. Who knows when those will get looked at.

Any input would be appreciated!

Monster

[rpowell01]

My Monster, I got a question for you. You stated in your topic that you had radiculopathy in both legs and arms. Are these both from Cervical only? I thought it was something in my head about the legs. Does this sound familiar? Lately I have been getting a lot of pains in both of my legs from top to bottom. Even both feet has been having pains. Also it feels that I am standing on something that is vibrating back and forth really small and fast. I guess the vibration is the same feeling I have in my hands but I just cannot compare anything anymore. I am losing feeling all over different parts of my extremities now so anything is possible.

Thanks...

[My Monster]

Nope. The legs and feet for me are caused by my lower back, lots of arthritis there. Not much fun.

[rpowell01]

I understand about the arthritis in the lower back, probably not as bad as you though. Thanks for your information you provided and I hope you get your answer. I am guess my spinal cord is being pressed against up in my neck....

[Hoppy]

“Cerivogenic headaches which may lead into a migraine.”

The above statement from the doctor tells the story. There are different types of

headaches. Migraines can be different and unrelated to Cervicogenic.

“Cervicogenic headache is a syndrome characterized by chronic hemicranial pain that

is referred to the head from either bony structures or soft tissues of the neck.”

http://www.jaoa.org/cgi/content/full/105/4_suppl/16S

It would not surprise me if the raters say there is no evidence you suffered from migraines while on active duty. If they deny the headache claim, the next step would be to get more medical evidence.

The doctor did try to show the migraines as secondary to the cervicogenic headaches. However, the use of the word “may” is not be strong enough. If it were me I would seek an opinion that it is “more likely than not” that the migraines are being caused by a progression directly related to the cervicogenic headaches.

If it were me I would keep a daily log of symptoms. I would show how many of the migraines are preceded by neck pain or a cervicogenic headache.

If the ridiculopathy is ratable, which I suspect it would be, then you definately need to appeal this part of the decision. Check the rating schedule and get the doctor to use the same language that is in the rating schedule. RO raters are pros a playing dumb. DRO's have much more experience and will seek answers when doctors suggest that things are more severe than the current rating.

[My Monster]

Thanks Hoppy!

The Neurologist cracked me up. He took a jab at Neurosurgeons, saying yup they "fix" your neck but send you to us when they can't figure out why you are still having pain. LOL

You're right there is nothing in my SMR about headaches, I never associated them with my neck. I always thought it was sinuses, dehydration or tension headaches.

The VA made no mention what so ever about the radiculopathy claim despite several surgeon notes stating it. Maybe I need to resend those reports with the radiculopathy part highlighted for them?

[Hoppy]

It took 3 years of my complaining about headaches, dizziness and light sensitivity before I was diagnosed. I was in a VA rehabilitation medicine clinic telling the doctor about my symptoms when she starts going off on me for not having a neurologist tracking my condition. I told her they sent me to neurology 3 years ago and they did a lot of tests on my brain which were all negative. Then she asks me if they did an MRI on my neck. I said, NO. Now she really gets pissed and tells me the symptom pattern I described was classic for a herniated disc and cervicogenetic headaches. She was pissed at the neurologist for not performing an MRI on my neck. She calls her assistant into the room and tells her to go up to neurology with me and demand an MRI on my neck. She told the assistant “don’t let them talk you out of getting the MRI. Neurology was the only clinic allowed to schedule MRI’s.

There are doctors who do not want to make diagnoses and they work for HMO’s. The VA works just like an HMO. They do not like to spend money on tests and make diagnoses that require even more treatment. On the other hand my brother was treated for the same type of neck problem by a private insurance plan and the only way the doctors make money is to make diagnoses and schedule more tests with their golf buddy doctors. He complained of a little neck pain and had MRI’s in a month.