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Sleep Apnea Disability Denial

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xman52

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:lol: I recently retired from the USA after 21 years. I was diagnosed with Servere Sleep Apnea (74 occurances an hour) four years ago and perscriped a CPAP. I have been using it religiously since. I was suprised to get my VA disability rating of 0% saying the Apnea was service connected, but because it didn't effect my ability to work a full time job, I was denied. I was shocked! Based on other friends I know, I was expecting 50%. What should I do now? intend to appeal, but don't know if I should contact the DAV for support. The majority of the issues I read about talk to proving the diagnosis and service connection. I have both documented. Can anyone help point me in the right direction? Thanks!
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:lol: I recently retired from the USA after 21 years. I was diagnosed with Servere Sleep Apnea (74 occurances an hour) four years ago and perscriped a CPAP. I have been using it religiously since. I was suprised to get my VA disability rating of 0% saying the Apnea was service connected, but because it didn't effect my ability to work a full time job, I was denied. I was shocked! Based on other friends I know, I was expecting 50%. What should I do now? intend to appeal, but don't know if I should contact the DAV for support. The majority of the issues I read about talk to proving the diagnosis and service connection. I have both documented. Can anyone help point me in the right direction? Thanks!

Because you're the guy who will bear the consequences if your Board of Veterans' Appeals (BVA) case fails, my strong advice to you is to research this thoroughly on your own BEFORE sitting down with a DAV or other service organization representative.

Read the VASRD requirements for sleep apnea and its various ratings.

Read the BVA decisions concerning

1. Award of service connection for sleep apnea, and

2. Award of the 50% rating you seek.

Know the standards like you know any of the important stuff from your MOS.

Why? You can't evaluate the performance of your "subordinate" (the rep) unless you know what he's supposed to know.

PM me if you want to go over stuff...I am a retired USAF paralegal. I can't give you legal advice, but I can give you some insights.

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Because you're the guy who will bear the consequences if your Board of Veterans' Appeals (BVA) case fails, my strong advice to you is to research this thoroughly on your own BEFORE sitting down with a DAV or other service organization representative.

Read the VASRD requirements for sleep apnea and its various ratings.

Read the BVA decisions concerning

1. Award of service connection for sleep apnea, and

2. Award of the 50% rating you seek.

Know the standards like you know any of the important stuff from your MOS.

Why? You can't evaluate the performance of your "subordinate" (the rep) unless you know what he's supposed to know.

PM me if you want to go over stuff...I am a retired USAF paralegal. I can't give you legal advice, but I can give you some insights.

NOD that TODAY retired AF also get 50% for sleep apena with CPAP machine

Jim

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xman what did the VA say in the decision letter. They should have stated why it was denied. That is the best place to start. Post it here the decision and why and others will come along and help, that has to be a big mistake.

stillhere

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xman52,

It sure sounds to me like you have a valid claim......here's some advice based on my experience finally getting 50% SC for SA.

Get "buddy letters" from co-workers and anyone else who witnessed your daytime sleepiness and night time snoring AND get a strong letter from your pulmonolgist concerning your current condition.

This dr. letter should reference the state of your condition (how long did it take to get this bad?). It should also specifically state the drs. opinion is based on his examination of you, your sleep study results, a careful review of your SMR, your statements about your symptoms since they began, and the official statements (buddy letters) of your co-workers, spouse, etc. If I understand correctly, you were diagnosed while on AD, so that should help...a lot!

My SMR was completely silent about any sleep issues whatsoever. I did have SC for GERD, since it was in the SMR. I was not diagnosed with SA until Dec 04, after retiring from the AF in Aug 03. So it was an uphill battle for me, but is achievable.....at least it was for my AMVETS VSO at St Pete RO.

We were denied SC for SA three times! We never appealed, only requesting "re-open my claim" with a new IMO letter and/or sleep study, and "reconsideration" at the local VARO. My pulmonologist wrote three IMO letters, each more specific and stronger than the last. He was not familiar with the VA process at all, and really got annoyed at my request for the third letter.....but he wrote it, and did it well.

After that third letter, My VSO was finally able to get the VARO review person to request a C&P exam at the St Pete VAMC. I went to that exam fully prepared to talk about my sleep apnea problems for the last decade. I even brought the CPAP! The examiner was quick, friendly, and to the point. It must have gone well, because less than two weeks later, my VSO calls with the good news.

I also included in my mailings to my VSO four printouts of BVA decisions that included approvals of SC for SA that had been denied the VARO level. All of them dealt with the fact that the vet had SA for years, but it was not diagnosed while on active duty, mostly because the AD docs didn't know what the hell it was, and vets don't either. I don't have document numbers of these decisions handy, but I'll look them up later and send them to you. Also, you can look them up here : BVA Decisions Try searching for "apnea is granted".

Last thing, I haven't received my latest decision in the mail yet. Once I do, I can read it to see what their reasoning was to grant approval. I'll let you know what I find out. Good Luck, and remember, every time one of us wins, it should make it easier for the next vet. So don't give up if you know you have a valid claim.

dwilli12

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:lol: I recently retired from the USA after 21 years. I was diagnosed with Servere Sleep Apnea (74 occurances an hour) four years ago and perscriped a CPAP. I have been using it religiously since. I was suprised to get my VA disability rating of 0% saying the Apnea was service connected, but because it didn't effect my ability to work a full time job, I was denied. I was shocked! Based on other friends I know, I was expecting 50%. What should I do now? intend to appeal, but don't know if I should contact the DAV for support. The majority of the issues I read about talk to proving the diagnosis and service connection. I have both documented. Can anyone help point me in the right direction? Thanks!

Ok just a couple or three questions:

1.First you state that it was SC'ed at 0 percent and service connected - they you state that it was denied. I understand that you are upset but you must provide the facts as provided in the rating decision. Was it service connected at zero percent or was it denied? Can you scan the appropriate portion (the reason and basis) of the rating decision so we can see what is going on?

2. You provided that you recently retired. When did you retire and how long was it before you were diagnosised and submitted the claim?

If the rating decision only provided you with a zero percent rating based upon the fact that you can still perform work then it is wrong for this type of disability. If you can post it then you will allow us to see the route they took to deny or improperly rate the claim which will allow us to assist you. Thanks

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xman what did the VA say in the decision letter. They should have stated why it was denied. That is the best place to start. Post it here the decision and why and others will come along and help, that has to be a big mistake.

stillhere

The decision said

" Service connection for sleep apnea has been established as directly related to military service.A noncompensable evaluation is assigned from September 1, 2007. A noncompensable evaluation is assigned for an asymptomatic condition. A higher evaluation of 30 percent is not warranted unless there is persistent day-time hypersomnolence.

The evidence of record indicates that you underwent a sleep study in service at Fort Leavenworth, Kansas in 2003. Diagnosis was sleep apnea. Current findings show that you use a CPAP machine. You have no problems with breathing and you have no signs of of hypersomnolence (need excessive amounts of sleep). The examiner states that your sleep apnea does not affect your occumaption or activities of daily living.

The evidence of record shows that you were initially diagnosed with sleep apnea in service, service connection is granted effective the date after your discharge from service.

This condition is rated at 0 percent disabling because evidence does not show any problems with breathing or any effect on your occupation or activities of daily living. A high evelauation of 30 percent of 30 percent would be warrented if persistent day-time hypersomnolence were shown"

The bottom line is I can's sleep without my CPAP. My problem is probally worse than when diagnosed with 74 instances an hour... What should I do?

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