What's your PTSD SC Rating and Effective Date? Are you positive that there are SMRs discussing treatment or complaints of sleep issues while on active duty? Do you have the Clinician Treatment Notes for your Sleep Issues, addressed in the 1st year after Discharge?
PTSD is @ 70% with an effective date of 10/2015, thats when it was increase with a cue due to initial assessment was only granted 30% which was with effective date of march-2013 same month i was separated from active duty. The PTSD was a long battle with VA due to initial claim was denied. As for notes for complaint for sleep issue were at exit exam on 2807-1, while in service (that is as much of info from in service) and also I have treatment notes from my initial assessment that the Dr. recommends for sleep study due to suspicion of OSA and probability of headaches coming from OSA.
Direct SC or Secondary to PTSD? Why not address both in a 21-4138? How to go about this. I have asked VSO about
and which way to go about it. VSO wants nexus. They want me to go over this with VA Dr. and the notes from the Sleep clinic to see if i can get the nexus that way. But not sure which route to push this a single SC or to secondary this to PTSD.
VMC Sleep Specialists are very reluctant to give a conclusive supportive DBQ or Clinician Note as to a PTSD Nexus. Then again you might Luck Out. Based on my personal experience, you would be wise to see a Private MD, Board Certified Neurologist Sleep Specialist. No DBQ necessary, strictly his initial exam consult Treatment Notes could seal the deal.
Could i use the assessment from the sleep study that i had for this and/or will i still need a nexus letter to file for it
You indicate your Sleep Study had your P02's dropping to low 80's. In addition to the CPAP RX, are you also on supplemental 02? If not, you should address this immediately with your VA SA Clinician and/or a Private Sleep Dr. A very dangerous situation. Periodic overnight P02 readings should be scheduled.
on the Polysomnohraphic split night report with CPAP goes as:
first hour of sleep 137.5 minutes of test without CPAP was report with AHl 70.7 and 7.3 minutes of oxygen below 88% with the lowest at 80%
assessment: OSA(G47.33 ) , Sleep related Hypoxemia (G47.34) , hypersomnia 780.54, nightmares, snoring and overweight