doc25

On the issue of Sleep Apnea: Being overweight is one factor that has been debunked. Yes. It can cause sleep apnea but so can GERD, Mental Health conditions, and others. There are plenty of veterans out there that are not overweight that still have Sleep Apnea. What are your SC conditions? and I will let you know if you can secondary service connect Sleep Apnea.

Wow. That's like the golden ticket for a VA claim. Dr. Anton mentions that PTSD/TBI overlap with your husband. The rater will need to determine which condition will be rated 100%.

If you read the top of the DBQ you posted; it shows that it's a PTSD DBQ. Under Section 1 line #2. You are diagnosed with (a) PTSD and (b) SSD. SSD is Somatic Symptom Disorder. It falls under a mental health condition. All mental health conditions are rated the same. By law, the VA can not rate two similar conditions seperately. That's known as pyramiding...and that's a no-no. PTSD with SSD would be how the VA rater would need to combine both to avoid pyramiding.

Most likely you'll be awarded "PTSD with SSD" both fall under mental health conditions. You possibly could claim Erectile Dysfunction under Special Monthly Compensation. It is rated 0%, but because it is loss of a creative organ it's an extra $100. The examiner noted that you have Total occupational and social impairment. That's rated 100%. The good part about the DBQ is that a favorable Nexus of Opinion is present and a detailed rationale is present. Everything points to a favorable decision for you. Best wishes.

Upon discharge, were you provided a copy of your Service Medical Record from medical? The Plantar Fasciitis diagnosis should be in there and if you had more complaints pertaining to it.

Wonderful! An Independent Duty Corpsman most likely. It appears you have met all the criteria required to Direct-Service connect. 1. Current Diagnosis for Sleep Apnea 2. In-Service Diagnosis for Sleep Apnea 3. A favorable Nexus of Opinion stating "most likely than not" with medically necessary CPAP. It checks out. Now for the rater to do the right thing. Best wishes.

Do you have an in-service diagnosis for Sleep Apnea?

After 5 months of waiting I got a phone call telling me I had submitted two requests and they wanted to know if I wanted it sent to my house. I was like YES! This was on Monday Feb 11. I was told I should get it within 2-3 business days....guess what? I'm still waiting. LOL.

Congrats! You received a favorable nexus. ROM and pain during your exam stands out to me. I believe you are eligible to receive a combined rating higher than 20%...which the rater might low-ball you with. ROM is rated like this General Rating Formula There is one general rating formula for any condition of the spine that is used in the majority of cases. We’ll discuss this general formula first, and then address exceptions. The general formula is based primarily on range of motion (ROM). The images below show a normal ROM for the cervical and thoracolumbar spines. Below is a chart of the general rating formula. A few points to know:

Unfortunately, the Veteran's Benefits Administration is not in the business of giving us 100%, alot of times not even a 0% rating . They're in the business of delaying and denying. But, fortunately for us, there are certain laws and there are ways around the delaying and denying that are favorable for us. You mentioned getting a 100% rating. I won't sugar coat it.It's going to be a tough road to take with your unfavorable nexus of opinion for your claim. The examiner did not find the medical evidence to substantiate your claim. Don't get me wrong. I do believe you because someone that is in "constant and chronic pain" has no reason to lie about how and when it started. I'm positive your pain continues to the present. By any chance are you diagnosed with Carpal Tunnel Syndrome either by a private doctor or a VA doctor? You were a combat truck driver. I believe this article may pertain to you. https://cdllife.com/2015/carpal-tunnel-syndrome-8-symptoms-and-6-solutions-for-truckers/ You are service-connected Arthritis. Where is the arthritis located? Hands? Elbows? Shoulders? Spine? Hips? Knees? Ankles? JKWilliams brings up a valid point with the buddy statements;consider this information for Lay Evidence in your hand or wrist claim appeal because you're going to appeal, correct? It'll be difficult, just get in the mindset of putting in the work to help your appealed claim. https://www.veteranslawblog.org/lay-evidence-in-a-va-claim/ I recommend you read this article that has some good information on Lay Evidence also. AuthorsCopies4-Coyle-Ishizawar-Seesel.PDF -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- I agree with Buck52; you can take that route for increase of your SC conditions you have already. You will need to build enough medical evidence, meaning continued treatment for your SC conditions that are present for worsened symptoms. 6 months to a year worth of built up medical evidence is a reasonable amount of time ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- The other option we have as veterans is Secondary-Service Connection. This means that a Secondary condition was manifested due to or the direct result of a Service-Connected disability. ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Individual Unemployability, could be another path. Have you lost jobs or earning capacity(ex. promotion opportunities) because of your SC conditions? Are you currently unemployed? IU might be something to consider. So, now you have four paths to get to 100%. It's totally up to you which path you wish to take. As, I mentioned before, get in the mindset of putting in the work, research, do your homework, keep asking questions. You won't be alone whichever path you choose to take. Best wishes.

Wow! What are the odds? Now you have more added weight to your claim.

I wouldn't question VA math, they do what they want anyway. Now, I want you to consider that all those zeros and 10% conditions; should they worsen, only require built up medical evidence to substantiate a request for increase.

Yes. You are good with the current diagnosis. Your sleep study should clearly confirm that you have Sleep Apnea. No. You don't need a new sleep study, unless your doctor wants to confirm that a.) You no longer have Sleep Apnea. b) It has stayed the same c) It has worsened. Let a dr. make that determination.

That same doctor did your C&P exam? Or he did the IMO?

It appears you received a favorable nexus and a rational was provided. Now to see how you will be rated.

After doing some research for you there is a possibility that you were rated incorrectly. You may need to appeal. I'm not trying to get your hopes up because this info requires it to be scrutinized by our more experienced members. I invite other members to please correct me if I'm wrong with any of the information provided. You are SC for prostate cancer. – Prostate cancer, code 7528 Were you ever treated for it at a VA facility/other facility? Did you receive a temporary 100% rating while you were being treated for prostate cancer? Is the prostate cancer still active? Is it inactive now? Code 7529: Benign tumors affecting the genitourinary system are rated based on how they affect the systems around them. For example, if the condition interferes with renal functioning, then it would be rated under the renal rating system. Code 7528: Malignant cancer is rated 100% while it is active. This 100% rating will continue for the first 6 months after the last treatment. The condition will then be reevaluated. If it is no longer active, then it is rated on any lasting symptoms like a benign condition. Notice the last sentence "If it is no longer active it is rated on any lasting symptoms like a benign condition". This is telling the rater to refer to code 7529. 7529 Benign neoplasms of the genitourinary system:Rate as voiding dysfunction or renal dysfunction, whichever is predominant. Code 7529 clearly states what you should have been rated as VOIDING DYSFUNCTION. Regardless, of what your urinary frequency symptoms are. Code 7529 clearly does not state to RATE AS URINARY DYSFUNCTION. It appears you were erroneously or deliberately rated to low-ball you. Why? This is the only rational explanation I could come up with below. If they rated you as Voiding Dysfunction ; and your symptoms were to become worse (which they may get worse over time) Urinary Frequency is capped at 40%. VOIDING DYSFUNCTION is capped at 60%. Urinary Frequency: A condition is rated under this system if it causes the body to urinate more often than normal. If you have to urinate 5 or more times during the night, or if you have to urinate more than every hour during the day, it is rated 40%. If you have to urinate 3 or 4 times during the night, or if you have to urinate every 1 to 2 hours during the day, it is rated 20%. If you have to urinate 2 times during the night, or if you have to urinate every 2 to 3 hours during the day, it is rated 10%. Voiding Dysfunction: All urinary conditions that cannot be rated as urinary frequency or obstructed voiding are rated by this system. If the condition requires the use of a catheter or other urinary assistive appliance to remove urine from the bladder, or if the condition requires the use of absorbent materials (like pads or Depends) that must be changed more than 4 times a day, then it is rated 60%. If it requires absorbent materials that must be changed 2 to 4 times a day, then it is rated 40%. If it requires absorbent materials that must be changed only once a day, then it is rated 20%.

I actually received a phone call on Monday about two requests that I had made for my C-file. One was done at the Release of Information office at my local VA. The other I forgot I had faxed to the Janesville Evidence Intake. The lady mentioned that she was sending it out that day, but if it went to the ROI office it would be redacted because of sensitive information. If she sent it to me it would not be redacted. I'm not sure why they would withhold your own personnel record. Are they trying to hide something from you? Just thought I'd share my experience.

Any chance the PA's last name is Abby or Abbay? I had a PA by one of those last names do my C&P exam in Pensacola also in 2007.

Yea. Unfortunately, we have to educate ourselves on VA law and medical terminology, conditions, and symptoms. I have medical experience and even I had to re-educate myself on how VA interprets medical evidence....with a blindfold. LOL. The law side is like trying to understand Klingon.

Cheese? That's news to me. Everyone knows the moon is made of spare ribs and I'd down it with a tall, cool Budweiser. Or is that just me? LOL. I'm kidding Oceanbound. You bring up valid points.

I apologize for misunderstanding your question. It usually takes approximately 3 to 14 days for a C&P examiner to submit the exam notes. Where exactly were your C&P exams conducted? That's highly unusual that it's taking that long. Whoever that examiner was is grossly incompetent. Sheesh. The guy you talked to is a complete idiot for telling you it takes months or years ? That only applies when a claim gets appealed and transferred to the Board of Veteran's Appeals from a Regional Office. Fully Developed Claims take about 120 days. Standard claims take approximately 180 days. Sounds like you've been getting the run around.

When was your separation date? And yes it matters because that will be your effective date and for retro pay. Do you have ebenefits or a myhealthevet account? If the C&P exams were done at a VA, you can access them through those two websites.

The examiner is full of horse manure. Want to know why? Review the research study I attached below that was conducted by a VA doctor and other doctors from Baylor. If your IMO is favorable and the examiner provides an unfavorable conflicting nexus....that is a positive and negative balance of evidence. That's a tie and a tie has to go to the veteran. §3.102 Reasonable doubt. It is the defined and consistently applied policy of the Department of Veterans Affairs to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. It is a substantial doubt and one within the range of probability as distinguished from pure speculation or remote possibility. It is not a means of reconciling actual conflict or a contradiction in the evidence. Mere suspicion or doubt as to the truth of any statements submitted, as distinguished from impeachment or contradiction by evidence or known facts, is not justifiable basis for denying the application of the reasonable doubt doctrine if the entire, complete record otherwise warrants invoking this doctrine. The reasonable doubt doctrine is also applicable even in the absence of official records, particularly if the basic incident allegedly arose under combat, or similarly strenuous conditions, and is consistent with the probable results of such known hardships. If it gets denied. APPEAL, APPEAL, APPEAL. SecondarySleepApneaArticle.pdf

1. Did your VA Dr. fill out a Sleep Apnea DBQ? 2. Did your VA Dr. provide a 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 military service (since your SMR has an in-service diagnosis.) that also states that it is "medically necessary" for you to use a CPAP machine. In addition, a rationale must be presented with the Nexus. You have two of three Caluza factors for direct service connection, according to what you have disclosed. 1. In-service diagnosis, injury, event 2. Current diagnosis of Sleep Apnea 3. No Nexus of Opinion. The Nexus of Opinion is the key to linking your Sleep Apnea to military Service. The CUE is meant to be as a very last resort in a claim. Once you use it for your claim you can't use it again. Re-open your Sleep Apnea claim with "new and material evidence" either a filled out DBQ or the nexus of opinion and if you get it granted(nothing is guaranteed with the VA).I recommend you save the CUE to appeal for the effective date to 2008 . That's 11 years ago (132 months). Since Sleep Apnea is rated 50% ($879.36).....132 x 879.36=$116,075 that you would be owed to you. [It'll be more if you have dependents.] i) Focus on service-connecting Sleep Apnea #1. ii) Then appeal the effective date to 2008 with your CUE #2. The other path you may want to consider; that's a path of least resistance, is Secondary connection of Sleep Apnea to one of your SC conditions. I'm going to guess that you are rated for PTSD or another mental health disorder? Sleep Apnea is well-known to be caused by Mental Health conditions via medications. I'm not sure the CUE would apply with Secondary connection. So, you're better off Direct-Service connecting your Sleep Apnea. Best wishes.

I would say 100% would be more accurate.