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Spine - Secondary Condition - Headache


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#1 ken1939

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Posted 13 January 2009 - 08:47 AM

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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#2 rentalguy1

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Posted 13 January 2009 - 10:33 AM

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.



#3 MRRRR5

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Posted 13 January 2009 - 07:15 PM

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, 13 January 2009 - 07:15 PM.


#4 rentalguy1

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Posted 13 January 2009 - 07:18 PM

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

#5 ken1939

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Posted 14 January 2009 - 10:24 AM

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.

#6 carlie

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Posted 14 January 2009 - 11:32 AM

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/ve...es1/9404239.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.

#7 ken1939

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Posted 15 January 2009 - 08:34 AM

Thanks Carlie,
It helps. The more I look at decisions and opinions the better prepared I am to come up with my own definition that fits my circumstances. Once I decide what needs to be said I will have to convince the doctor to cooperate and use the VA terminology. By the way, I got an answer from IRIS where my question was what is the definition of a "characteristic prostrating attack" and where is this definition referenced in the regs. The answer was to refer me to the rating table which tells me nothing. It tells me how to rate it if I have it but it doesn't tell me what it is. In other words, a "characteristic prostrating attack" is a "characteristic prostrating attack." Just take our word for it. Ken




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