Jayco

Third Class Petty Officers
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About Jayco

  • Rank
    E-3 Seaman

Previous Fields

  • Service Connected Disability
    70
  • Branch of Service
    Army

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  1. Diabetes, hypertension, and weight gain all occurred before 2001 bypass surgery. I vaguely remember there was a section that explained the acronyms used on this site. Looked for it, but could find. Could someone point me in the right direction? One thing that struck me is the doctors statement that no recent sleep study has been done to determine if my conditions have been made worse. He seems to be admitting that there is a possibility they have been. I would think since it has been 11 years since the last sleep study, the doctor would have recommended a new sleep study. Diagnosis for SA was obstructive back in 2006. I am inclined to think that it is mixed, partly obstructive and partly central. Thinking maybe I should get another test. If the new test found mixed, would that make any difference? Thanks.
  2. Attached is a copy of the VA doctors response to my NOD. Also find two court cases. Thanks Redacted NOD Response.pdf Court case 2.pdf Judgement.pdf
  3. Diagnosed by my GP, who was also a sleep specialist, at a private hospital in the US in 2006 . I was not even aware I could qualify for disability before 2012. After I arrived in Thailand Dec 2011, I ran into a fellow vet who explained the agent orange connection. If I had never come to Thailand, I probably would never have known. As I said earlier according to the study I stop breathing 20 seconds out of every minute. My oxygen level measured down around 89. I've never met with a VA employee of any kind. I filed the claim myself and received an email from the American Embassy in Bangkok to arrange an exam. Doing this off of memory, but seems like the embassy gave me a few doctor suggestions, but recommended an American doctor that was experienced in doing VA exams. He worked in a hospital in Bangkok. He gave me copies of the exam results. He is also the one who rendered an opinion in support of my SA claim. In my original claim I did list SA along with heart and diabetes. Since I did not know what to list, it was more of a list everything approach. At that time I was not sure what would be covered. They denied it. I did not pursue because I knew nothing about secondary conditions. Later once I knew more I filed a claim for SA secondary to diabetes. To speed things up, could I have a sleep study done here in Thailand and possibly take that study to your non VA sleep neurologist in the US? Could probably have the sleep study done in the next couple of weeks. If the neurologist needs to see medical records, that could take a while. I do not have a copy of my C file. If all he needed was a sleep study and do an exam, that could be done fairly quickly. Okay to post a copy of the VA response from their doctor on here? Gastone, did you handle your SA claim yourself? Thanks.
  4. Something I failed to mention is that I am located in Thailand and am under the foreign medical program. It is my understanding that the FMP will not pay for non SC. In the US the VA would. I am at a point that I am willing to make the necessary trips to the US to get this done. I could possibly ask for assistance from my VR, but I do not have a whole lot of confidence. VA sends correspondence to him, but I am not sure I am getting copies of everything. The medical report concerning the VA doctors opinion on my SA was something that was not mailed to me. It was only after talking with the VR asking questions that he asked if I wanted a copy of the medical opinion. I thought I was automatically getting copies of all correspondence, but apparently not. Overall I guess I am okay with my VR. However, he did read the VA medical opinion on SA and discouraged me from pursuing. Sometimes you have to wonder who's side they are on. I don't have a copy of my medical records for anyone to review. I failed to ask my physicians to send me a copy when they mailed to the VA. Would my VA claims file have everything needed for a physician to review? I can request a copy from VA, but not sure how long that would take. In order to get a VA sleep study done, do I need to fly to the US, meet with a VA doctor, and request a VA sleep study or can all this be done from Thailand? Once the sleep study is done, can I use a sleep doctor here to write the opinion after reviewing the study results and my medical records? Again, I would be glad to make the necessary trips to the US to get this done if that would be best. Thanks.
  5. I referenced in my OP a doctor who would not prescribe a CPAP or surgery for over weight and older people because they did not work well enough. Not everyone can use them nor do they work well at least according to one doctor for a certain group of people of which I am one. Over the 10 years of trying to use a CPAP, I have overcome some issues and have it down to one issue that prevents me from using a CPAP. Paper dry mouth. I use a machine that has a humidifier, but still not enough. Keeping my mouth closed has always been a problem, but even when I do I still get dry mouth. I wake up in the night struggling to swallow. I recently talked to my cardiologist about pursuing further treatment. I just havn't pulled the trigger. It is not covered by VA, so out of my pocket. I am service connected for CAD and Type 2 diabetes. Filed for SC first time in 2012. Was for hypertension, but that got cut. In my original filing I ask for SA, but then decided not to pursue. At the time did know if I could make a case for SA. Then later read where it was being covered for some people. Problems not service connected are over weight and SA. Recently had a pacemaker installed due to hypersensitive carotid artery which I guess falls under CAD. VA paid. I was diagnosed with hypertension and diabetes in the 90's. Bypass surgery in 2001. In 2009 determined one bypass is completely blocked. Nothing done. No danger of dying and unblocking could cause more problems. SA was not diagnosed until 2006 kind of as an after thought. One day my GP suggested I might want to do a sleep study. No one had talked about it prior to that. SA is severe. Test results showed I stop breathing on average of 20 seconds out of every minute. On why I think I might qualify for SC on SA, I've read one case where one person had SC approved for SA that at least on the surface did not seem any different than my situation. It came down to basically his diabetes caused him to be overweight as oppose to the other way around. Being over weight then caused the SA thus the SC. VA basically says that my weight caused the SA. It has been determined that “it is more likely than not” that my CAD and diabetes was caused by agent orange. If that is the case, weight gain did not cause CAD and diabetes. AO did. So what caused the weight gain? Is it possible for CAD and/or diabetes to cause weight gain? If yes, thus the SC. If not, then I think no reason to pursue. As I mentioned I read about one legal case which was won based on SC diabetes causing weight gain which then caused SA. I remember many decades ago my father having to go to court for SS disability. I remember a comment he made that almost everyone has to actually go to court to have a chance of getting approval. They try to make you give up. I have no evidence other than what I have already stated. Can you give me an example of evidence you are talking about? This is one reason why I need someone who has the expertise to handle the filing. I just do not have it. Thanks.
  6. I filed a claim with the help of my doctor for sleep apnea as secondary connection. Denied. Filed a NOD. Denied. The NOD was denied over a year ago. A doctor for the VA said my sleep apnea was due to being over weight and that I "refused" to use my CPAP. They offered me a hearing, but I never responded. I have tried off and on for 10 years to use a CPAP and just cannot use them. Discouraged by the whole process I just gave up. Read this concerning weight: "Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor that raises the chances of a person developing a disease for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight." Read this on CPAP machines and surgery in a forum in Thailand: "I went to Bummrumgard here in TH and the doctor told me he didn't dispense them to overweight people they didn't work well enough. He also didn't do the expensive surgery for sleep apnea on older or overweight people." Bummrungrad is a well known and highly respected hospital in Bangkok. I went there for heart disease and diabetes, but not sleep apnea. I'm now thinking about trying again. I have two questions: Do I start over like it is a new claim? Can someone recommend an attorney or doctor with experience in filing claims for sleep apnea? I think I have a case. It most likely will end up having to go to a hearing, so I need expertise in filing the claim. Thanks.
  7. Update. Contacted my RO and he responded very quickly. According to my RO the payment was made Feb 1 and it should have been received. So, most likely the problem resides at my bank. I sent an email to a contact at my bank last Friday, but haven't received a response. Just sent another one. Rather than wait on the VA to contact me to correct the overpayment, I'm going to send a letter bringing the overpayment to their attention. I need to get this off my plate. Too much of a worry. Also, I need to figure out how to upgrade eBenefits. It keeps rejecting any previous address I had in the states. Now it says I have to call. Hopefully I can get through and get it set up. If I could have checked eBenefits first, I would have saved a lot of worry and other peoples time. Thanks everyone for your help.
  8. A couple of months ago I received an overpayment for medical expense reimbursement. Since part of the money was mine I deposited the check and have been waiting for a corrected EOB which should state how much I owe and where to send. I am located overseas and FMP made a currency error. Nothing has been received notifying me of the error and how to fix. If this is what it is related to, I am surprised they would just immediately stop monthly benefits without first sending a notification. It's not like they can't stop future benefit payments. Since garnishment is apparently the way they want to go to get their money back, do I just let it ride assuming they will stop the garnishment once it is satisfied? I have basic eBenefits. Tried to upgrade with no success.
  9. Not sure where to post. Anyone ever have their disability stopped without first receiving a notification of why? Do they just stop your monthly payments without sending something in the mail? Thanks.
  10. Is there a specific address and/or contact for obtaining a LOA? I have a blockage that will need to be addressed soon. Thanks.
  11. Update: FMP came through and paid all. So all is well. They renewed my faith. Still have that one small office visit that was rejected at the beginning and caused me to assume they were going to reject my claim. That's been re-submitted and I'm sure will be paid. What is a LOA? Other than verbal approval, I had nothing and was offered nothing in writing.
  12. Update. I have not received a response to my reimbursement request for the pacemaker, but today did receive a response to a reimbursement request for doctor's consultation where the original diagnosis was made. It was denied because carotid sinus hypersensitivity is not considered service connected. Going to talk to the person who pre-approved the procedure to see if anything can be done, but looks like I may be out a lot of money. IMO, a service provider should be able to submit a diagnosis to FMP. FMP then would either issue an authorization or a denial. If an authorization is issued and the procedure is completed, FMP should not be allowed to change their minds. As it stands now FMP is nothing but a crap shoot.
  13. I am rated at 70%. It is my understanding once you reach 50% you can get treated free for non service connected problems at the VA in the US. Under the FMP you cannot. You get treated free only for service connected problems. Could someone please explain the logic of such a policy? I live in Thailand and medical care is much cheaper here. I would think it would be to their benefit to have everything treated under FMP as well. Thanks.
  14. Contacted Glenn Johnson at FMP by phone and he approved the PM procedure. Could have flown to the US and had it done under Medicare or VA, but thought I would give it a shot. If by some reason they don't pay it will be a much more bitter pill to swallow knowing I could have gotten this done for little or no cost in the US. The only reason I did not have it done in the US is because they said they would pay. Had the procedure done by a government hospital in Bangkok at half to a third of what it would have cost at a private hospital in Bangkok. Everything went well. I had to pay out of pocket. Could have used Bangkok Hospital who would have billed FMP direct and no out of pocket, but would have been 2 to 3 times more expensive. The government doctor was trained in the US and worked in both private and government hospitals. She stated that if I had the procedure done at the private hospital she worked it would cost 2 to 3 times. Sent the bill for reimbursement in March by registered mail. After 4 months of no news sent email to check status. The response was they had no record of having received. There was another bill I had sent by registered mail also in March. Same response. No record of my claim. They requested I send again, so sent by email. Received email confirmations, so know they have in house. I have tried sending claims by email, regular mail, and fax. All have their own problems. Doctor I used in Bangkok said so much of what he was mailing to VA on behalf of his patients was getting lost. Started sending by fax and that seemed to work. Still waiting on reimbursement. If they do not pay, it will be an expensive lesson.
  15. I am service connected for ischemic heart disease. Recently been diagnosed with carotid sinus hypersensitivity and they want to put in a pacemaker. Even though it affects the heart, I am not knowledgeable enough to know if it would be covered. I can get the procedure done in the US for free, so would like to have some assurance that if I pay to have it done in Thailand it would be covered by FMP. A cardiologist told of a case where the patient was certain he was covered, so paid out of his pocket. Later he found out his condition was not covered and he was out the money. Not sure if it was the FMP, but he was just pointing out that I need to be certain before paying from my own pocket. Leaving it up to me to decide if a condition is covered or not in my opinion is a major weakness of the FMP. It's my understanding that carotid sinus hypersensitivity is fairly rare. There should be a process where I can simply ask the FMP if the condition is covered or not, yes or no. Simple. Do not understand why that is so difficult.