new claim, appeal or reconsideration

[oldtimer92]

OK Experts,

I am currently rated 30% under migraines for headaches NOS. Before i ever put in a claim, I was experiencing jumping of my left eye. I kept going to my family doctor and telling her about the issue and also at my year eye exams. Explained the issue with my optometrist. Kept being told it could be stress, eye strain, lack of sleep. As my headaches became more frequent due to the issue or thee issue made headaches that much worse and the jumping moved down the side of my face to my lips. Well this scared me so I made an appointment with an opthamology specialist, he ordered a cat scan. Diagnosed as hemificial spasms:

hemifacial spasm by definition

a disorder of the facial nerve characterized by unilateral involuntary paroxysmal contractions of the facial muscles,caused by high-frequency bursts of motor units lasting from a few msec to several seconds; reported causes include compression of the ipsilateral facial nerve near its exit from the 9pons by a vascular malformation, compression of theipsilateral facial nerve by a posterofossa neoplasm, and idiopathic derivations

 

Condition is the same as having convulsive tics or terret syndrome. I was told by the opthamologist that I could have a surgery or do botox injections. This would help with the tics and the headaches. So I choose to do botox every 4 months. First few rounds went great no issues, now all of a sudden I have muscle weakness and a droopy left eye. Given eye drops to help raise the eye lid. This of course is affecting my vision in my left eye.

 

I filed a claim with hemifacial spasms secondary to migraines, of course the claim was DENIED. VA says that this was not caused by headaches and I know it started when headaches increased and intensified. I was going to drop it and let it go, but now with these new issues and I am being told that they dont know if this will reverse it self or this will be my permanent look.

 

I have until December to file for an appeal. Do I submit a new claim or do  I file for muscle weakness, convulsive tics, droopy eye or all separate as secondary to migraines or secondary to botox that was treating the migraines?

 

Thanks in advance

 

[Gastone]

Never let a Denied Decision become FINAL, due to not filing a Timely NOD!

Never heard of your Claimed Condition, certainly can't help you there.

Appears to me, you definitely need a Neurological Specialist's Clinician Notes or actual IMO supporting a Secondary Nexus.

Filing a NOD, requesting a DRO Hearing, not a DRO Review, should give you ample time to get the N & M Evidence (Medical) that is needed to reverse at the DRO Hearing. Without the VA Mandatory Submission of N & M Evidence, your Denial will be continued, next stop, BVA.

Time appears to be on your side, your condition's not life threatening, right?

Semper Fi

[oldtimer88]

Thanks Gastone,

 

No I have never been told life threatening, limited vision is quite possible.

I think that is the issue with VA this condition has never been called this, in my research it seems to be rated under Blepharospasm is a condition where the eye twitches uncontrollably. It is rated under code 8103, convulsive tic.

Now the  VA doctor has requested a MRI be done and says in his notes the MRI is related to service connection condition, but VA keeps saying they are not related so maybe this will help as well. After this MRI, he is referring me to a Neurologist with VA. Appointment in December, I am going to submit NOD now. 

[Berta]

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp15/Files2/1511264.txt.

This was the only BVA case that seemed almost similar to yours.

They granted for tension headaches but not for them hemifacial muscular spasms.. but the veteran did not claim that as secondary to the headaches.

Still the decision does show some rating info for this condition.

You said:

"I have until December to file for an appeal. Do I submit a new claim or do  I file for muscle weakness, convulsive tics, droopy eye or all separate as secondary to migraines or secondary to botox that was treating the migraines?"

 

I would raise, if I were you, all of those ,to include the potential that the Botox treatment caused this , right in the NOD:

https://www.botoxchronicmigraine.com/important-safety-information

 

And I think the best thing you can do is definitely try to get an IMO from an opthamologist....BUT when is the MRI scheduled? It could help your claim.You might not even need an IMO.

Oddly enough I found that both migraines and this facial spasm problem are both being treated with Botox by the VA, :

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp08/Files2/0810331.txt

but still the Botox info link and this one says it can cause some eye problems as well:

http://www.rxlist.com/botox-side-effects-drug-center.htm

 

Definitely pursue this! And get a copy of the MRI results As soon as you can.

 

[Berta]

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp15/Files2/1511264.txt.

This was the only BVA case that seemed almost similar to yours.

They granted for tension headaches but not for them hemifacial muscular spasms.. but the veteran did not claim that as secondary to the headaches.

Still the decision does show some rating info for this condition.

You said:

"I have until December to file for an appeal. Do I submit a new claim or do  I file for muscle weakness, convulsive tics, droopy eye or all separate as secondary to migraines or secondary to botox that was treating the migraines?"

 

I would raise, if I were you, all of those ,to include the potential that the Botox treatment caused this , right in the NOD:

https://www.botoxchronicmigraine.com/important-safety-information

 

And I think the best thing you can do is definitely try to get an IMO from an opthamologist....BUT when is the MRI scheduled? It could help your claim.You might not even need an IMO.

Oddly enough I found that both migraines and this facial spasm problem are both being treated with Botox by the VA, :

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp08/Files2/0810331.txt

but still the Botox info link and this one says it can cause some eye problems as well:

http://www.rxlist.com/botox-side-effects-drug-center.htm

 

Definitely pursue this! And get a copy of the MRI results As soon as you can.

 

[broncovet]

Great advice from Berta, as ususal.  I would add:

Whether or not you file for a "reconsideration", file your nod within a year.  If you have new and material evidence, under 38cfr 3.156, it may help.

You posted, "  but VA keeps saying they are not related ".   

Dont expect any benefits when medical exams do not supply the required Caluza triangle of dignosis, in service event, and nexus.  

Based on what you posted, especially what I quoted,  you do not have the Caluza triangle, but filing a NOD will give you time to get it.  If your "regular" VA doc will not supply a nexus, then try another VA doc, or an IMO/IME.  

Absent any one or more of the Caluza triangle elements, you are setting yourself up for failure, until and unless you get all 3.  

Edited November 9, 2016 by broncovet

[oldtimer88]

Thanks Berta and Broncovet,

 

 

My VA scheduled MRI is December 19, 2016. That puts me outside the 1 year window to file a NOD. And yes, facial spasms/migraine botox injections being covered by VA Health Choice. But my claim for the spasms denied. But, the Health choice was just recently approved. So will that be considered new evidence or material?