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    • My guess is that it would put me back at the beginning of the process but they've only had it 2 months. I have some new info that I think could really help since it seems the rules for sleep apnea have changed. 
    • I attached the the IME, "Ellis VA IMO redacted" to my post.  Im SC for tinnitus.   I have a current NOD in for a previous claim for sleep apnea secondary to psychotic mood disorder and PTSD. They denied everything without any C&P exams. Will my new FDC suffer because of the NOD already in the system? Looking forward to your thoughts on my IME
    • T-89031, if you have the (1) SC at 100% SC, all by itself, with no other SC's combined for the 60% for a Statutory SMC S (1), the only other way to get to the Housebound SMC is with a Physician's completion of the VA Housebound/aid & Attendance application form, it's not an automatic award. When you have a chance, review the 09/28/16 VAOIG Report that Buck referenced. The SMC S (1) over-payments as well as under-payments will make your head spin. See VBMS 11-0 issued 06/17/2016, VA Rating Staff Directive regarding, rater must consider all Claims where a single condition is rated as 100%, for Statutory SMC S (1). Semper Fi
    • Gastone........it is 30% sc allergy, 10% sc sinus......also had deviated septum surgery (1970) while on active duty and another again at Dallas VAMC in 2007.   The 10% on sinus is also on NOD claim for increase to 30%.. I had mild OSA in 2006 and blew it off as told I was overweight and told to lose weight before they would do anything else first........I did just that and elected to have lap band surgery and it dropped my weight by 50 pounds by 2007, and nothing else happened with Neurology so I figured all was good then and let the OSA slide...........but then wife noted that my non-breathing episodes were now increasing and longer in duration in 2015, so she convinced me to go have another sleep study done last November and this one it came up as moderate OSA, and I had not gained any weight back at all.  I have been on CPAP since December 2.  Since I am on CPAP now, I have filed a NOD for OSA based on sc aggravation due to allergies, sinus, and having deviated septum surgery. I was rejected on my first try because I was not on CPAP when I filed.  
    • I have also been told to bring my CPAP in every sleep visit I have. Yes they do use it to monitor your breathing issues and if you don't use it they do hold that against you to evaluate your condition getting worse. You have to understand that not using your CPAP will decrease your chances of a good nights rest but what about insomnia. Yes you do feel rested for the first hour or two but that only means if you are active. If not active and work at a desk then I'll give your rested feeling around 30 minutes top. My opinion is if your goal is to get good sleep use the CPAP, if your goal is not to feel sleepy throughout the day seek out a neurologist  for further diagnoses.   You know one of the presumptive issues is insomnia.





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Hoppy

Smitty's Gerd Claim

4 posts in this topic

I am still alive. I have been battling a major lower back problem for over five months. Sitting was difficult. The computer became an enemy. The symptoms have almost completely resolved, so I will try to get back to the board. Smitty called me yesterday and told me he won service connection for his GERD claim at the second go around at the BVA. He is mailing me the decision. He says it is 25 pages. 25 pages and two denials for a pretty obvious (to me) valid claim. Basically the claim was awarded without any significant new medical evidence. Basically what it took was being persistent and connecting the dots for the raters. The trick was explaining to them that the C&P reports used as evidence against the claim on the two previous denials was based on the failure to make a diagnosis of GERD by the C&P examiners that had no legal merit and that the only significant evidence was the continuity of symptoms and diagnoses clearly established in the VAMC treatment notes and a DBQ written by the primary care doctor. On the previous denials they Gave weight to two C&P that said there was no objective evidence of GERD. There actually were several reports based on scientific tests showing reflux. Additionally, I found BVA cases where subjective complaints of GERD were sufficient even in the absence of scientific evidence. Smitty’s symptoms started in the military and continued without any significant interruption or resolution. These facts were well established in the VAMC treatment notes.

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Thank you Hoppy for connecting the dots, in a way, a first grader could follow. Thank you for helping me. I will be sending the descision letter to you.

Without you, Hoppy, I would have been another disgruntled vet that the VA swept under the rug. Again sir, thank you!!



Thank you Hoppy for connecting the dots, in a way, a first grader could follow. Thank you for helping me. I will be sending the descision letter to you.

Without you, Hoppy, I would have been another disgruntled vet that the VA swept under the rug. Again sir, thank you!!

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Hoppy.. Glad to see you posting again. You give excellent advice.

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Well, according to the VA, I called yesterday to get an update, I was assigned a 0 percent rating. After 5 years of denials,BVA,AMC,BVA, and finally conceded by the BVA. I am happy it was SC, however, with the treatment records, multiple endoscopy reports, and the outstanding DBQ filled out by my PCP, I will get a 0 percent rating. I wrote my congressman, Jeff Miller< to have his office look into WTF. I have looked at the CFR to get an idea of how they should have rated it. If I understand correctly, there is no code for GERD. I understand that they rate it analgalously with Hiatal Hernia because the symptoms are so close. I was denied tha Hiatal Hernia claim by the BVA, but awarded GERD, and Gastric ulcer. Looks like this is going to be another 5 year battle. I want to also thank HOPPY, for all his help,experience and input into this claim. I dont feel I would have made it through the BS without him. Although this is a bit premature, as the guy at the VA said it was in the authoization phase, I feel LOW BALLED!

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