Can someone tell me what "prostrating" regarding migrains means in laymans terms? in VA Disability Claims (General) Forum

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Can someone tell me what "prostrating" regarding migrains means in laymans terms?

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chevjerico

Can someone tell me what "prostrating" regarding migrains means in laymans terms?

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Posts: 38

Mar 3 12 9:46 PM

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I serched the internet, but couldn't find a simple definition.

Thanks guys!

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brewha44

#1

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Posts: 996

Mar 3 12 9:53 PM

I was just approved for prostrating migraines. It means to lie down in a dark room face down. Nobody i know lays facedown in a dark room. I just told the Neurologist that i could not function with a Migraine and had to lay in a dark room for several hours to recover. He wrote prostrating several times on the exam report. If you can continue working with the onset of a Migraine they will not think it is prostrating.

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ecxpa

#2

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Posts: 897

Mar 3 12 10:06 PM

It in essence means severe to the point of disabling. People with prostrating migraines cannot function.

How am I today? Too early to tell and too late to make a difference........and who cares anyway.

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maparker

#3

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Posts: 2192

Mar 3 12 10:13 PM

If prostrating (used in the 10% and 30% rating criteria) means cannot function, then what does completely prostrating mean as it is used in the 50% rating criteria?

These terms have not been defined by the VA and that drives the problem.

Go to the BVA site and research migraine cases to see if their any cases that one can draw a conclusion from.

Mike

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brewha44

#4

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Posts: 996

Mar 3 12 10:23 PM

I think the 50 % means several incapacatating migraines a month that interfere with your work and social life.

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cruiser

#5

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Posts: 17618

Mar 3 12 11:48 PM

When a VA regulation does not specifically define a word, the Board of Veterans Appeals or the Court of Appeals for Veterans Claims will generally defer to the standard dictionary definition of the word. There is no such definition specified for prostrate. The predominant dictionary definition is that it is the act of lying in a prone face down position. There is no requirement that it be in a dark room.

Having said that, very few VA decision makers at the local level or the BVA for that matter tend to define it this rigidly; however, that doesn't mean that they would be wrong if they did. I can't ever recall asking a veteran or a C&P examiner if the headaches required the person to lie face down nor do I ever recall this description being used by either a doctor or veteran, but I assigned quite a few 50 percent evaluations for migraine over the years.

Cruiser

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brewha44

#6

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Posts: 996

Mar 4 12 12:23 AM

I probably did interject the dark room part since that is what i do!

By Mayo Clinic staff
A migraine headache can cause intense throbbing or pulsing in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can cause significant pain for hours to days and be so severe that all you can think about is finding a dark, quiet place to lie down.

Edited 3 times by brewha44 Mar 4 12 1:28 AM.

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chevjerico

#7

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Posts: 38

Mar 4 12 8:17 AM

Thanks guys! That explains it very well. Even I can understand...lol

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jpapa

#8

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Posts: 1976

Mar 4 12 9:10 AM

brewha44 wrote:
I probably did interject the dark room part since that is what i do!

By Mayo Clinic staff
A migraine headache can cause intense throbbing or pulsing in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can cause significant pain for hours to days and be so severe that all you can think about is finding a dark, quiet place to lie down.

Drs wrote this in my progress notes...(cut & paste)

... @chevjerico have they prescribed you w/ good stuff?...I wouldn't wish this "prostrating migraines" to anyone, its evil....

Honor Bound To Defend Freedom!

Retired USN
70% PTSD/ 90% SC,
100% TDIU
SSDI

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maparker

#9

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Posts: 2192

Mar 4 12 9:36 AM

The lack of universally defined terms does drive variance into the process.

I get that completely prostrating needs to lead to economic indaptability for a 50% rating. But if one was suffering from a prostrating migraine and another was suffering from a completely prostrating migraine, how would their symptomology, manifestations, intensity differ? As I migraine sufferer, I have always felt puking your guts out so hard you expect your shoes to come up through your mouth is completely prostrating, at least in the short term.

If it is in the eyes of the rater, then that will drive differing ratings results across the board. Maybe someday the VA will get their raters on the same page on this issue.

Mike

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dittybopper

What exactly is "economic inadaptability"?

#10

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Posts: 901

Mar 4 12 10:03 AM

Does it mean that you loose work time due to completely prostrating heacahces and therefore loose salary? If that is the case, what about a retiree who has already worked 40+ years of his life and has created/achieved his/her own economic adaptaility?

I have any where from 3 to 5 prostrating headaches a month. Am I completely "laying down? You bet, but I'm ALWAYS laying on the oposite side of the throbing lobe.

I am currently SC'd but at zero percent due to an incorrect statement made by a PA during a C&P. That statement has been corrected by the PA that did my C&P after an NOD. The world will continue to revolve and I will continue to pay taxes and this to shall come to pass.

Good luck to all you "prostraters"!

DB

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dittybopper

How often is "frequent"?

#11

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Posts: 901

Mar 4 12 4:44 PM

maparker wrote:
The lack of universally defined terms does drive variance into the process.

I get that completely prostrating needs to lead to economic indaptability for a 50% rating. But if one was suffering from a prostrating migraine and another was suffering from a completely prostrating migraine, how would their symptomology, manifestations, intensity differ? As I migraine sufferer, I have always felt puking your guts out so hard you expect your shoes to come up through your mouth is completely prostrating, at least in the short term.

If it is in the eyes of the rater, then that will drive differing ratings results across the board. Maybe someday the VA will get their raters on the same page on this issue.

Mike

8100 Migraine:

With very frequent completely prostrating and prolonged attacks

productive of severe economic inadaptability 50

With characteristic prostrating attacks occurring on an average once

a month over last several months................................................ 30

With characteristic prostrating attacks averaging one in 2 months over

last several months 10

Since they assign an average number for the 10% and 30% ratings, what number does "frequent" equate to? Is frequent anything higher than the one per month average described in the 30% rating? That leaves a lot of room for disparity also.

DB
DB

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brewha44

#12

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Posts: 996

Mar 4 12 7:13 PM

I would think 3 to 5 should qualify for 50 % if you cannot fuction afterward.

I received 30% for 2 a month.

Between the Meneires and the Migraines i rupture the capillaries in my face from throwing up.

The Neurologist said the Meneires and Migraines may be one animal with two faces!

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dittybopper

Ruptured capillaries..........

#13

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Posts: 901

Mar 4 12 7:31 PM

brewha44 wrote:
I would think 3 to 5 should qualify for 50 % if you cannot fuction afterward.

I received 30% for 2 a month.

Between the Meneires and the Migraines i rupture the capillaries in my face from throwing up.

The Neurologist said the Meneires and Migraines may be one animal with two faces!

I've done that on more than one occasion myself from migraine un-swallowing. Have little red specs all over my face and even in my eyes. I have dry heaved several times so hard and so long that I passed out. Something about a gag reflex that you just can't "pinch off"!

When I get a sure nuff bad one I can't keep water down. So every rescue pill I take usually comes back out so fast the M&M is still printed on the side!

What did your C&P exam say to get you the "2" ? My request for increase was for 2-3/month, but C&P notes stated 1-3/month. That averages to 2/month. 2-3 per month would average 2.5/month. Wonder what is the magic "frequency". Wish one of the raters would tell us.

Just last Friday I switched over from Relpax to Maxalt as a rescue drug. Anyone here have any experience with this drug?

thanks in advance.

DB

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brewha44

#14

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Posts: 996

Mar 4 12 8:42 PM

Ditty,

I have approximately 8 vertigo attacks a month usually 4 seizure like without the vomiting. Then approximately 4 with the vomiting. Then of the 4 usually 2 of them i get the true migraine with Aura. This is why the Neurologist says i may have Vestibular Migraines and Meneires both. I think 3 to 5 migraines should be considered frequent. just my opinion. Dealing with the 4 severe vertigo attacks and migraines a month is living hell. I know you truly experience migraine attacks by your description .The passing out is vasoconstriction in your throat. The same thing BUSH passed out from on National Television.

Edited 1 time by brewha44 Mar 5 12 1:07 AM.

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OldSoldier

#15

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Posts: 29

Mar 5 12 12:46 AM

chevjerico,

prostrating is defined as, debilitating in nature, or to prevent normal function.

It may help you to go to the BVA website http://www.va.gov/landing_bva.htm and select search decisions. In the search box type "prostrating". This will allow you to review cases utilizing the word prostrating and give you an idea as to how VA interprets and otherwise uses the word prostrating.

Jim

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cruiser

#16

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Posts: 17618

Mar 5 12 10:27 AM

OldSoldier wrote:
It may help you to go to the BVA website http://www.va.gov/landing_bva.htm and select search decisions. In the search box type "prostrating". This will allow you to review cases utilizing the word prostrating and give you an idea as to how VA interprets and otherwise uses the word prostrating.

While your suggestion is certainly a good one, I don't think that you are going to find any concensus there as to how "VA interprets" the word prostrating. A BVA decision is nothing more than one person's opinion and is not binding on the next person. It's the same with decision makers at the Regional Offices. You must also remember that BVA is divided into different regions, each with it's own little organizational structure and in areas where there is a lot of subjectivity, it's not uncommon for each region to lean this way or that way in a slightly different manner than the other regions.

In other words, in an area like this it isn't always easy to predict the outcome of one case by looking at some others at BVA, and you definitely cannot predict the outcome at the Regional Office level by looking at BVA cases since BVA tends to sometimes do it's own thing in a way that the Rating Specialists and DROs at a Regional Office simply cannot do.

But again, BVA decisions are interesting to read and I highly recommend that one do so for general information and guidance.

Cruiser

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maparker

#17

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Posts: 2192

Mar 5 12 10:35 AM

In my NOD for a 0% migraine rating, I included a BVA decision where the circumstances were similar to mine and resulted in a 30% rating. I don't know if it helped or not but I did get the 30% rating. I also asked the RO in my NOD to provide the definitions of prostrating and completely prostrating but they did not answer these questions.

Mike

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Survivir

#18

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Posts: 10351

Mar 5 12 11:20 AM

maparker wrote:
In my NOD for a 0% migraine rating, I included a BVA decision where the circumstances were similar to mine and resulted in a 30% rating. I don't know if it helped or not but I did get the 30% rating. I also asked the RO in my NOD to provide the definitions of prostrating and completely prostrating but they did not answer these questions.

Mike

It was probably easier for the rater to grant you the 30% rating.

Than to explain what Prostrating and Completely Prostrating is/are. Shrug