Subtle Changes in Seizure Analysis in VA Narcolepsy Cases

I am beginning to see a pattern in which VA rating analysts are trying to raise the bar regarding the type of activity that qualifies as the equivalent of a petit mal seizure to warrant increasing a rating for either narcolepsy or idiopathic hypersomnia.  Until recently, any momentary loss of focus seemed to meet the criteria; however, I have reviewed several recent rating decisions in which the veteran was denied an increase or was informed of a proposed decrease because the language contained within the medical records submitted did not specifically analogize this activity to petit mal seizures.  This subtle change means that your providers will have to include explicit language in their reports and treatment notes that draws a parallel between your symptom and petit mal seizures. Anything less may soon prove to be unacceptable.  I will update this post as more information regarding this practice becomes available.