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dvikings

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Posts posted by dvikings

  1. I posted this to and old thread and trying to get some thoughts for my friend.Well, He is still waiting. (gathering ev).

    1 1st doctor= suggest that it is service connected. Military doctor

    2 2nd doctor= less likely than not. VA C AND P EXAM.

    3 3rd doctor= at least as likely as not. VA MENTAL HEATH.C AND P EXAM.

    rater then sends back for another opinion.

    4 4th doctor=opines that doctors 1 and 3 are speculating base on no records and no basis for opinion and currently remains in gathering evidence stage for six weeks. Anybody have any thoughts?

  2. Well, He is still waiting. (gathering ev).

    1 1st doctor= suggest that it is service connected. Military doctor

    2 2nd doctor= less likely than not. VA C AND P EXAM.

    3 3rd doctor= at least as likely as not. VA MENTAL HEATH.C AND P EXAM.

    rater then sends back for another opinion.

    4 4th doctor=opines that doctors 1 and 3 are speculating base on no records and no basis for opinion and currently remains in gathering evidence stage for six weeks. Anybody have any thoughts? 

     

     

  3. He was in desert storm. He received 2 letters from the Dept of def in 1997 and 2000 stating that several incidents occurred during his time there. 2 were possible chemical incidents. They concluded that they couldn't determine if they did or did not happen. He was also a diesel mechanic when he was in.

    Thanks for all your help.

  4. Thanks Berta

     

    How the heck can the VA doc  say the SA was not found to be SSed if they didn't even have the STRs? Good question. He requested them for 2 years and the Hawaii VA state office asked for them as well and they could not be found.

    Does he have other claims pending? Yes, he has a General appointment with the same doctor for Respiratory disorders (paralyzed diaphragm), Insomnia and Joint Pain and fatigue. Should he challenge the doctor on the above question since his  specialty doctor is a military doctor at Tripler Army med center and stated that in the 90's there was no testing for sleep apnea being done as prevalent as it is done now.

    Is this is first claim? Yes

    Has he tried to get his STRs himself at www.nara.gov yes. last 2 years. Yes. Also the VA Hawaii state advocate office did with no luck.

  5. Thank you Berta. Here is the DBQ from the C&P. Not sure how to attach. So I cut and paste.

    LOCAL TITLE: MEDICAL C&P REPORT

    STANDARD TITLE: INTERNAL MEDICINE C & P EXAMINATION CONSULT

     

    AUTHOR: URGENCY: STATUS: COMPLETED

    Sleep Apnea

    Disability Benefits Questionnaire

    Name of patient/Veteran:

    Is this DBQ being completed in conjunction with a,

    C&P Examination

    Request?

    [X] Yes [ ] No

    ACE and Evidence Review

    -----------------------

    Indicate method used to obtain medical information to complete

    this document:

    [X] In-person examination

    Evidence Review

    ---------------

    Evidence reviewed (check all that apply):

    [X] VA e-folder (VBMS or Virtual VA)

    [X] CPRS

    Evidence Comments:

    no active duty str available in vbms for review. files labeled

    strs were

    from post service

    1. Diagnosis

    ------------

    Does the Veteran have or has he/she ever had sleep apnea?

    [X] Yes [ ] No

    [X] Obstructive

    ICD code: G43.77 Date of diagnosis: 2014

    2. Medical history

    ------------------

    a. Describe the history (including onset and course) of the

    Veteran's sleep

    disorder condition (brief summary):

    VETERAN IS HERE FOR CLAIM OF SLEEP APNEA

    RIGHT HANDED

    MILITARY: MARINE CORPS 1998-2/1992 1341

    WORK: ENGINEER

    VETERAN STATES:

    ONSET: 1991 COULDN'T SLEEP. GUYS IN TENT COMPLAINED OF LOUD

    SNORING. PUT

    VETERAN ON NIGHT SHIFT WHILE DEPLOYED. HAD TO HARD TO

    FALLING ASLEEP.

    WOULD ALSO WAKE UP IN THE MIDDLE OF THE NIGHT LIKE EVERYONE

    ELSE FROM

    ALARMS AND NOISES SO DIDN'T THINK IT ODD.

    WHEN GOT BACK TOLD HAD BELLS PALSY NO TREATMENT.

    IN 2006 GOT TO HAWAII BREATHING GOT BAD WITH FREQUENT

    PNEUMONIA

    EPISODES. SENT TO SPECIALIST AND DID SLEEP TEST DUE TO

    BREATHING,

    SNORING AND SLEEPING PROBLEMS.

    DX WITH OSA.

    SINCE STARTED USING CPAP, STILL HARD TIME FALLING ASLEEP

    BUT NOW CAN

    STAY ASLEEP THROUGH THE NIGHT.

    STILL TIRED DURING THE DAY EVEN IF SLEEPING BETTER DESPITE

    USING THE

    CPAP.

    NO MEDICATIONS FOR SLEEPING.

    ?date letter wife. after gulf war noted having hard time

    sleeping.

    snoring and lack of breathing choking or gasping. finally

    got him to

    doctgor in 2013 and dx with osa. still snores with cpap but

    not as

    loudlyy.

    7/18/08 wt: 222

    12/30/13 pul eval ros: no snoirng yet dx snoring long

    standing hx of

    snroing of sinificance. sxs to suggest insomnia.

    1/10/14 pul eval diaphragm paralysis, ros notes o snoring

    no htn but

    some daytimes somnolence. psg

    2/20/14 psg

    5/13/15 pul eval. dx osa.

    9/8/15 va eval gw osa on cpap

    10/14/15 dr. rossoff osa dx in 2/2014 but sxs suggest

    present during

    active service when knowledge of disease was more limited.

    same time c/o

    sxs of insomnia and paralyzed left hemidiaphragm.

    b. Is continuous medication required for control of a sleep

    disorder

    condition?

    [ ] Yes [X] No

    c. Does the Veteran require the use of a breathing assistance

    device?

    [X] Yes [ ] No

    d. Does the Veteran require the use of a continuous positive

    airway pressure

    (CPAP) machine?

    [X] Yes [ ] No

    3. Findings, signs and symptoms

    -------------------------------

    Does the Veteran currently have any findings, signs or symptoms

    attributable

    to sleep apnea?

    [X] Yes [ ] No

    If yes, check all that apply:

    [X] Persistent daytime hypersomnolence

    4. Other pertinent physical findings, complications, conditions,

    signs,

    symptoms and scars

    ----------------------------------------------------------------

    -------

    a. Does the Veteran have any other pertinent physical findings,

    complications, conditions, signs or symptoms related to any

    conditions

    listed in the Diagnosis Section above?

    [ ] Yes [X] No

    b. Does the Veteran have any scars (surgical or otherwise)

    related to any

    conditions or to the treatment of any conditions listed in

    the Diagnosis

    Section above?

    [ ] Yes [X] No

    c. Comments, if any:

    No response provided.

    5. Diagnostic testing

    ---------------------

    a. Has a sleep study been performed?

    [X] Yes [ ] No

    If yes, does the Veteran have documented sleep disorder

    breathing?

    [X] Yes [ ] No

    Date of sleep study: 2/22/14

    Facility where sleep study performed, if known: sleep

    center hawaii

    Results:

    wt: 235# severe oss ahi: 74.1

    b. Are there any other significant diagnostic test findings

    and/or results?

    [ ] Yes [X] No

    6. Functional impact

    --------------------

    Does the Veteran's sleep apnea impact his or her ability to

    work?

    [ ] Yes [X] No

    7. Remarks, if any:

    -------------------

    QUESTION:

    Does the Veteran have a diagnosis of (a) sleep apnea that is at

    least as

    likely as not (50 percent or greater probability) incurred in or

    caused

    during service?

    OPINION:

    VETERAN WAS DIAGNOSED WITH OSA IN 2014 WITH POSTIVE SLEEP STUDY.

    LAY PERSONS

    REPORTS WERE NOTED HOWEVER SLEEP APNEA IS A DIAGNOSIS MADE

    SPECIFICALLY BASED

    ON DIAGNOSTIC CRITERIA WHICH WAS NOT MET UNTIL PSG WAS DONE IN

    2014. IN THE

    EVIDENCE PROVIDED, THERE WERE NO OTHER EVALUATIONS FOR SYMPTOMS

    CONSISTENT

    WITH SLEEP APNEA UNSTIL 2014. GIVEN THE LACK OF THIS EVIDENCE

    PRIOR TO 2014,

    IT IS LESS LIKELY THAN NOT THAT VETERAN'S SLEEP APNEA WAS

    INCURRED IN

    SERVICE.

  6. Good morning all.

     

    I had a friend who had his C@P exam last week. He had  a nexus letter from his specialty doctor stating his condition suggests that his condition happened during military service.

    After checking his DBQ, the VA doctor noted the doctor NEXUS letter however, she opined that the condition was less likely than not that veterans condition occurred during military service.

    Any chance the nexus letter carries more weight than the VA exam with the raters.

  7. Here is my posted BVA results.

    Citation Nr: 1547296
    Decision Date: 11/09/15    Archive Date: 11/13/15

    DOCKET NO.  13-32 679 ) DATE
    )
    )

    On appeal from the
    Department of Veterans Affairs Regional Office in Honolulu, Hawaii


    THE ISSUE

    Entitlement to service connection for obstructive sleep apnea.


    REPRESENTATION

    Veteran represented by: Hawaii Office of Veterans Services


    WITNESS AT HEARING ON APPEAL

    The Veteran


    ATTORNEY FOR THE BOARD

    V. Chiappetta, Counsel


    INTRODUCTION

    The Veteran served on active duty from July 1980 to July 2005. 

    This matter is before the Board of Veterans' Appeals (the Board) on appeal from a May 2012 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Honolulu, Hawaii. 

    The Veteran testified before the undersigned at a hearing held in September 2015.  A transcript of the hearing has been associated with the Veteran's claims file.


    FINDING OF FACT

    The Veteran's obstructive sleep apnea is shown to have had its onset during his period of active service.


    CONCLUSION OF LAW

    Obstructive sleep apnea is due to disease or injury that was incurred in active service.  38 U.S.C.A. § 1110 (West 2014); 38 C.F.R. § 3.303 (2015).


    REASONS AND BASES FOR FINDING AND CONCLUSION

    Duties to Notify and Assist

    The law provides that VA shall make reasonable efforts to notify a claimant of the evidence necessary to substantiate a claim and requires the VA to assist a claimant in obtaining that evidence.  38 U.S.C.A. §§ 5103, 5103A (West 2014); 38 C.F.R. § 3.159 (2015).  To the extent that there may be any deficiency of notice or assistance with respect to the Veteran's sleep apnea claim, there is no prejudice to the Veteran in proceeding with adjudication given the favorable nature of the Board's decision.

    Analysis

    Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service.  38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a).  Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability.  Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009).

    Service connection may also be granted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2015).

    The Veteran in this case asserts that although obstructive sleep apnea was first diagnosed in November 2011, approximately six years after completing his period of active service, his sleep apnea actually began during service but was never tested or formally diagnosed.

    It is undisputed that the Veteran was diagnosed with severe obstructive sleep apnea following a sleep study administered in November 2011.  See the Veteran's November 20, 2011 Polysomnographic Report.  Although he was not diagnosed with sleep apnea during service, his service treatment records include complaints for "wheezing during his sleep" and dyspnea dating as far back as 2000.  See a November 2, 2000 in-service consultation report.  He also received treatment during service for hypertension, headaches and general feelings of weakness.

    At the September 2015 hearing, the Veteran competently testified that he began feeling increasing dyspnea, shortness of breath and daily fatigue and tiredness in and around the year 2000, as is consistent with the Veteran's contemporaneous service treatment records, highlighted above.  He noted ongoing symptoms of high blood pressure during service, as well as headaches, both of which he documented on his Report of Medical History upon separation on May 12, 2005.  Also on that report, the Veteran noted a history of breathing problems and high blood pressure. 

    In a February 2012 statement, the Veteran's wife indicated that she has been married to the Veteran for over 20 years, and has noted the Veteran's sleeping habits have been steadily getting worse, and that his virtually impossible to sleep with because of the noise and distractions.  She noted that the Veteran' stops breathing and makes gasping and choking sounds in his sleep.  She specifically stated that the symptoms began in the early 1990s, and highlighted the Veteran's in-service treatment for fatigue and breathing issues. 

    In support of his claim, the Veteran has recently submitted a medical opinion from Dr. J.S.S. dated July 27, 2015.  After reviewing the Veteran's history as outlined above, and upon examination of the Veteran, Dr. J.S.S. pertinently determined that although the Veteran's sleep apnea was not documented until 2011, he had "symptoms (headache, hypertension) suggesting possible sleep apnea preceding his diagnosis for at least 10 years."  Dr. J.S.S. noted that the Veteran has a long history of snoring and hypertension that was difficult to control noted in his previous medical records.  He concluded that these symptoms and conditions may have resulted or been worsened by "unrecognized, undiagnosed, and untreated sleep apnea." 

    The Board observes that a May 2012 VA examiner opined against a relationship between the Veteran's sleep apnea and his period of service, but simply noted by way of rationale that there was not enough objective evidence to make the connection.  The Board finds the negative and generally unexplained medical opinion of the May 2012 VA examiner much less probative than the more specific favorable opinion of Dr. J.S.S., who discussed the Veteran's medical history, recognized the fact that the symptoms exhibited by the Veteran during and after service constitute well-documented complications of untreated sleep apnea, and came to a logical conclusion supported by the other competent lay and medical evidence of record.

    Thus, in light of the fact that (1) the Veteran's service records note complaints of and treatment for symptoms such as dyspnea, wheezing in his sleep, hypertension, headaches and fatigue, which are shown to be complications of untreated sleep apnea; (2) the Veteran and his wife have offered competent and credible testimony pertaining to the dates of onset for sleeping problems (during service), and the treatments the Veteran has received for ongoing symptoms suggestive of sleep apnea during and since service; and (3) the favorable and probative medical opinion of Dr. J.S.S. described above, the Board resolves all doubt in the Veteran's favor and concludes that the evidence favors a finding of in-service incurrence of obstructive sleep apnea.  The benefit sought on appeal is granted.


    ORDER

    Service connection for obstructive sleep apnea is granted.



    ____________________________________________
    H. N. SCHWARTZ
    Veterans Law Judge, Board of Veterans' Appeals
     

     

  8. I cut from another post:

    Just wanted to update since my last. I checked ebenefits Saturday and my status went to 100%. I call my rep today just to confirm and it is correct. Should get yellow envelope today or tomorrow. I am very pleased so far with the NOD process. It may have taken a while since I filed NOD. (14 FEV 2012). However, Had my hearing on 21 sept 2015. Decision granted on 6 Nov 2015. RATING REVIEW ever since. My AB form says 100%. My REP also stated that the decision was sent 5 DEC 2015. I also check to see if my BVA decision was posted on the appeals site and it looks like it will be next month. I will post the decision when it comes up. Thanks to everybody for posting on this site. It does make everything a whole less stressful.

  9. Just wanted to update since my last. I checked ebenefits Saturday and my status went to 100%. I call my rep today just to confirm and it is correct. Should get yellow envelope today or tomorrow. I am very pleased so far with the NOD process. It may have taken a while since I filed NOD. (14 FEV 2012). However, Had my hearing on 21 sept 2015. Decision granted on 6 Nov 2015. RATING REVIEW ever since. My AB form says 100%. My REP also stated that the decision was sent 5 DEC 2015. I also check to see if my BVA decision was posted on the appeals site and it looks like it will be next month. I will post the decision when it comes up. Thanks to everybody for posting on this site. It does make everything a whole less stressful.

  10. MSATTLER

    I to have a status of RATING REVIEW in EBENEFITS since last Monday. I filed NOD and had my hearing on 21 Sept. I rec'd my decision on 13 Nov in the Mail SC SLEEP APNEA GRANTED. I called va 1000 number and they were still waiting for the letter from BVA. I am assuming that they are calculating my increase back to 2011. I could be wrong but, that is the only thing I have on ebenefits. Good Luck.

     

  11. I got my NOD back today. My appeal was granted. ebennies has my appeal complete since last week. Now i just wait until VA does there thing.The worse is over. This should take me to 100%. Thank you to all, reading everything on this has been helpful while I waiting thru the process. The biggest surprise was that 21 Sept was my hearing with the judge and decision was made last Friday. It went so fast it scared me. The end is near and hopefully they rate me correctly.

  12. I got my NOD back today. My appeal was granted. ebennies has my appeal complete since last week. Now i just wait until VA does there thing.The worse is over. This should take me to 100%. Thank you to all, reading everything on this has been helpful while I waiting thru the process. The biggest surprise was that 21 Sept was my hearing with the judge and decision was made last Friday. It went so fast it scared me. The end is near and hopefully they rate me correctly.

  13. Stillhere

    Sound like you are a few days ahead of me. My status is the same as yours as of yesterday. I filed my NOD in dec 2012 and had my hearing on sept 21. I have only 1 appeal for sleep apnea. I have no idea how long it takes with VLJ? I thinking if is come back soon it will be denied. My advocate briefed/argued my case will and I had sleep specialist letter in my favor. Good luck.

  14.  

    I filed a NOD after being denied CO for sleep apnea I rec'd this in less than 3 weeks of filing, I recently seen the Judge on 21 Sept 2015 for NOD.(thought it went well) My status on Eben has change from assigned docket number (not sure what it is) to With Veterans Law Judge. Things seem to be moving fast. I filed NOD in early 2012. Anybody know what comes next and how long the remaining process will take.

    mental/anxiety 70%

    back 40%

    legs 10% ea

    hypertension 20%

    brain aneurysm/tia's  10%

    hearing 10%

    tinnitus 10%

    something else not sure 10%

     

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