doc25

Coincidentally mine has the same dates. We'll find out together on our claims.lol.

Yea he's good at what he does. He went through my smr and found I had stomach issues that started in-service and they've gotten worse over the years but I have a claim pending. So, I'm gonna hold off on that.

Looks good. Hopefully, the ratings scheduler grants the appropriate percentage. Best wishes.

I went with Dr. Bash and he's charging me 10k. I'm on a payment arrangement. I've only received DBQs for flat feet,knees,and lower back. I suppose because I didn't give $$$ upfront I will have to wait for my IMOs. I'm fine with waiting. No biggie.

A PTSD diagnosis will only be diagnosed if your reported symptoms consistently score a 33 or higher on your PCL-5 questionnaire. If I'm not mistaken. I will research further.

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DO NOT claim Sleep Apnea just yet. You may begin an "INTENT TO FILE" after it's confirmed you have Sleep Apnea from a Sleep Study. Insomnia(trouble falling asleep or going back to sleep) is caused by untreated Sleep Apnea, not the other way around; in most cases. There's a process to it. Answer these few questions: #1. Do you stop breathing in your sleep? Yes or No. #2. Do you wake up gasping to breathe or feel like you are choking in your sleep? Yes or No. #3. Do you have family, friends, or a significant other tell you you stop breathing while you sleep or snore? Yes or No. #4. Do you feel exhausted when you wake up and it takes you more than an hour to "feel fully awake"? Yes or No. #5. Do you have constant daytime sleepiness? Yes or No. ***Women are less likely to have or develop Sleep Apnea than men, but women do develop it. So, it's not that rare.*** To secondary connect sleep apnea: #1. Get referred to a Sleep Specialist/Pulmonologist to see if you require a sleep study to see if you have sleep apnea or not. #2. Get a sleep study to confirm you have Sleep Apnea. #3. The sleep study or the doctor's note MUST STATE, "medically necessary CPAP" or something similar.( If it doesn't say that, the claim will be denied.) #4. You must meet this criteria: i) Current Sleep Apnea Diagnosis (You don't have a diagnosis yet) ii) Have a service-connected disability (PTSD) iii) Nexus of opinion stating the minimum threshold of "at least as likely as not" the veteran's sleep apnea is due to or the direct result of service connected PTSD. A rationale must be provided linking Sleep Apnea to PTSD.

70% – “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.” This is what best describes your criteria. Now it's up to the ratings scheduler to get it right.

Should you get PTSD granted...and you have or develop sleep apnea. You can secondary connect Sleep Apnea to PTSD. Other forum members and I can help provide information for that. FYI, every service-connected disability granted has secondary conditions that can be caused or aggravated by them.

"At least as likely as not" (equal to or greater than 50% probability). Meaning your were given favorable nexus of opinions. Had you received "Less likely than not" (less than 50% probability) it wouldn't look good. Hopefully, you receive the proper ratings and not get low-balled. Best wishes.

I agree. The NOD preserves the effective date if it gets granted.

Has your "earning capacity" been effected because of your wrists/hands? Meaning, have you lost significant time from work (more than two weeks per year)? Have you lost jobs or lost promotion opportunities? IU is one option to 100%, unless you want the Ratings Scheduler 100% and still work.

Congrats!

What does your nexus of opinion say near the bottom of your C&P exams; if they were done at a VA facility? I suggest you stay off ebenefits and vets.gov (I've gone crazy too, so you're not the first or last. It's normal). The only accurate updates are when you see an increase or no change in your disability percentage in ebenefits OR when you receive your granted or denial letter in your mail. Hope that answers your question. Best wishes on your claim.

Disclosure: (I'm not an actual doctor, but I have medical experience as a Navy Corpsman.) I suspect your condition sounds like Sinusitis. Please correct me if I'm wrong. Here is how Sinusitis is rated to give you an idea of what it would be rated, if it is granted. Sinusitis Rating System Sinusitis occurs when the sinuses swell and is most often caused by infection or allergy. Most sinusitis is easily cleared up within 2 weeks, and so it is only ratable if it is chronic. Sinusitis can occur in each of the different sinuses or in all at the same time (“pansinusitis”). Treatments range from medication to surgery. If the sinusitis is constant or near-constant with headaches, tenderness to the touch, and the discharge of puss or crusting after repeated surgeries, or if a radical surgery was performed and there is ongoing infection in the facial bones (osteomyelitis), it is rated 50%. If there are 3 or more incapacitating episodes each year that requires 4 to 6 weeks of antibiotic treatment, or if there are more than 6 episodes (not incapacitating) each year of headaches, tenderness and the discharge of puss or crusting, it is rated 30%. If there are 1 or 2 incapacitating episodes each year that requires 4 to 6 weeks of antibiotic treatment, or if there are 3 to 6 episodes each year of headaches, tenderness, and the discharge of puss or crusting, it is rated 10%. Anything less is rated 0%. Sinusitis codes:

1. When was your C&P exam for your back administered? 2. Where was your C&P exam conducted? At a VA or a contracter? 3. Did the doctor state the minimum threshold to substantiate a granted decision of " at least as likely as not" (equal to or greater than 50% probability) the veteran's back condition is due to or the direct result of the incident in-service?

Read this BVA citation. It will provide you some insight on what you'll need to do. This service member's pre-existing condition worsened during service and service connection was granted on the basis of aggravation. https://www.va.gov/vetapp08/files2/0814999.txt

I imagine it will be a nice retropay. Congrats!

A 10% isn't always a bad thing, you can work on building on medical evidence to get an increase. It takes time, but it's well worth it. Get onboard with PTSD 101, Individual or Group Therapy through the VA. If you would rather not get seen at the VA, you can go to a Vet Center or a private therapist. The key is building at a minimum one year's worth of medical evidence to solidify an increase. I agree with Buck52. Since you have a chronic sleep impairment, you need to consider getting referred to a sleep specialist/pulmonologist and get a sleep study. If the sleep study shows you have sleep apnea. The sleep study or the dr. note is required to say "medically necessary CPAP" for a ratings scheduler to grant it. You can put in a claim for sleep apnea, as secondary to PTSD.

From my understanding, the first thing that needs to happen is to get service connected first, then use a Clear and Unmistakable error(s) to appeal the effective date to the initial claimed date. Can other forum members correct me if I'm wrong?

It appears you have the knowledge base of a ratings scheduler. Therefore, I'll ask this: Is it a rare practice for a ratings scheduler to use a Physician's Assistant diagnosis over a Doctor's in-service diagnosis? Feel free to provide any feedback.

Wonderful!

Good catch on the personal info. LEAVE IT OUT JAENOBE. I've provided JaeNobe two articles that are of relevance to his claim. If I'm not mistaken, his sleep study was conducted by one of the named VA contributers to one of the articles. I'll fact-check myself on that. I agree 100% with getting buddy statements. Anyone that has witnessed him having Sleeping Apnea symptoms while he slept will place more weight in his favor. I think if it gets denied again, the RO level is not the ballpark his claim would have a fair chance to win on appeal. Maybe the BVA or CVAC?? His claim has been continuously prosecuted; so if he wins on appeal he won't have to find a CUE to appeal to the effective date.

You're correct on the part of secondary connecting OSA to PTSD only. There's been studies over the past 15-20 years that have concluded the correlation between OSA and Mental Health conditions. (Please see attached files at the bottom of this post). You're also correct on PTSD medications can be used to secondary connect Sleep Apnea on an aggravation-basis. PTSD medications can aggravate Sleep Apnea. PTSD alone can also aggravate Sleep Apnea. Here's a BVA case that uses aggravation of OSA due to PTSD without any mention of PTSD meds. https://www.va.gov/vetapp16/Files6/1648003.txt SecondarySleepApneaArticle.pdf Sleep apnea, psychopathology, and mental health care.pdf

Good thing I submitted my reopened claim 1/31/19.