Detonator

Thanks Broncovet. Possibly the vets are getting them on disc from the records division at the hospital as well. I hadn't thought of that. I appreciate your response.

I will continually see Veterans who post portions or all of the text from a C&P Exam. It's obvious they are copying and pasting from something. In the past none of my C&P exams have been available in MyHealthyVet (Blue Button). When I do a Health Record search it will show the C&P appointment but say "You May not View this completed exam." I've always gone to the records section of the VA Hospital and gotten a paper copy. So how are you guys getting the electronic version? What am I missing? Thanks

Hi everyone, I wanted to get some thoughts and advice on filing a claim for Sleep Apnea as secondary to my service connected issues. SC for Degenerative Disc Disease Lower Spine (20%), R Knee (20%), L Knee (10%), Bilateral Sciatica (10% each side), Insomnia including Major Depressive Disorder & Anxiety (50%) - Yes, all three are combined. I am a long time sufferer of major insomnia related to my lower back problems. I take several sleep medications to include Quetiapine, Ambien, Trazadone, Prazosin, and other meds to include Gabapentin, Sertraline, Bupropion, Hydrocodone. I've had lower back surgery at the VA several years ago and my lower back has worsened. This last year I've had 3 levels of nerves burned in my lower back and multiple injections. I gained up to 25 lbs and lost some of it. Recent MRI showed bottom disc levels are worsening. The VA now shows me as overweight / obese but the weight does go up & down based on my mobility. During the last 2 years my sleep has gotten much worse with nightly awakenings and night sweats. No joke, it's horrible. In 2007 I had a sleep study done and it showed no sleep apnea only very mild upper airway resistance syndrome. I recently had another VA sleep study which now shows moderate sleep apnea (OSA). My pulmonologist who has treated me for many years wrote in his notes that "it is likely that weight gain has increased severity of airway obstruction. Weight gain may be due to reduced activity from chronic back pain and also medication side effects." They have me on a CPAP (I meet the VA requirements) now although its difficult to use because of my anxiety and insomnia. Questions: I would like to file a claim for Sleep Apnea as secondary to weight gain from my lower back issues, depression and medications. Do you think what my pulmonologist wrote in his note is enough? I just received the sleep study report (today) and it said to avoid sedatives...This sounds like a stupid question but aren't sleeping medication sedatives? Should I file a claim for obesity? I'm not sure if there is even such a claim. Thanks for any help you can provide. Detonator

Thanks Navy04. I hadn't thought of submitting an IMO and have the measurements included. I appreciate your help.

Hi everyone, my insomnia was increased from 10% to 50% to now include depression & anxiety. I thought depression would have been listed as a secondary condition but I'm okay with the increase. I was also awarded bi-lateral radiculopathy at 10% for each leg which is great. These awards increased me from an overall 50% for the last 19 years to now 80% overall. So thankful. :) However, I did request an increase for my degenerative disc disease in my lower back which has always been at 20% but it was denied because the doctor did not do any measurements at the C&P. The C&P doctor felt conducting measurements would have exacerbated my condition (My back was very bad on the C&P exam day). His lower back C&P report was well done (very accurate diagnoses) but lacked any measurements. I have one year from the date of the award letter to do something. Should I get an outside doctor to do a DBQ with the measurements and submit as additional evidence for consideration? Should I try to get an outside doctor to only do the DBQ measurements, document and submit those physician notes? Should I file a NOD or appeal? I explained what happened to my VA primary and asked if he would do a DBQ so I could get lower back measurements...he has been treating me for 10 years and basically told me to pound sand. He was a serous jerk and even half-documented our phone conversation in my benefits notes. Please let me know your thoughts. Thank you.

Hi Berta, Well you made me feel better. Thanks!!!! I was worried that term would be used to deny my depression claim. It does make sense now his statement is similar to a nexus statement for the two issues. I will address your questions: Yes, I'm SC for Insomnia already as secondary to chronic pain. Just applying for an increase for that and depression as secondary to insomnia & chronic pain. I feel the evidence is good since I've been seeing sleep doctors for 10 years at the VA, I've had a sleep study, gone through sleep and depression related programs for years, I've seen several therapists and currently see a psychologist routinely. The C&P doesn't mention much about how the issues effect me. He only marked X for depressed mood, chronic sleep and disturbances of motivation and mood. There are a couple more symptoms that should have been marked. I'm hoping the VSR will look at all my psychologist's past notes and not just the couple of past notes that were pasted into the C&P report. The notes he put in really don't demonstrate how the insomnia or depression impact my life. It does show Axis I: 296.30 Major Depressive Disorder and 780.52 Insomnia on the last page. I'm thinking positive! Your insight is appreciated.

I had a C&P for an increase for insomnia and secondary claim for depression. I'm curious if anyone can tell me if what the doctor wrote about "comorbid" is helpful to my claim or not. I only have a paper copy of the C&P. Diagnosis #1: Specified Depressive Disorder Diagnosis #2 Sleep Disorder Insomnia This is the part that confuses me... Does the veteran have more than one mental disorder diagnosed? Yes Is it possible to differentiate what symptoms are attributable to each diagnosis? No "Conditions are comorbid and causally related to each other. Symptoms overlap and exacerbate each other and are otherwise intertwined and cannot be separated from one another." He checked X for Occupational and social impairment with reduced reliability and productivity. But again wrote you can't distinguish between each diagnosis as they are comorbid. Any help with understanding this phraseology and whether it is good or bad for my increase for insomnia and secondary request for depression would be helpful.

Thank you Vync for the reply. Hopefully the evaluator will review my past notes carefully. I keep checking to see if the C&P reports have shown up in the Myhealthevet blue button but nothing so far. It's been over 3 weeks. :(

I filed an increase claim for insomnia and a new claim for depression related to pain and sleep issues. At the C&P the psychiatrist said, "I'm here to do an update exam on you." I told him what exams (Insomnia and Depression) I was there for and that I'd never had a mental health C&P before. He looked puzzled and then started "rapidly" firing demographic questions at me (family, medications, work history, physicians, medical problems). He handed me a depression survey to fill out and said we were done. The C&P maybe lasted 20 min in total. He was only "concerned" with the heavy amounts and types of psych meds and sleeping pills I take. He didn't ask any questions about my insomnia or depression. Has anyone had a mental health C&P like that before? I thought they were supposed to ask all kinds of questions related to the issues. Strange for sure....hopefully the exam results will be favorable.

Removed content

Hello, I wanted to see if anyone could provide some guidance. I got out of the military in 1995 and was given a 50% VA disability rating (Back, Knees). In 2008, I was given 10% rating for insomnia related to my lower back and knee conditions. However, my rating stayed at 50%...I still don't understand that math. :) I was at a Veteran's outreach event recently and a vet had told me she received 10% for a cyst that had been removed. I looked in my VA medical records and I also had a cyst noted on my Service Medical Records back in1995 and my final Army medical evaluation. I believe I had the cyst removed before I left the military but couldn't find that record...or possibly by my doctor when I got out. Either way there is a 2 inch scar on my back where the cyst had been. Do you think the documentation in my service medical records of the presence of a large cyst on my back and the scar where it was is something I can still claim? If so, could this earn a rating of 10%? Would I be able to get back pay or did I need to claim that when I got out? Any help would be appreciated.

Is it worth filing a claim for a SC back surgery scar? Has anyone gotten a rating for a scar? I'm just curious if it's worth anything.

I just wanted to say that was a great reply Rentalguy! I am service connected for DDD L4 / L5 and L5 / S1. I had a herniated disc repaired at the VA Loma Linda 1 1/2 years ago. I've been down the whole lower back road and everything you wrote was perfect advice. FYI, if anyone wants a GREAT spine surgeon, Dr. Shook at Loma Linda is IMO great! I was told the VA did everything they could to get him from Loma Linda University! I look forward to reading more in the Spine Repository section. Good Luck rdnkjeeper!

I wanted to add a dependent parent but I'm not sure if her income level is to high Can anyone tell me what the income level is before I go through all the paperwork and hassle of submitting to add a dependent parent? What law or VA regulation can I look at? <h1 style="margin: 0in 0in 6pt;">Why Is the Dependent Parent Benefit Based on Income and Net Worth?</h1> Since the benefit is based on need, VA cannot pay additional benefits for a dependent parent(s) if their countable income is greater than the limit set by law, or whose net worth is sufficient to meet basic needs without assistance from VA. To determine need, the parent(s) must report their income from all sources, such as gross wages, Social Security, retirement, pension, insurance, interest, and dividends for the last 12 months. The parent(s) must also report the current value of all interests, such as annuities, stocks, bonds, businesses, and bank accounts. They do not have to report personal property such as a home, car, furniture, or clothing.

I applied for service connection for Insomnia due to chronic pain and was awarded secondary SC 10% granted (6/27/08): Insomnia with mood disorder not otherwise specified due to chronic pain associated with degenerative disc disease lumbar spine post laminectomy. I'm just curious if anyone knows what "mood disorder not otherwise specified" means or if it has any significance. I'm not sure if this was a vague attempt to not recognize depression. In looking at the decision, it appears that wording came from a mental health evaluation I had regarding insomnia. I'm going to a psychologist in January to get treated for depression as it relates to Insomnia. My second question is, would this be a separate condition that I can apply for or is it related to an increase for insomnia? Thanks for any help provided.

Thanks for the info Trailblazer!

Ricky, I looked over the rating report and did not see any codes listed for the Insomnia. Thanks for the explanation on the percentages.

John, I did get evaluated by a VA psychologist and was referred to a therapist for relaxation techniques. I just looked back at that initial overview and in the report I did mention that I was run-down and had some depression. Their scale listed a 4/10 on the depression scale. None of that was listed in my rating report. Also, I was upset that during my C&P exam, I was never asked about the insomnia issue. The doctor said he only handled the orthopedic issues. Their insomnia decision was only based on what was in my records. I've discovered that all the petty little B.S. that I've discussed with my sleep doctor and others seems to be what gets put in my records. Important stuff, like I only work a part time teaching job in the evening because of my insomnia doesn't get mentioned...which could probably have helped my case. I definitely think I'm going to file a NOD. This time, I'm going to make sure my VA sleep doctor documents everything (depression, the fact that I can't work a regular day time job and my dependence on sleeping pills). I also plan on having my wife write a letter how my insomnia has affected our lives (it truly has become worse than my injuries).

Also, if my insomnia condition continues to worsen....since it is service connected now....could I get that temporary total disability? Could my VA Sleep Doctor request that? Sorry to keep adding questions...I'm just a bit frustrated with that letter. It didn't come at a good time!

The letter states we do no add the individual percentages of each condition to determine your combined rating. Also under the insomnia decision, because apparently my doctor didn't put in there that insomnia effects my employment, it has some significance. Even though I only work one day a week (Part time job) and just recently began seeing a therapist for depression side effects.

I left the Army in 1995 with 20% lower back, 10% left knee meniscus, and 20% right knee PCL deficiency following surgery (50% total). Last year, I asked for an increase on my left knee, right knee and requested a secondary service connection for insomnia due to chronic pain. Today, I received a letter stating that they denied any increase for my knees but did grant service connection for my insomnia (it dates back to 1998) and awarded 10%. However, the letter states the VA does a combined rating and will not increase past my 50%. So what does the 10% service connection for my insomnia mean? I was hoping to get at least a 12 month back dated check for the 10% but it doesn't sound like I will get anything. If someone could explain how this service connection for insomnia will help me....please let me know. Also, the way they worded the decision, it makes it sound like I'm lucky they didn't decide to reduce my 50%. Amazing! Any insight would be helpful!

I am currently at 50% combined and am seeking an increase. What is the maximum amount you can earn a year if you reach 100%? Can someone tell me what VA policy or code this is under. I am interested to know if "earned" income is the key or any income. I receive a non-taxable disablity retirement from a former employer. This money is reportable on my taxes but does not get counted as taxable income. Any help on this matter would be great. Detonator

Hi Dennis, I will let you know how it goes. I left the Army with a Posterior Cruciate Ligament replacement in the right knee. So I feel your pain! My left knee is what I'm asking the increase for regarding the arthritis. My guess is it will take a while! Detonator

Hi Berta, Thanks again for your quick reply to both posts...I will answer your questions that apply. As a matter if fact- are you working? - I am still working part-time. Has a doctor suggested that your SC disabilities have contributed to the sleep problems and the migraines? - My Sleep Doctor wrote the following: Insomnia since 2001. Began having knee and back pain at that time which resulted in insomnia. He received a prescription for temazepam which helped with sleep initiation yet made him feel sleepy during the day. Has had back surgery one week ago. Uses temazepam or over the counter sleep aid 5/7 nights per week. Sometimes temazepam is not sufficient for sleep and requires vicodin in addition to be able to sleep. ASSESSMENT: 1. Insomnia due to pain which has resulted in primary insomnia even when pain is controlled due to association of pain history with sleep environment. Have you filed for migraines yet as secondary to the medications for the insomnia due to pain from your SC conditions? - I have not...the stress tension headaches from lack of sleep is not noted in my VA notes. I will address this with my doctor. If you are employed do these sleep problems, the pain of the SCs and also the migraines- cause you to be late for work or have to take time off? Is your job performance affected or -if you are unemployed was it affected by these conditions? - Nope, I plug along! Do you have a vet rep? I became a life member with the DAV last week and spoke to a rep. He filed the paperwork for an increase on my (L) knee, Lower back and secondary for insmonia and interesting a claim for the scar on my back from surgery. What does a scar claim actually mean or rate? Detonator

Berta, Thanks for the quick reply and the information. I will research and post some followup questions if they arise. Detonator