Secondary Service Connection

[Fat]

My gym buddy was recently service connected for Sinusitis at 10%.

He was diagnosed with Sleep Apnea back in 2008.

The sleep apnea is not service connected.

He now wants to get the Sleep Apnea service connected secondarily to the Sinusitis. 

Can he get the Sleep Apnea secondarily connected even though it was diagnosed before the Sinusitis.

 

ALL COMMENTS ARE WELCOMED...........

[Fat]

VYNC, I jus reread you comments and now I'm following your train of thought.

(Paraphrasing) If the doctor says the service connected Sinusitis condition caused/contributed to Sleep Apnea, then he also needs to state the primary issue of sinusitis originated back to the members active duty years of 2003-2007. 

The aforementioned secondary issue of sleep apnea was diagnosed in 2008 after the patients active duty commitment.

[Vync]

1 hour ago, Fat said:

VYNC, I jus reread you comments and now I'm following your train of thought.

(Paraphrasing) If the doctor says the service connected Sinusitis condition caused/contributed to Sleep Apnea, then he also needs to state the primary issue of sinusitis originated back to the members active duty years of 2003-2007. 

The aforementioned secondary issue of sleep apnea was diagnosed in 2008 after the patients active duty commitment.

Hey Fat,
You're on the right track!

Also think about it like this. AskNod explained situations like this in a bit of a better way when he was describing Hepatitis C. Back when was infected with it in Vietnam, nobody had a clue it existed. Until it was formally identified, he was not officially diagnosed -- but he definitely had the symptoms.

Along the same lines, it only makes sense to show some sort of continuity of symptomatology going back to when SA was diagnosed. Even without a formal diagnosis of "sinusitis", if the symptoms and/or treatment happened, that gives the doctor the ability to state in their opinion that this has been going on for along time, point to specific dates or date ranges of treatment, and then tie them together.

Going back through STRs and other medical records since service may help to build the paper trail over time. Look for anything related to sinus and/or respiratory treatment, be it subjective of objective. Look for things like runny nose, rhinitis, sinusitis, upper respiratory, nasal drainage/drip, crusting, headaches. Because sinusitis rating criteria includes many of those symptoms, it helps to look for the symptoms which match the criteria.

Gastone's chicken and the egg argument is important because of medical rationale. If the doc just opined sinusitis as secondary to SA, the VA might request a C&P exam and deny if the examiner included medical rationale. However, if the doc provided meaningful medical rationale, the VA still might request a C&P, but then relative equipoise would likely tip the scales in favor of the veteran. Remember, chance favors the prepared mind. Don't leave everything up to the VA.

[Andyman73]

Hmmm, I have a handful of those types of STR entries, and one for pneumonia.  

See, it is possible to learn something by osmosis.