Read Disability Claims Articles
View All Forums | Chats and Other Events | Donate | Blogs | New Users | Search | Rules
- 0
Help With Sleep Apnea Denial
Rate this question
Read Disability Claims Articles
View All Forums | Chats and Other Events | Donate | Blogs | New Users | Search | Rules
Rate this question
Question
Joep
Hello all; this is my first post. I’ve learned a lot in this forum yet realize I have so much more to learn.
More confused and disappointed about misinformation than anything else but I got a heads up from the DAV that the VA denied 8 of my claims. I didn’t get the official VA package yet, only a heads-up letter from the DAV who is in the loop on my claims. One of the big items they disapproved was my sleep apnea. I had very bad gout/arthritis issues just as I was about to start my terminal leave. During that time, a tumor was found and removed from my right foot. These issues delayed the start of my terminal leave and resulted in me having to sell back 60 days of leave.
Retired 1 Sep 08; Referral from primary care provider: 19 Nov; Initial sleep study consult 29 Dec; Sleep study Feb 09; follow-up with doctor Mar 09.
I suspected sleep apnea for quite some time but wit everything else going on, that had to wait. I wasn’t worried because I was repeatedly told that anything I claim within one year of my retirement will be treated just like I was on active duty. I was told this by at least 3 VA reps visiting my local base while on active duty. So, a month after my retirement, I scheduled an appointment with the base hospital that just started a sleep lab. It took a month to see the doctor and two months to have the study done.
About a month after the study, I had my follow-up and the doctor; now at my six month point since retirement, and he told me I had the worst case of sleep apnea he has ever seen and that I must have had it for years. I asked him to put what he just said into my medical records but he only put “severe sleep apnea”. He ordered the machine and I used a rental during that time all through my cost share and Tricare.
Under the guidance that this was within my first year since retirement I was shocked that they out right denied my claim for sleep apnea. I contacted the DAV and tried what some people on this forum have done/tried and attempted to get the decision over-turned now, before the review process is done and the VA sends the package but the DAV said I must wait as the decision was already made. The DAV said I didn’t show enough of the sleep apnea being service connected; that I had the issue while on active duty. Again, I am still confused because 3 VA reps told me anything the first year was as if I was still on active duty! Yes, confused and stressed!
I made another appointment with the same doctor and will ask him to put what he said into my medical records or something to the fact that in his opinion, my condition isn’t something that typically is so severe that just occurred since retirement. I also understand that I can/should get letters from co-workers supporting symptoms observed while around them. Once I receive the VA package, I will then submit this information to the VA for appeal.
Am I missing anything that I should also do? How long is a typical appeal process? If over turned, do they start compensation as of the date I initially filed, date of appeal, or approved date?
To be honest, my quality of life after starting using the CPAP machine more than tripled so I am in a win/win situation already. I fell asleep on the highway more than once driving home from work since retirement and the reason I didn’t have this issue while on active duty is I lived on base, only 5 minutes from work. Now I’m 40 minutes from work by highway and was dosing off frequently.
For years, I would frequently wake up with a violent jerking reaction, often waking/scaring my wife. I had no idea this was or could be related to sleep apnea at the time. This is already documented in the sleep study medical records since retirement but I guess carried little weight in the decision making.
Any advice is most welcome.
Thanks all;
Joe
Link to comment
Share on other sites
Top Posters For This Question
1
1
1
Popular Days
Aug 28
1
Sep 19
1
Sep 23
1
Top Posters For This Question
12R3G 1 post
Joep 1 post
ppeter 1 post
Popular Days
Aug 28 2009
1 post
Sep 19 2009
1 post
Sep 23 2009
1 post
2 answers to this question
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now