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Denied Mixed Sleep Apnea Claim

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Draw808

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Currently have moderate Mixed Sleep Apnea (Central and Obstructive).Got denied for Service connection for Sleep apnea. Submitted NOD requesting DRO and added 5 buddy letters (included a statement from an E-7) who witnessed my apnea episodes while I was in service between 2012-2013. Also included two in-service complaints of trouble staying asleep and snoring (just in case VA never received them). Just wondering what do you think of my odds are at service connecting and any suggestion as well is much appreciated.

TIMELINE:

Military Service between Dec 2009 to Dec 2013.

sleep complaint - Jul2012

sleep complaint - Aug2013

Separated Dec2013

Filed VA claim for sleep apnea Feb 2014

Diagnosed by VA with Mixed Sleep Apnea - May 2015 (couldn't afford a couple thousand dollar sleep study myself so I couldnt get it diagnosed earlier)

Denied Service connection Sep 2015

Filed NOD requesting DRO Sep2015

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When were you Discharged? If you have medical evidence or SA or MSA in any of your post Discharge Private or VA Medical records, that could be a very Big Deal for your appeal.

I'd have to defer to Post Nam Vets, as far as DX's or symptoms appearing after the Nam 1 Yr after Discharge SC connection. You indicate your MSA DX took place during the 13th month after discharge, right.

When and what prompted the DX? Think, Paper Trail Medical Evidence.

Semper Fi

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I was discharged in december 2013. I had complained to my doctors but you already know how military doctors are they told me to take over the counter sleep medicine. After I got discharged i got situated and filed a my disability claims I knew for a fact I had insomnia but i also looked up my other symptoms and sleep apnea kept popping up so I filed for that as well. Unable to afford a sleep study i had to wait a year after i filed my claim for the VA to conduct it.

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Draw808,

Let me tell you...this will be one of the hardest rows to hoe!  I am currently trying to claw my way through my own SA claim.  I have an upcoming sleep study, for re-evaluating my SA. I thank God that I have private insurance.  My sleep specialist said she is willing to write the Nexus letter, but not sure if she can really make the link.  So I am just working for the "at least as likely as not" statement.

Ask is correct, my own VA MH dr gave me the scoop on how he can write only what he is allowed, and what he can't. Fortunately he wrote me up for neuro exam, and he said once those results are back(any day now) he will write his opinion on that, combined with what he already knows.

Gastone is spot on as well. 

Sleep apnea is the next big thing in the VA today, like Gulf War illness and Agent Orange of the decades past.  Be glad you're getting in now, before it becomes a true nightmare.

Semper Fi

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Good feed back on SA. I am getting tested for insomnia and don't know why. I have OSA and getting VA treatment but it's not SC. I was told the VA will start charging your civilian health insurance and you co-pays if your not SC for the illness. Has anyone heard of that happening?

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Sleep apnea is an upper airway obstruction which disrupt normal sleep patterns.

No doubt you probably have SA and it was present during active duty.

However the catch is it was reported as a sleeping problem and not rightfully diagnosed as Sleep Apnea.

The wording is the hardest thing to overcome in this claim.

Veterans have to demand verified medical terms and not a description of the problem.

Example: knee hurt vs torn meniscus, shoulder strain vs torn labrum, tired vs sleep apnea, foot pain vs fallen arches, etc.

Its going take a good sleep doctor to connect the dots, but it can be done.

Also, consider trying to get the sleep apnea secondarily service connected to a service connected respiratory issue.

There is medical literature supporting upper respiratory issues (rhinitis, sinusitis, deviated septum, etc) to sleep apnea.

GOOD LUCK

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On 5/13/2016 at 4:11 PM, RickyDee said:

Good feed back on SA. I am getting tested for insomnia and don't know why. I have OSA and getting VA treatment but it's not SC. I was told the VA will start charging your civilian health insurance and you co-pays if your not SC for the illness. Has anyone heard of that happening?

A recent change in the law allows the VA to try to recoup some $(which is our tax $) to cover costs.  The VA can't charge you for what ever the insurance doesn't cover. They have been billing my insurance for some time now.  I see on my EOBs what they allow and what they turn down, from the VA.  It does help to use up my annual deductable as well.

Semper Fi

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