Patton

Thanks Buck52 - The VA said that I require a C-PAP, noting that I had 30.4 Apneas per hour. The VA also stated that my Sleep Apnea is caused by my weigh (190 pounds at 5'10") but I am not buying it. I had issues long before I started gaining weigh, but they won't listen. Hopefully now that I have to use a Private Doctor, I can get down to the route of the problem. I have just ordered a new copy of my C-File, I should receive it in a couple of months. I would like to have it along with my VA and Military records to take to the Doctor and hopefully they will give an opinion. I am finding that the German Doctors are more open to give an opinion even when it deals with the VA.

Thanks for the information Doc25 - I will read the PDF's, it looks like a lot of good information. Max Hirshkowitz, is a VA Doctor who has done a lot of Psychiatric Disorders and Sleep Apnea. I have seen his name on a lot of research on the subject. I have been denied twice also, but I was trying to directly service connect OSA. I truly believe that I had OSA in service but in the 1980's OSA was unheard of. So I am going the Secondary route this time and hopefully I can find a Doctor to back it up. I will bring the documentation with me to the Doctor and maybe he/she will use some of it.

Thanks vetquest - 80% - I also have one appeal pending for Plantar fasciitis. Thanks doc25 - I have started working on my next claim for IBS and Sleep Apnea. IBS should be straight forward, as it is documented in my Military records and I am still being treated for it now that I am going to a Private Doctor. The VA had me on Meds for it but would not diagnosis it. Sleep Apnea is going to be a fight because I was not diagnosis with it until the VA MH sent me to a Sleep Study. I am looking for a Doctor that will review all my Medical Records and then give a opinion but it is hard since I am in Germany. I have researched the information you have gave me in another post and believe GERD's is at least part of the cause for my Sleep Apnea. I am also service connected for anxiety, depression and insomnia. BDD (Benefits Delivery at Discharge) has reviewed my records and stated that I should also look at URI (Upper respiratory infection). He said that I should try to go to the American Sleep Center in Frankfurt but have not been able to contact them yet. If I can get service connected for both of these plus the Plantar Fasciitis, I should be very close to 100%. Thanks for all your help!

Well it took a little longer than a month, but in the end the VA granted me 30% for GERD's. They did use the DBQ from my Private Doctor.

An update: When the VA reopened my bilateral plantar fasciitis claim, it started at "Preparation for Decision" but it went back to "Gathering of Evidence" with a estimated completion date of 02/12/2020 - 03/17/2021. So I guess I have a little wait before this is settled. Talking to the BDD, it sounds like I will get a 3rd C&P Exam since the last one did not address what the VA needed to resolve my claim.

They denied everything on my first try, but I have learned a lot since then. It takes a lot of work to put a claim together the right way. Good luck!

LHairston, They reopened my claim without me asking. The only thing that I can think of, is that my DBQ was delayed. Since they now have all the information they needed, so it was reopened. It is showing a completion date between November of this year and March of next year. I had opted into RAMP since my appeal has been going on since 2015. It look like you need to show that you still have issues. You need to go to the doctor to document the issue and show that it chronic. You will also need to show how it impact your daily life (does it affect work). I am not sure what it would be file under but they have denied my claim because I did not use the right code. Welcome to the forum! There is a lot of good information on here that will guide you in the right direction.

Congratulations Firedog!

Please let us know how it all turns out.

That is great to hear! The first C&P Exam (non-VA Doctor) I had left me confused, as he did not want to talk about my issues. Anytime I would try to talk about my issues, he would cut me off and redirect the questioning about my childhood. I got denied, so I refiled, and got a second C&P Exam with a VA Doctor. She was great, and had taken the time to read my file before my Exam. She understood why I am having issues and helped me understand how to deal with depression / anger. We even laughed at some of the stupid things I have done over the years. It lasted for over 2 hours. I am rated at 30% and I am good with that. I just had a third one for Insomnia (it is filed under Mental Health) with a non-VA Doctor. She took the time to talk about all my sleeping issues and even suggested a few Doctors to see since I am new to the area. Best of luck,

Hang in there you will get thru it.

It states "No Longer Needed", so I would not worry about it. You can call them and they be able to tell you something but I would not count on it.

Thanks vetquest! Hopefully it will go well for me also!

It just means that something needs to be corrected or they need more information. I have had it happen to me before, and never had a second C&P Exam. I am not saying that they will not request another C&P because you never can tell with the VA.

I have never had a claim settled without a C&P Exam. I am pretty sure that it will be returned to Gathering of Evidence and I will end up having a C&P Exam. Just wishful thinking. I will keep you posted on how it turns out.

I filed for an increase (from 10% to 30%) for GERD on February 16, 2019. Since I received a DBQ and NEXUS letter from a Private Doctor, so I did file it under a fully developed claim. I checked eBenefits today and it states "Preparation for Decision" with an Estimated Completion: 03/08/2019 - 03/21/2019. I am lost for words, but this could be settled in under a month? When I was service connected for GERD, it took almost 3 years. Has anybody had a claim completed so quickly?

"at least as likely as not (50% or greater probability)" is the key words. You should be granted for PTSD but you will have to wait and see what they rate you at. If this is a claim (not an appeal or RAMP), mine normally took about a month for a rating decision on eBenefits. Below is how they should rate PTSD: General Rating Formula for Mental Disorders: Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name 100 Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships 70 Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships 50 Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events) 30 Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication 10 A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication 0 Best of Luck.

This is some great information Doc25! I will get the increase in GERD filed today. I will be including a DBQ from my Doctor stating that my GERD has worsen. He also added research documentation that shows how GERD affects quality of life. He is a retired Army Doctor who sat on the board. So hopefully this claim goes well. I have been denied twice also, but I was trying to service connect it. I truly believe that my Sleep Apnea is directly related to all my sleep issues (Insomnia) during service, but no sleep study was done. I will hopefully be able to contact the American Sleep Clinic in Frankfurt this week to setup an appointment. I am waiting on the VA Foreign Medical Program (FMP) packet, so they can pay for it. I been told that they will review all your Medical records then give an assessment. At the end of the day, I am doing this to ensure that my wife is taken care of if something would happen to me. Sleep Apnea, GERD and IBS is linked to many deadly diseases. She has always supported me even though I can be very difficult to deal with. Thanks again!

Doc25 , Below is what I have so far: 30 % Persistent Depressive Disorder (Dysthymia) with Insomnia 20% Lumbosacral Strain secondary to Right Ankle 20% Left Knee secondary to Right Ankle 10% Right Ankle 10% Radiculopathy right lower extremity secondary to Lumbosacral Strain 10% Tinnitus 10% GERD Bilateral factor of 3.5% for DC 5271, 5257, 8520 My BMI is normally around 28.5 but has been as high as 29.7 and as low as 27.6. If I could get Sleep Apnea secondary to something, IBS service connected (I need to get to a Doctor over here for more documentation) and an increase for GERD (I am almost ready to file this) I would be a happy camper. Plantar Fasciitis would be a bonus then. Thank for your help, Patton

Thanks Broncovet, I should have example myself a little better. I did not use false statement. I requested my records to be corrected twice now and nothing has been changed. I last time was a year ago and I followed up about 45 days later. I was told that the Doctor needs more time. When I had my next appointment (6 months later) with him I asked him to please make the changes. He called the Nurse in and they escorted me to Mental Health. The PA for my GERD C&P Exam pointed this out to me. My Prime Care Doctor has me on Loperamide for Diarrhea, but then he goes on to say: GI: Negative for nausea, negative for vomiting, negative for abdominal pain, negative for melena, negative for hematochezia, negative for hematemesis, negative for constipation, negative for diarrhea. Looking at my records, it has been the same ever since I started using the VA. I had a history of Irritable bowel syndrome (IBS) in service and I am SC for GERD. I still have the same issues today but he has not add it to my VA Problem list. I requested a new Prime Care Doctor, but by the time I seen her, it was 2 weeks before I was moving. So she wanted to ensure I got all my medication refilled and did not address the issue. The first time was with sleep medicine. He stated: This is a 56 year-old overweight gentleman with severe obstructive sleep apnea who presents for follow-up evaluation. He reports trying to use his CPAP machine nightly but has difficulty tolerating it long. The CPAP machine inadvertently comes off overnight. He generally sleeps until about 12 midnight then wakes up and can't go back to sleep. He reports intermittent morning headaches. This one really bothers me, because it has nothing to do with me tolerating my mask. I stated that I only get 4 to 5 hours of sleep on a good night and if something is bothering me I don't sleep at all. I don't sleep for a number of reasons to include stress (or mad about something), pain and acid reflux. I also fight in my sleep or cannot get comfortable at night. He said that I needed to lose weigh because my BMI was at 28.8, so I needed to exercise. I stated that I am exhausted and have no energy to exercise because of lack of sleep. He did not offer any solutions. I reported that I have morning headaches 2 to 3 times a week. It as if he is saying that my Sleep Apnea is caused by my weigh. I am not buying it. Hopefully I can find a Doctor here that will address the real issue. Thanks Doc25, I have all my documentation except for the DBQ from the VA Contractor (VES). I did include everything with my packet.

The sad part is that I did not miss my appointment. I don't know who dropped the ball, VES or the VA, but I am the one who is being punished for their screw up! I will get a copy of my C-File and get to the bottom of it. I will look into doing a reconsideration. The last time I questioned the VA on making a false statement, I was escorted to mental health. Then they refused to correct their mistake? My VA Medical records has so many mistakes in it because they copy and paste bad information and nobody will do anything about it. I will get it fixed by not using the VA until I get everything documented correctly! Then hopefully I will get the correct disability rating.

They made a decision on my appeal (RAMP) and I am confused? I am happy with the outcome except for the Plantar Fasciitis which was denied. I talked to the Benefits Delivery at Discharge program (BDD) here in Germany and he said that it states: History of Plantar Fasciitis in service. Ongoing treatment after service. Claim denied due to missed C&P exam. Veterans Evaluation Services (VES) conducted the C&P Exam north of Frankfurt on January 22d, 2019. I also had an Insomnia C&P Exam on the same day, and they tied that to my SC Depression (which is what I expected them to do). I wrote the person who setup the appointments but she have not gotten a reply back to me yet. What steps should I take next, so that it doesn't take another 3 years before I get this resolved? In my experience, they do the DBQ after the appointment, is there a regulation to ensure that I get a copy of the DBQ before I leave the appointment? I have asked for it before and was told no. Thanks for any help.

It took about 190 days for them to complete mine. In the end, I believe that the outcome was correct (for the most part). I need to request my C-File to see why denied my Plantar Fasciitis claim, but other than that I am very happy with the outcome. Best of luck, Patton

Thanks for the information Galen, This week I learned that my NOD (RAMP) for Insomnia was added to my persistent depressive disorder (dysthymia) with no increase in disability. Then they denied my claim for Plantar Fasciitis even though it is in my Military Medical records and the VA is treating me for it (steroid shots). Also my Private Doctor (in Texas) did a DBQ. I don't have the letter yet, but I am going to address any concerns they had with my claim. I started this in 2015 and will not give up until I receive what is due to me. I have an appointment with the VA (BDD-Benefits Delivery at Discharge program) on Tuesday, hopefully they will give me a copy of my C-File, so I can take it to the next level. I am still going to file for an increase for GERD. Since the VA will only record the symptoms and treat me for IBS but will not diagnosis with it. I am going to find a Private Doctor here in Germany to get it document it correctly.

Thanks Vync and Broncovet, It sounds like I need to get back to the Doctor for the IBS. Getting the VA to documenting medical conditions correctly has been the biggest challenge. While in the Army, I was diagnosed with IBS and the VA has stated that I have diarrhea and abdominal pain. The VA also noted that I had IBS during service. They have also removed 3 polyps from my colon. When I was issued the Loperamide, I had a Gastrointestinal Hemorrhage (and listed under Allergy Name: Nonsteroidal Anti-Inflammatory). At the same time they removed a large polyp from my stomach. I am not sure how to go about this, but my stomach bleeding was cause by the VA issuing me Ibuprofen. When I was issued the 800mg of Ibuprofen, I questioned their choice (because of my stomach issues), but he stated that it is completely safe. I guess I will file for the increase for GERD now and try to get the documentation needed for IBS for a later date. This whole process has been very challenging, but I will never give up until I get everything I am due. Thanks again, Patton