Sleep Apnea Asthma PTSD

[Sabino]

Hi 1%'s. I stumbled over this site and this is a great resource! I never knew it was here. Read some great posts and I will admit I need some advice/help. Been abused by the VA for years and never got an guidance on what I should be doing. Lots of guesswork on how to handle this.

I used to be in great shape-tours to Iraq and Afghanistan turned my lungs to junk. Rated at 10% for asthma. I have read that if I take my inhalers every day I can push this up to 30%. How should one go about doing this? Just file a claim with the VA or use a local doctor first? But this past year with the flu season its been brutal.

Which leads me to my second question-been diagnosed with sleep apnea-is there a nexus letter that I can use? Never had sleep apnea before-come home from the stan and I have asthma and apnea. Been recommended a CPAP machine.

Also have some PTSD-should I include that in the nexus letter. Just a bit confused about nexus letters and what they do. Help?

 

 

[Berta]

Glad you came on board here.

A Nexus is the inservice cause or link to any disability you have now.

This is a great link to how Sleep Apnea can be caused by  SC Asthma:

https://www.hillandponton.com/4204-2/

Matt Hill is a member here and lawyer for vets.

You should file a claim for a higher rating of the asthma.How long ago did they award the 10%?

I assume you did not appeal that rating.

Also you should claim the sleep apnea, as secondary to the SC asthma and by all means claim PTSD too.

The VA will set you up for C & P exams for these three conditions.

Hopefully the VA will provide a nexus statement for the sleep apnea and the PTSD.

It pays to go over the 2010 PTSD regulations here , as they were developed to help Iraq/Afganistan veterans.

They are in this thread :

https://community.hadit.com/forums/topic/55322-filed-fdc-for-reconsideration-how-long/

If you have the CIB, CAR, or PH on your DD 214 VA will concede that  you experienced a stressor- if you fit into the rest of the  2010 criteria but if not on your DD 214, you will need to tell the VA f a stressor. I am sure you might have had many stressors,but it is best to pick the easiest one to verify.

For PTSD claims- the nexus is the proof of the stressor.

I am not sure what you mean by nexus letters........but anything you can provide them with should support the Nexus-

the inservice cause of the disability.

Some vets need IMO/IMEs- meaning an independent medical opinion from a doctor with expertise in the field of disability who can write a strong medical rationale to establish the Nexus......in an opinion (letter) for the VA to consider but I dont think you are at that point yet.IMOsIMEs can be very costly.

For the sleep apnea claim you can provide any good internet print outs ( even that article from Matt might do)

that asthma can lead to causing sleep apnea.

For the PTSD claim you can tell them of a few stressors or at least one- that can be easily verified by the VA (or by you with a buddy statements, etc...there are many ways to verify stressors )

and if you feel you should have the CAR, or CIB, or PH on your DD 214, that can be corrected with application on a DD 149- the form is available here under a search.

Question-were you in the Burn Pit Registry?

Did VA award for the asthma as directly due to burn pits?

Some here have gotten VA doctors to write a DBQ for them.....still-if that does not provide a rationale for a Nexus to their service, in the DBQ it might not help them a bit.

 

 

 

 

 

Edited March 13, 2018 by Berta
spelling

[Vync]

Welcome to Hadit!

To request an increase in your Asthma rating, just have medical evidence showing you meet rating criteria of 30% or higher and submit a request for an increase.

Here's the §4.97   Schedule of ratings—respiratory system.

Quote

6602   Asthma, bronchial:
FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications	100
FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids	60
FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication	30
FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy	10
Note: In the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record.

The asthma ratings at each level are loaded with OR's. This means you just have to meet one of the various criteria. Here is a quick description of the med-based ratings

10% "intermittent inhalational or oral bronchodilator therapy"
This can be an inhaler, nebulizer, or swallowed (non-steroid), but prescribed as needed. You do not use them daily.

30% "daily inhalational or oral bronchodilator therapy"
This can be an inhaler, nebulizer, or swallowed (non-steroid), but must be prescribed daily

30% "inhalational anti-inflammatory medication"
This is usually some inhaled medication which contains a steroid

60% "intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids"
This can be swallowed, injected (shot or IV) steroid, like prednisone, medrol, betamethasone, dexamethasone, solumedrol, etc... What's key about this is that it states "at least three per year", which does not mean calendar year. They can be prescribed by your doc or administered as treatment at the facility. I tend to get periodic IV treatments of solumedrol for my asthma in the ER.
  The only problem with the 60% rating via this route is the VA tends to consider the rating temporary and will bring you back in the future for rexamination. If you no longer meet the 60% rating requirements, they will bump you back down to 30%.

100% "systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications"
Same as preceding entry, but self-explanatory, daily.

 

For an increase, go through your treatment and prescription records for the preceding 12 months. If they prescribed or treated you accordingly within the preceding 12 months, that can count. Be careful to check the instructions on prescriptions and also the doctor's notes. The reason I advise preceding 12 months is you can backdate an increase up to 12 preceding months if you have evidence showing it, which could mean retro if your combined rating increases.

Berta offered some great advice! If you can get a doc to opine in your favor regarding the CPAP machine usage, either directly related to service or as secondary to asthma, or secondary to PTSD (if you are SC for it), then you may be able to be SC for SA. Just keep in mind that SA is rated as a respiratory condition and might pyramid with your asthma rating (they will apply the higher rating towards your combined rating). SA with CPAP is a single 50% rating.

I hope this helps!

[broncovet]

If you have been diagnosed with PTSD, then you need to also apply for that, too.  PTSD ratings can be as little as 0 percent or as much as 100 percent, depending upon the severity of your symptoms.