sleepyjenn

I think this may be the article you're talking about? benefit commission article

Vike 17, I think you're right about everything you said, and I'm trying to wait patiently. Pete, my sleep study was done at the end of 2005 but it wasn't done by the VA. It was done by a sleep specialist in Los Angeles--he is a diplomate of the American Board of Sleep Medicine. I guess if the VA isn't going to listen to him, they aren't going to listen to anyone. B) I'm not sure how they'll rate my sleep disorder, though, since it's not one they have listed in their rating schedule.

"does it say anywhere else that the doctor found this all to be more than likely due to your service by way of the SC cervical radiculopathy?" No, what I posted below was the entirety of his report, or at least that's all the VA sent me when I requested a copy of the exam. He really didn't seem to have any opinion at all, about any of my conditions, from the way I read the report. That's why I got curious about how helpful his report is or isn't. It shouldn't be too difficult for the arthritis to be service connected--I've only been out since 2005, and my claim for this was submitted less than a year later (although the VA 'lost' the claim once and I had to resubmit it) and all the symptoms were well documented before I was discharged. It even makes mention in the original letter the VA sent when they granted my disability that I was awaiting a future sleep study and diagnostic images. "Did I understand that you are left handed with SC at "0" for left sided sacroiliitis? Does this SC affect the ability to use your wrist and hand?" Yes, I'm left handed and am SC at 0% for left-sided sacroiliitis. At the time it was granted they said that a higher percentage of 10% wasn't warranted unless there was forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85, or combined ROM greater than 120 but not greater than 235. I think the ROM from my recent C&P fits that criteria now? Yes, it does affect ability to use my wrist and hand because of pain, numbness, tingling, etc. My left arm is significantly weaker than my right, even though the left is my dominant arm. "Do you have any documentation that shows that you ever fell asleep on any job?" No way. lol. I started having all the symptoms of this disorder while I was still enlisted, and there was NO WAY I was ever going to allow myself to fall asleep at work. At least not when anyone could see me. I was too scared of the consequences. Did I actually ever fall asleep? Sure, plenty of times. But my friends always made sure I was awake before the supervisor came back to the 'shelter' where we did maintenance. When I was stationed in Korea I even had a supervisor who would let me go sleep in an unused office for part of the night when we weren't busy. No one thought that was odd at all, though, because we worked nights and most of us were tired. Thankfully, I recognized that my symptoms were worsening to the point that I wasn't able to control them anymore, and since I had become an NCO in the last few years of my enlistment I didn't feel I was fulfilling my job requirement because I was too tired to want to do anything--so I initiated my discharge under the Force Shaping program a few years back. Sorry, a long answer just to say that no, I never had any documentation that I fell asleep on the job. "I think you should apply for TDIU" Does the VA ever infer this based on the nature of the illness, or do you always have to file separately? The nature of the type of illness I have, like Narcolepsy, pretty much says that I'm not supposed to drive. I think in some states they even take your license once you've been diagnosed with this type of disorder. Thank you for your comments. B)

Yes, he did.

I read here often, but post very infrequently. This may be a little long, so my apologies in advance. I recently (May 2007) had a C&P exam done in Columbia, SC for a possible increase in my benefits. I'm currently rated at 40%--30% for residuals of insomnia (persistent daytime hypersomnolence), 20% for cervical radiculopathy and strain with left upper extremity weakness, and 0% for left-sided sacroiliitis. After my initial claim was granted I had sleep studies and MRIs that showed that my 'insomnia' was actually a more serious sleep disorder called Idiopathic CNS Hypersomnia (similar to Narcolepsy, article here for anyone curious) and that I have Cervical Degenerative Disc Disease with loss of lordosis and also Lumbar Disc Disease. My new claim asked them to consider the new diagnoses for the sleep disorder and the arthritis. When I received the copy of my recent C&P exam for those conditions, I was unsure if what the doctor (Dr. Durkin) had to say was helpful or harmful in any way. He did not have my C-file when he did the exam, and it doesn't appear that he reviewed it afterwards. Some of the things he says are slightly inaccurate, such as that movements of my neck and lower back aren't painful. He also left out a statement that I made to the affect that I didn't believe I was currently able to hold employment outside the home because I didn't know of any employer that would put up with me falling asleep on the job. I would love to know what anyone thinks of whether his report will help or hurt my claim, and of the possible ratings for the conditions based on his report. I'm a little confused by how to interpret the ROM percentages, too. The diagnoses for the hypersomnia and arthritis are well documented with sleep studies and diagnostic imaging, as well as treatment notes from the sleep specialist and neurologist. The symptoms for everything and the ongoing treatment for those symptoms is also well documented in my SMRs. My claim went to the ratings board less than a week after my exam--May 18th, 2007 and it is still there. Thank you in advance for any advice/opinions. The report stated the following: This 29 year old white female, who is left-handed by her report, served in the active duty military from 05/99-05/05. She states that in 2004 while in military service she became extremely tired and had daytime sleepiness. She also sometimes does not sleep well at night and she attributes this in the past to her neck pain and more recently due to her low back pain. Apparently, she had a sleep study at night which was normal. The daytime study, however, showed a short sleep latency, and apparently a diagnosis of idiopathic hypersomnolence was made. She was placed on Provigil 400mg daily which helped some. She stopped the medication when she became pregnant. She states that she was screened for depression in the military, but otherwise a search for a psychiatric cause for her sleep disorder has not been made. The veteran states that she tries not to drive by herself because she is afraid that she will fall asleep driving. She has not had any motor vehicle accidents attributed to falling asleep. As far as her neck is concerned, it started bothering her in 2001 while in military service. She denies any injury and denies any problems with her neck prior to military service. She has neck pain which radiates posterolaterally down the left upper extremity into the thumb and index fingers. Her neck does not affect her ability to walk, and she denies any acute incapacitating episodes in the past 12 months in which a physician prescribed bedrest. She has never had any surgery on her neck but has had some facet joint injections which helped for about a month and a half. She states that she had an MRI of her cervical spine in 2006 in Lancaster, CA which showed facet joint disease and some bulging discs. She is not currently working. She has two children and is 30 weeks pregnant with her third child. When she was in the military she worked as an Avionic Sensor Technician doing electronic component repair. She states that the neck would interfere with any kind of work which required lifting more than 5-10 pounds. This limitation on lifting also affects her activities of daily living. She denies any flare-ups and does not use any assistive devices. As far as her lower back is concerned she began having pain in late 2004 and early 2005 while in military service. She did not have any injury. She denies any problem with her low back prior to military service. She complains of lower lumbar and midline and left sacroiliac pain which sometimes radiates posteriorly down the right thigh to the distal right thigh. Because of her low back, she does not walk any distances. In this way, her low back affects her ability to walk. She denies any acute incapacitating episodes in the past 12 months in which a physician prescribed bedrest. She has never had any surgery on her low back. Prior to her pregnancy, she took Ultram and Vicodin for her low back. Prior to her separation from the military her low back did not interfere with her work, but it seems to have gotten worse. She is concerned that if she were to work her limitation in bending and lifting due to her low back would cause a problem with her work. The limitation in bending and lifting does interfere with her activities of daily living, and her low back bothers her at night. She is pregnant at the present time. She denies flare ups. She does intermittently use a sacroiliac belt which helps a little. PHYSICAL EXAM: Well developed, obviously pregnant white female in no acute distress. Neurologic: She is alert and cooperative with normal speech. The cranial nerves are intact. Motor strength and tone are normal in all four extremities, although there is some incomplete effort in the left upper extremity. Her optic discs are sharp. Finger-to-nose and gait are normal. The deep tendon reflexes are 2+ and symmetrical in all four extremities. Light touch sensation is normal in all four extremities. Examiniation of the cervical spine reveals flexion to 40 degrees and extension to 35 degrees. Rotation is 40 degrees to the right and 45 degrees to the left. She can laterally flex 35 degrees in both directions. These are without pain and do not change with repetitive use on exam. There is no spasm or tenderness on palpation of the neck. Examination of the low back reveals flexion to 70 degrees. Again, she does have a large gravid uterus. Extension is to 25 degrees. Lateral flexion is 35 degrees in both directions. Rotation is 45 degrees in both directions. Lumbar range of motion is not painful. Cervical range of motion is likewise not painful. The range of motion of the low back is not additionally limited following repetitive use on this exam. There is no spasm on palpation of the lumbar musculature. She is tender over the left sacroiliac joint. Straight leg raising is negative bilaterally. Clinical and diagnostic tests: none are requested today. Diagnoses: 1. Idiopathic Hypersomnolence 2. Cervical degenerative disc disease 3. Lumbar disc disease 4. Left sacroiliitis Comment: The above diagnoses are based on the veterans history and the reports of tests in the general remarks section.

Terry, what kind of bloodwork are you suggesting? My primary care doc has done bloodwork for various things in the past, but are you thinking of something specific? Thanks, Jenn

I did have a C&P exam back when they were first deciding my claim, but that's not where the MRI came from. At my C&P they only did an X-RAY and the doc poked around for a few minutes and had me do some movements (I guess to check for ROM). The VA came up with the radiculopathy diagnosis on their own. I was a little confused about this, too, so after I got my award and saw what they had diagnosed I went to my primary care doctor on base and told him. He ordered the MRI that I posted the results from here. I still don't have a complete idea what the implications of this MRI are. I guess I will find out when I go to the neurologist next week. I don't know about the herniation issue and the radiculopathy diagnosis...I just know what kind of pain I have. I can't say why the MRI does or doesn't explain the symptoms, except to say that maybe they need to look at the rest of my spine, too? I thought that maybe the osteophytes and the bulge at C5-C6 might explain the left sided pain, but I don't know enough about spinal problems to say that for sure. Are you confused because I don't have any herniations? I thought that's what a bulge was, more or less? Like I said, I'm pretty uneducated about spinal issues. I just know I hurt. B) Thanks for the advice!

PS, I do think that Rosacea would fit the category of a chronic disease, so I'll look into that. I know it's definitely manifested at least 10% because it affects not only my facial skin, but my eyes. Thanks again.

I guess I'm confused about why you think the Idiopathic Hypersomnia is a new condition? It's not. The sleep issues have been ongoing for years, as documented in my service records. There just wasn't a good diagnosis of it yet, so the VA rated it as "Insomnia" at the time of my initial claim. They knew that a second sleep study was going to be done. There is some mention of that in my initial award. So really, I would just be submitting new information about the same issue I already had. Since IH is somewhat more severe than Insomnia, I was wondering if anyone had any thoughts about how they might rate it. It is sometimes called by doctors "Non-REM Narcolepsy." Also, why would a degenerative spinal condition only be a 0% SC? As above, this is only new information about a condition that I already had. They already knew I had neck/shoulder issues, they just didn't know that it was rooted in a disc disease. Can you please clarify your reasoning on this? Are you saying it would be a separate rating from the cervical radiculopathy rating? The rosacea thing, I admit I don't have a clue about how that would work. I spoke to someone at the VA yesterday, and he told me that yes, there was a one year period when any new conditions diagnosed were presumed to be service connected. I've only been out for 8 months. Maybe I misunderstood this...I'll do some more research. Thank you for your replies, and I'm sorry if I come across as ignorant. I'm trying to learn as I go. I have never had any problems with the VA to this point, and it only took them about 3 months to approve my initial claim. So maybe my problem is that I haven't lost faith in them yet. B)

Hello, I've been a member for a while here, but I've never posted. I would really love some input from you all about the best way to go about reopening my claim with the VA. As of right now I am rated at 40% total, which breaks down to: 30% for Insomnia, 20% for cervical radiculopathy and strain with left upper extremity weakness, and 0% for mild left sacroiliitis. The 30% for Insomnia was based on a sleep study that showed disturbed nightime sleep. No MSLT (daytime sleep study) was done at that time. The 20% for cervical radiculopathy was for left shoulder pain that I had been seen continuously throughout my military service for, but had never gotten a firm diagnosis. Now, here is where I have questions. Since being discharged in May 2005, my primary care doc (I am lucky that I am married to someone who is still active duty, so I still receive care in the base clinic) ordered an overnight sleep study with MSLT based on my continuing complaint of being constantly exhausted. Sleep issues/fatigue were well documented in my service records. The sleep study and MSLT found pathologic daytime sleepiness. My doc gave me the diagnosis of Idiopathic Hypersomnia. This is the first issue. Second, doc ordered a cervical MRI to try and establish a firm diagnosis, based on the VA opinion that I have cervical radiculopathy. The MRI findings were: Findings: There is a slight straightening of the normal cervical lordosis. The signal of the spinal cord is normal. There is no evidence of tonsillar herniation. All cervical vertebral bodies are normal in height and contour. C2-C3 and C3-C4 show no significant disc bulge or disc herniation. The central canal and neural foramina are patent. C4-C5 shows minimal disc/osteophyte complex posterocentrally. This is better visualized on the axial images. No significant central canal or neural foraminal narrowing is identified. There is left uncovertebral hypertrophy. C5-C6 shows bilateral uncovertebral hypertrophy, which is more prominent on the left. There is superimposed bulge. No significant central canal or neural foraminal narrowing is seen. C6-C7 and C7-T1 normal Impression: Minimal Spondylitic disc disease of the cervical spine, predominantly at the level of C5-C6 and C4-C5. My symptoms are neck/left shoulder/shoulder blade/left arm pain, numbness, tingling, burning. Weakness and shakes in the left arm at times. I am 28 years old, and these symptoms began when I was 23. It is well documented in my service records, just no diagnosis. I have an appointment with a neurologist in a week. This is issue #2. Third, my primary care doc just diagnosed me with Rosacea. I have an appointment with a dermatologist on Monday. Okay, the questions are: How do I go about submitting this information? One of the conditions is completely new (rosacea), but since I've been out for less than a year there will be a presumptive service connection, correct? When I go to the dermatologist and neurologist what information should I get from them to submit? Keep in mind these are not C&P exams, so the drs. will not be going by VA protocol. Do I ask them to write some sort of statement of their diagnosis? Any thoughts on what the heck my MRI findings mean? Has anyone had any experience with "spondylitic disc disease" (whatever that means--is that DDD, DJD, IDD, arthritis???), "Idiopathic Hypersomnia" or any similar sleep disorders, or "Rosacea?" If so, what ratings did you get or what ratings would you expect me to get? Increase of current rating, decrease? I think that's all my questions. Like there weren't enough of them, right? B) Any who read/respond, thank you, thank you, thank you. I know I just wrote a lot of information to wade through but I wanted to try to give all the pertinent facts. If anyone needs more information to answer any of my questions, please let me know. Thank you,