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Wayne TX

Question

Back in May 2015 had a IME/IMO exam and was told I should put in a claim for deviated septum cause I had surgery for same while on active duty and again the same exact surgery in 2009 at VA.  I had no intention of applying for it until it was brought up.  I went ahead and submitted and  it got denied, did an NOD and still sitting in Appeal now.  I have not had any additional deviated septum surgeries since filing (2015) and no more clinical indications another surgery is needed therefore MY QUESTION: 

(1) Does the fact I have had two surgeries mean anything as far as service connection goes or.... 

(2) is this just a lame duck I should cut loose since no more surgeries have occurred since 2009. 

Final question,  if still sitting and waiting on multiple Appeals does dropping one of those Appeals speed the others along any faster or does it even matter?  Can those on Appeal be processed individually at any point in time that RO decides to overturn same..... or do they wait until all of the Appeals made and filed together are fully decided one way or another?  Just seeking some opinion on this from more seasoned folks in Forum.

Edited by Wayne TX
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  • Content Curator/HadIt.com Elder

For purposes of my response, let's assume this is a new claim and not secondary to anything else.

You'll need:
1. Event/injury while in service: Septoplasty surgery
2. Current diagnosis of a disability related to #1
3. Medical opinion connecting #1 and #2

By itself, surgeries do not necessarily mean you can be SC for them. You'll need to show that you have a current disability per the VA disability rating criteria (https://www.ecfr.gov/cgi-bin/text-idx?rgn=div5;node=38:1.0.1.1.5). I assume the explanation in your denial letter was based on #2 and/or #3.

Common disabilities involving a septoplasty would be for sinusitis and/or allergic rhinitis (if septum is found deviated). But if your septum is now straight (no longer deviated), that criteria would no longer apply going forward. Even after septoplasty, it is still possible for the septum to be damaged and go back to being deviated. However, have you had any complications since the surgery? In the case of sinusitis, having surgery doesn't mean your problems are guaranteed to be gone. You can still have episodes, crusting, etc... Go through the sinus rating criteria (see above link) and compare your related medical treatment records. Look for and reported symptoms and/or diagnosis which matches up to the rating criteria.

Back in the 1990's, my appeals related to allergic rhinitis w/total sinus blockage and deviated septum took about 4 to 5 years to finally win. I had the event/injury in service and a current diagnosis, but what I needed was a medical doc to tie it together with strong medical justification.

 

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Vync.......I think I was denied on all 3 counts, but basically I was denied because they said I did not incure a traumatic injury while in service, which is true but I did get into a fist fight and took a few blows to the face and on the nose but no broken nose.  Of course, the incident was never reported and the bruising was minor......therefore no sick call was needed and no record ever found its way into SMR.   I did not know I had a deviated septum until they told me I had one in service and did not know I had it again in 2009 until VA told me.  Both required surgeries to correct my deviated septum to simply breathe better.  As of now no complications of a deviated septum exist.  I am s/c for both sinus and allergeric rhinitis and awaiting appeal for Sleep Apnea (which should be over turn as now on CPAP - wasn't on the machine when I first filed just diagnosed), which all three very active, current and being medicated.  That is why I am not sure what action to take...hold or fold. The question what if deviated septum started closing up again out of the blue and I needed a third surgery?   

 

Edited by Wayne TX
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  • Content Curator/HadIt.com Elder

If your ability to pass air through your sinuses worsens, surgery could be a potential option, but not necessarily a permanent solution. My sinus surgeon said the turbinates can grow back and a straightened septum could become deviated if I experienced trauma.

Claim-wise, using a machine and having an SA diagnosis are not necessarily guaranteed SC. You would still need a doc to opine in your favor and relate the diagnosis to your service or secondary to another disability.

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makes sense......I got two IMO's stating two (2)secondary s/c applied to Sleep Apnea.  

 

 

Edited by Wayne TX
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Wayne, not being on CPAP or BPAP would not in and of itself be grounds for a SA DX not to be Awarded an SC 0% or the next higher rating before the 50%.

It would be very helpful if you would post a redacted copy of the Denial Letter, specifically the Rater's Decision reasoning and the list of Evidence of Record (EOR) reviewed. The SA SC is very difficult to link as a Secondary Issue, as your Denial demonstrates.

Redacted copies of your IMO's and any actual Clinician Notes linking the SA to your Active Duty would also be very informative.

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  • HadIt.com Elder

Wayne  just my 2 cents

I believe if you can link the Deviated Septum in some way to your military service  then you could use the secondary rout to your S.C. D.S.Condition that relates to it , a broken nose would cause you to have the D.S. years later and a Dr could opine that BUT HE WILL NEED MEDICAL PROOF OF THAT...your going to need to link a condition you had in military to win a Sleep Apnea Claim.

if your claim is not a well grounded claim for S.A. they will dig deep to deny you.

I' don't mean to bust a bubble here but UNLESS you have some concrete  medical evidence to link your now DX Sleep Apnea to any related or /caused by from your prior military service that can be a secondary condition  it has denial written all over it.

If you had buddy statements about the fight  that may help some but they usually will come back and say veteran had buddy statements about a fist fight he had while in military and although Dr smith opinion that the fight the Veteran had while in military was related to or caused this veteran to have  the D.S. (Deviated Septum) today.....first thing a rater will see is that there's no medical evidence to substantiate this/or support it, they will call it speculation  and speculation is never a help winning claims  especially for Sleep Apnea.

    Sleep Apnea Claims require direct medical evidence to be related to or caused by  secondary S.C. Condition if you don't have it    usually a denial will be set forth.

So even if you have a Dr to state your Sleep Apnea is related to your D.S. if there's no medical evidence to support his/her statement  they will tear this Dr a New A***hole

Sorry you been getting negative responses but thats thats just the way it is when it comes to Service Connecting a medical condition or a secondary condition to a already S.C. Condition.

 Medical evidence is the key that unlocks that door to an Award.

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