Form 2507 wording for aggravation of nonservice-connected disabilities

[ballistics-guy]

I have service connected COPD, and I have OSA (not considered service connected). 

I know of lots of information that shows that the combination of the two is much worse than either alone. 

First question:  what does the rating official need to ask for in the Form 2507 for the C&P doctor to write an opinion on whether my OSA is exacerbated by my COPD. 

Next: am I reading 38 USC 3.3.10(b) correctly to mean even if my sleep apnea is not service connected, if it's aggravated by something that is service connected, it's service connected.

[sphynix06]

I am in a similar situation. I have service connected asthma and was denied secondary connection for OSA.

I few week ago I called the C&P examiner directly and asked him if he would reconsider his opinion because his report stated that asthma and sleep apnea are in no way related. I shared with him several articles which stated otherwise and also shared several BVA cases which granted sleep apnea as secondary to asthma (both directly and from aggravation). He told me that no one in the fort worth office has ever granted service connection for sleep apnea as secondary to asthma, but that I should refile and request service connection for asthma aggravating the sleep apnea. He stated that he would think about amending his notes to opine that my sleep apnea is at least as likely as not aggravated by my service connected asthma.

Well, today I looked at my notes on myHeathevet and noticed he amended the OSA DBQ to reflect the following:

02/18/2017 ADDENDUM                      STATUS: COMPLETED

With regard to the Veteran's OSA and potential aggravation from his asthma condition, I have reviewed the medical literature articles that the Veteran has kindly sent to me along with his medical history and problems and now I offer the following comments:

Whereas there is no current documented clinical evidence supporting direct causation of OSA by asthma, it is medically plausible to opine that asthmatic exacerbations with wheezing and shortness of breath at night can aggravate OSA by causing ineffective utilization of the CPAP apparatus due to the asthma attack because of inability to relax airways from the asthma.

Thus it is as least as likely as not that the Veteran's current OSA is clinically aggravated by his asthma.

Recent PFTs performed in Dallas on 1/26/2017 revealed inconsistent results, due to the fact that the Veteran could not produce enough airway pressure with hi s respirations for a satisfactory flow loop on the recording machine.
Results were as follows:
                

Pre % Predicted        Post % Predicted
FVC                 59                       63
FEV1               63                       64
FEV1/FVC       79                       75
DLCO              73

Thus, while the results were inconsistent, they do show a significant drop in both FVC and FEV1, which indicates to me that the asthma is currently symptomatic.

So, I am going to discuss with my VSO whether this is new and material evidence to submit a new claim or whether I should ask for reconsideration since the examiner changed his opinion on the initial exam.

[Buck52]

Good for you sphynix06 Not that many Dr's or examiners will do that.

re  submit it as evidence if I was you.

this should get you approved/S.C. for OSA

Way to go Buddy.

[john999]

Does anyone think Dr. Bash would or could write an IMO to connect OSA as secondary to DMII and CAD?  I know that my OSA is aggravating my SC CAD since if I stop breathing at night this sends my BP up and puts a strain on my heart.   So if OSA aggravates my CAD to the point my heart stops beating what is cause of death?