ptsd C&P Sleep Apnea (trying to get it right)**Urgent**

[Leon2015]

Fellow Veterans,

Please point me in the right direction if possible. I have respiratory/Sleep Apnea claim back to 2007. In 2012 in response to my appeal the VA sent my C&P appt to my previous address and I never made to the appt, so they made a decision with out my C&P exam and I was denied. I appealed this all the way to CAVC and won a remand back to AMC. Well almost 10 years later I'm finally getting my C&P for Sleep Apnea. During this long awaiting period I gained 60% GERD and 70% Major Depression/PTSD and I able to use this as additional evidence. My main question is should I fight with the ammunition (Sleep Study, CPAP, Nexus for Insomnia already acknowledged by VA, Basic Letter from Sleep Doctor) in my file and wait to see what the C&P results are or should add in a IMO from a accredited doctor prior the decision or fight with the IMO letter after the results? I need input ASAP, my C&P is tomorrow. Thanks guys

 

[broncovet]

Did you go to the CAVC Pro Se?  If you did, then you probably have a great grasp of VA law.  If you had an attorney, then you should first ask him these questions as he knows more about this than you. 

In ANY C and P exam, you should do some simple preperation.  Focus on the big 3:

1.  Current diagnosis of sleep apnea

2.  In service event or aggravation OR secondary condition where your sleep apnea was caused by a service connected condition. 

3.  Nexus or link between one and 2 above. 

If you lack any of these 3, then you will likely need an IMO/IME, yes.    Read your C and p exam, and look for the term, "at least as likely as not", since you probably have a sleep apnea diagnosis, especially if you use a CPAP machine.  (they dont hand those out without a sleep apnea diagnosis)  

Number 2 is not applicable if you are seeking sleep apnea secondary to an already service connected condition.  That is, you already have your "in service event" with the primary condition, so you dont need to duplicate that with a secondary condition.  

You said the Nexus was a given by VA..so you should NOT need an IMO/IME, but you should consider posting your nexus to make sure its in a form VA will accept.  

VA will want a "reasons and bases" as to why the doctor opines that your sleep apnea is at least as likely as not due to military service.  

Edited March 21, 2017 by broncovet

[Leon2015]

BroncoVet....thanks for you input. I'm onboard with everything you wrote!

*The VA basically gave me a nexus for insomnia (written language in my appeal) but not for Sleep Apnea which is what my claim is for.

My claim is for Sleep Apnea secondary to GERD and MDD/PTSD.

I don't have my Comp and Pen results yet so I was trying to decide whether to submit an IMO with my claim prior to approval/disapproval or after as a appeal. I basically want to win at this stage with out doing an another appeal. It has already been 10 years since my original claim. I'm trying to win now!

Edited March 21, 2017 by Leon2015

[Buck52]

Its very hard to get S.C  for Sleep Apnea  now days  because the VA is tighten up the rope....here lately.

with no in service validation 

you can't get secondary to PTSD to S.C. Sleep Apnea ...But you can get it related too Sleep Apnea  from the medications you take for PTSD 

A Qualified Dr will need to give his opinion '' it is least likely as not'' this veteran Sleep Apnea or OSA is Related to his VA Prescribe Medications (list them)

[broncovet]

Yes, getting sleep apnea SC'd at the RO level is difficult.  You will likely need to appeal.  If you meet the criteria, above, that is, the Caluza triangle of current diagnosis, in service event or aggravation, and nexus, then you should be able to get service connected even tho the RO is reluctant to grant SC for OSA.  

[ArNG11]

I agree with Broncos advice, it is sound.  The local stinky Regional Office won't approve SA at the regional level even with an IMO sometimes.  Mine went that way. Even in appeal and with a nexus the local office said no way, but the real deal in my case will be at the BVA. I can't wait either.  I'm angry and mad and can't wait to educate the VA on regulations and evidence they so conveniently dismissed.  

Not being too ornery, but I am going to cut down the bogus c&p exam I was given. Just have to wait for my turn in the hot seat. Just remember to have all the 3 bullets for service connection.

in-service symptoms of the disease or illness

treatment records mentioning the symptoms and or treatment

and a doctors medical opinion tying the two together using medical rationale.  Extremely important!

JMO