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Nexus Letter

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pog

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Hi folks,

I asked my Dr for a nexus letter. He complied. So I thought. He made a note in my chart, that I have forwarded to my VSO.

In the section of my notes under "History of Present Illness" the Dr noted...

"Patient reports that OSA symptoms began while he was in active military service, while serving in the Army. He believes that his symptoms were present, but were at the time attributed to PTSD and depression. I HAVE REVIEWED SEVERAL SERVICE MEDICAL RECORDS THAT ALLUDE TO SLEEPINESS AND UNREFRESHING SLEEP AT THAT TIME."

Then in the assessment portion of my chart he wrote.

"I beleive it is as likely as not the pt had sleep apnea while he was in the Army."

My question is... Is this strong enough to link my Sleep Apnea to service for disability rating?

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What frustrates me is to have my question derailed - I get it. The statements might be verified. But given that they are credible what are the implications of the C and P examiners opinion? - I have yet to get an answer on that.

I think the CandP opinion helps me but I don't know why it did not include a reference to my doctors nexus letter (it was in the list of evidence considered).

pog,

I sure don't see where your question has been "derailed".

You have received several responses and keep in mind this is all on a voluntary basis.

In my opinion the VBA decision makers will take bits and pieces of the medical evidence

that supports whatever decision they have decided to make, whether it be a grant or

a denial.

People have posted the pros and cons to this claim issue as they see them.

The C&P examiners opinion as you posted below can go either way.

"It is at least as likely as not that the veterans current condition of obstructive sleep apnea existed during military service as evidenced by multiple buddy statements to support the presence of snoring, apnea and sleep disturbances during active duty, symptoms which are consistent with sleep apnea."

Yes, you say that the buddy statements are credible but only the decision maker

can assign credibility. Thats why I posted to you that they will probably need to check

out the buddy statements and this is done by additional development to ensure

these people were stationed with you during the specific timeframe.

This particular C&P examiners opinion of," It is at least as likely as not"

is based on your buddy statements,not medical evidence.

It's too bad that this C&P examiner didn't bother to mention your doctors nexus letter in her examination report.

Now the report from you doctor that states,

"Based on my review of his service medical records, I believe his sleep apnea today is more likely than not related to military service, as it was likely present and undiagnosed at that time."

In my opinion the decision maker could take the above statement into consideration

and use it for some merit in granting the claim.

OR

In my opinion the decision maker could take the above statement and say to themselves,

claim denied, this opinion is not supported with any medical rationale.

The Dr. has obviously reviewed the SMR's but has not pointed to anything contained in the SMR's that relates to SA.

Due to a lack of medical rationale, this DR's statement of

"as it was likely present and undiagnosed at that time" is nothing more than mere speculation.

The decision maker could go either way but if they consider ALL of the evidence

your claim might get granted due to the BOD regarding the additional medical evidence.

Is that clear enough ?

Also, as for an IMO from Dr. Bash, I do not think it would help you.

If I remember right his specialty is as a Radiologist.

carlie

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