hj232

Thanks for the info! Yeah, my deal is that I now have all the symptoms that are listed in the 30% rating so that is what I would look for. I just wasn't sure exactly what the VA definition of considerable impairment of health was--these things sure seem considerable to me! Thanks again, hj232

Hi, I have a SC for hiatal hernia with gastroesphageal reflux. The SC was established about three years ago. At that time it was rated at 10%--due to "symptoms of reflux, regurgitation and heartburn, dysphagia, epigastric pain, hematemesis, regurgitation of stomach contents, nausea, and vomiting, which occur constantly." In addition, "EGD revealed a small hiatal hernia, nonobstructive Schatzki's ring. Diagnosis is hiatal hernia with GERD." The rating schedule says that "a higher evaluation of 30 percent is not warranted unless there are symptoms of persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain which is productive of considerable impairment of health." My question is this: I have recently developed substernal pain that is often associated with the HH and referred to in the 30% rating--but what does the VA consider a "considerable impairment of health?" Thanks! hj232

Oh--and no, never had PFT of that sort (had plenty of other PFTs though). ;)

The latest: I got an email today from the AD doc that originally diagnosed my problems as obstructive sleep apnea. Surprisingly, he remembered me and sent me a copy of my SMR from the day that I saw him when I was still on AD. The SMR for the visit clearly states, "Hx is classic for OSA. Pt wakes in middle of night gasping for air. Spouse complains of loud snoring that is worsening." He said that this should do the trick for a AD nexus. Based on my limited understanding I agree. Any thoughts? Thanks!!!

I emailed the AD doctor yesterday telling him that I needed a letter. That appointment where he tried to get me a sleep study is documented in my SMR, however. Maybe that record will suffice but I'll try to get as much evidence as possible. I'll let you all know what happens. Again, I really appreciate everyone's thoughts on this. Thanks! hj232

Should I try to get an IMO from the first doctor I saw after sep from AD--the one that referred me to the neurologist for the sleep study? Or should I actually talk to the neurologist that did the sleep study about this? Should I try to get anything in writing from the AD doctor that I originally complained about the sleep problems to? I appreciate the advice!

Here's my story: Began having symptoms of sleep apnea towards the end of my time on AD. My wife began to complain about snoring, etc. About 1 month before I separated I went to my military primay care physician about this. We talked about it--he said that he was certain I was experiencing obstructive sleep apnea and that I needed to have a study done. He tried to get me an appoint but the soonest was about three months after I was already going to be separated. So that was that. After getting out I had the study done by a civ provider about six months after separation (I went a primary care physician right after getting out but the earliest I could get a study appt was that long.) Anyway, the diagnosed me having obstructive sleep apnea and needing a CPAP machine. At that time (January 07) I filed for compensation with the VA. With my application I included a letter of one person that served with me that could attest to my sleep issues and one of course from my wife. Any opinions on whether or not this will suffice for SC nexus? Thanks!