ptsd Va Comp Increase Questions?

[USMC_HVEQ]

I'm wondering if I should file for an increase in some of my disabilities.

PTSD Increase 50% ---> 70%???? My PTSD, has not gotten better. I've felt awful. I've been avoiding treatment, have been in/out for a few years consistently. I was granted a DRO review last year, think december/january. I originally was low balled at 10% PTSD and asked for DRO review by de novo process and they said if we grant you 50% will you drop your appeal? I said yes, becuase i wasnt working and needed the money. I felt I've met the criteria for 70%. My pysch doctor, has my case red flag because of suicidal idealation. I've gotten in fights, have road rage (this is what i'm talking about unproved anger). I've lost friends, don't have hardly any. I've lost gfs, cuz I snap over small things. I'm like what the heck did I flip out for. Things seem to irritate me, super fast. I have had panic attacks everyday, sometimes multiple days for 4 yrs now. I keep missing appts to set up pyschiatrist appts so I can get some meds to help this. I have been on Setraline(zoloft, ithink) on/off when I can remeber to take it, when I had it. I've been super depressed the entire time as well. I have put on tons of weight as well over the 4 yrs my case has been going on from origination til now (maybe 150+ lbs) and now I'm obsese. It makes me sick to even say that. I have an up coming PCP appt (Dec 7) and will make appts for more cousneling. I want to go back to group therapy as well for returning OIF/OEF vets.

I have been out of treament for a while (less then 1 yr). Do they order a new C&P, I assume? what other stuff/visits do I need to obtain?

I have other issues as well, I want to get addressed.

• Shoulders-Bilaterally I'm SC at 20% each and given a 40% total bilateral factor rating for instability with guarding of movements. I have hill sachs deformities (glenohumeral heads) of both shoulders, bankart lesion and torn labrum, and arthritis in both shoulders as well. I was looking at the criteria. How do I get an increase? Do you file for arthritis, which would be another 10% each shoulder or 10% total if granted? wondering what does marked deformity mean for humeral head? (i can understand if someone said moderate deformotiy but what is a marked deformity?), Where does hill sachs deformity fall under? My shoulders are in pain all the time, back side of shoulders mainly.
  
  
  
  
  • Sleep Apnea-I think I may have it. I've been told I snore extremely loud (mouth open). I wake up every night. SOmetimes for brief periods others are long, such as tonight. I think with gaining all this weight and all. At my PCP appt, I am going to request a sleep study. What do you tie it too for SC if It is proven to have it at sleep study? Background medical condition I have ptsd, HTN (sc), tinnitus, Shoulder probelms.
    

  What should I file for in letter to VARO?

  I appreciate any help/advice given here on hadit.

  thank you all in advance.......

[USMC_HVEQ]

i have a primary care appoint scheduled for Dec 7th. I will be making my primary care physican aware of all my disabilities. I will ask for a sleep study. Any idea how long it takes to get one? How many nights is it? Then if Sleep APnea is found, must i get my primary care doc to right up a letter or do I need somethign else. I am connected from PTSD, Bilateral SHoulder Subluxation, HTN, and Tinnitus. Which of these is the most successful to have as a secondary to? I personally think it is because all the weight I gain by being depressed, gained over 150 lbs.

Im not sure, but wait and see I guess.

[Vync]

i have a primary care appoint scheduled for Dec 7th. I will be making my primary care physican aware of all my disabilities. I will ask for a sleep study. Any idea how long it takes to get one? How many nights is it? Then if Sleep APnea is found, must i get my primary care doc to right up a letter or do I need somethign else. I am connected from PTSD, Bilateral SHoulder Subluxation, HTN, and Tinnitus. Which of these is the most successful to have as a secondary to? I personally think it is because all the weight I gain by being depressed, gained over 150 lbs.

Im not sure, but wait and see I guess.

I don't know if they do these on a set schedule, but last week I requested mine and received a questionnaire in the mail on Saturday. They send you to a sleep apnea educational meeting prior to the actual study. Mine is scheduled for next week. I really have no idea what to expect, but will be leaving my pillow at home.

Others here might be able to offer their opinions. I am hoping to have my condition diagnosed as secondary to allergic rhinitis/TMJ. It sounds wierd, but I can't really breathe through my nose very well, even with all the meds the VA gives me. Also, the VA made me a giant bulletproof night guard to help keep me from grinding my teeth at night. Even though I can breathe through my mouth, that thing gets in the way too.

I am not sure which way to have yours diagnosed as secondary, but check this out. If they got it approved, then hopefully you can too. It looked like the Veteran who had PTSD also was overweight and they granted the claim on benefit of the doubt. Also note that this case is a bit old.

http://www4.va.gov/vetapp01/files01/0102100.txt

Citation Nr: 0102100

Decision Date: 01/25/01 Archive Date: 01/31/01

DOCKET NO. 99-22 315 ) DATE

)

)

On appeal from the

Department of Veterans Affairs Regional Office in St. Louis,

Missouri

THE ISSUE

Entitlement to service connection for sleep apnea as

secondary to service-connected post-traumatic stress disorder

(PTSD).

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Richard A. Cohn, Associate Counsel

INTRODUCTION

The veteran served on active duty from April 1970 to December

1971.

This matter comes before the Board of Veterans' Appeals

(Board) on appeal from an August 1999 rating decision of the

Department of Veterans Affairs (VA) Regional Office in St.

Louis, Missouri (RO) which denied service connection for

sleep apnea as secondary to service-connected PTSD.

FINDINGS OF FACT

1. The record includes all evidence necessary for the

equitable disposition of this appeal.

2. There is competent medical evidence linking current sleep

apnea to the veteran's service-connected PTSD.

CONCLUSION OF LAW

The veteran's sleep apnea was aggravated by his service-

connected PTSD. Veterans Claims Assistance Act of 2000, Pub.

L. No. 106-475, 114 Stat. 2096 (2000); 38 U.S.C.A. § 5107,

38 C.F.R. § 3.310(a) (2000).

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The veteran attributes sleep apnea to his service-connected

PTSD. The veteran does not contend that he incurred or

aggravated sleep apnea during service and there is no

evidence of sleep apnea or other sleep disorder in the

veteran's service medical records SMRs.

Procedurally, this appeal is developed fully and ready for

Board adjudication. The RO has verified the veteran's period

of service; there is no issue as to the substantial

completeness of the veteran's application for VA benefits;

the veteran has undergone VA examination pursuant to the

application; the RO has requested and associated with the

claims file all available service and postservice medical

records pertinent to this appeal; VA is unaware of other

unrequested records pertinent to this appeal, and; the

evidence is sufficient to permit the Board to proceed with

appellate review. See Veterans Claims Assistance Act of

2000, Pub. L. No. 106-475, 114 Stat. 2096, (2000).

A veteran may be entitled to service connection for a

disability under either a direct or secondary analysis.

Direct service connection is warranted for disability

resulting from disease or injury incurred or aggravated in

service. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. §

3.303 (2000). Secondary service connection is warranted both

for a disability caused by a service-connected disorder and

for a disability aggravated by a service-connected disorder.

38 C.F.R. § 3.310(a) (2000). In the latter case,

compensation is limited to the extent to which the service-

connected disorder increased the severity of the secondary

disorder. Allen v. Brown, 7 Vet. App. 439, 448 (1995); Jones

(Wayne) v. Brown, 7 Vet. App. 134, 136-37 (1994). A service-

connected secondary disorder becomes part of the original

disorder. 38 C.F.R. § 3.310(a).

The veteran is a decorated former Army combat soldier whose

PTSD has been service-connected since July 1995. SMRs

include no evidence of a sleep disorder in service and the

veteran claims none.

VA medical records confirm that the veteran underwent sleep

studies in February and October 1998 from which he was

diagnosed with sleep apnea. A VA psychiatric progress note

from February 1999 briefly reviewed the studies' findings and

applicable research and concluded that PTSD and its treatment

"in all probability has aggravated the obstructive sleep

apnea." The note further states that "it is certainly as

likely as not that this veteran's sleep apnea is directly

related to his PTSD." The VA physician who examined the

veteran in July 1999 identified two likely causes of his

sleep apnea: enlarged tonsillar tissue and obesity. The

physician found no etiological connection between PTSD and

enlarged tonsillar tissue. However, he acknowledged that

"an argument could be made" linking the veteran's obesity

with PTSD although the veteran's medical records did not

include another medical opinion to that effect.

In the Board's judgment the record presents adequate evidence

upon which to base a finding that the veteran's PTSD

aggravated his sleep apnea. The opinion expressed in the

February 1999 progress note is neither ambiguous nor

equivocal on that point. The July 1999 examination report is

more tentative -- finding only a medical possibility of

attenuated causality under a different rationale.

Nevertheless, the July 1999 opinion does not refute the

February 1999 opinion, and it is well established that VA

itself may not refute expert medical conclusions in the

record with its own unsubstantiated medical conclusions.

Colvin v. Derwinski, 1 Vet. App. 171, 175. (1991).

Therefore, absent medical evidence actually denying a causal

linkage between PTSD and sleep apnea in this case, the Board

reads the two opinions together as providing, at minimum,

evidentiary equipoise which must be resolved in the veteran's

favor. See 38 U.S.C.A. § 5107(;). Accordingly, the Board is

constrained to find that service connection for sleep apnea

is warranted here under a secondary analysis. See 38 C.F.R.

§ 3.310.

ORDER

Service connection for sleep apnea is granted secondary to

service-connected PTSD.

WARREN W. RICE, JR.

Member, Board of Veterans' Appeals

[USMC_HVEQ]

thank you very much. I serioulsy think the obesity, which is from the PTSD, has caused this sleep apnea. I guess it is a wait and see and see the results. Thanks for the heads up about information first.

[Berta]

Could any of the meds caused you to gain weight?

I take a HBP med that has weight gain as side affect,.I went from 120 to 135 in a year.

[USMC_HVEQ]

there is always a possibility, but I've often failed to take the meds, so I would say no, but I'm not a doctor. I'm prescribed Sertraline (for ptsd) and Lisinopril/HCL (for HTN). I'm going to the doctor on Dec 7, so I will be asking for more meds. I'm out of everything. I see this process is going to be tough. Should I be putting in for sleep apnea before the tests to preserve EED?

[12R3G]

Yes

Either file the claim, or send a letter--you can even use IRIS--stating your intention to file a claim. The informal claim established the ED as long as you file the formal claim within one year.

Sertraline can cause weight gain

Edited December 2, 2009 by 12R3G