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Found 7 results

  1. Hello group - I had a sleep study in 2007 while on active duty and got diagnosed with "mild obstructive sleep apnea." There was no treatment provided/necessary. I retired from the Navy in 2017 after 25 years of active duty and submitted the sleep study in my claim. Unfortunately, I did not have documented proof of hypersomnolence. In May 2018 I had another sleep study with the result being "severe obstructive sleep apnea," and was prescribed a CPAP which I use currently. This particular evidence was not submitted in my claim package. I just received my VA decision letter on 10/4/18, the VA assigned a disability rating of 0% for the apnea (as expected), but listed it as "service connected." My question is this: I have the medical evidence now to prove I have severe apnea and I'm getting ready to submit a NOD. Do I have to also prove "service connectivity?" or has this been sufficiently established and cannot be taken away by the DRO? Also, do I have to provide evidence that I had hypersomnolence from 2007 to 2018 to prove it's all connected? This will be the tough part for me. It seems pretty straight forward, but I know nothing is ever a slam dunk in this arena so what am I potentially missing? Thanks! Joe
  2. Back in May 2015 had a IME/IMO exam and was told I should put in a claim for deviated septum cause I had surgery for same while on active duty and again the same exact surgery in 2009 at VA. I had no intention of applying for it until it was brought up. I went ahead and submitted and it got denied, did an NOD and still sitting in Appeal now. I have not had any additional deviated septum surgeries since filing (2015) and no more clinical indications another surgery is needed therefore MY QUESTION: (1) Does the fact I have had two surgeries mean anything as far as service connection goes or.... (2) is this just a lame duck I should cut loose since no more surgeries have occurred since 2009. Final question, if still sitting and waiting on multiple Appeals does dropping one of those Appeals speed the others along any faster or does it even matter? Can those on Appeal be processed individually at any point in time that RO decides to overturn same..... or do they wait until all of the Appeals made and filed together are fully decided one way or another? Just seeking some opinion on this from more seasoned folks in Forum.
  3. I still active in the ARMY. Im been using my CPAP machine for more than a year. I got the machine because the ARMY send me to the hospital because I cant sleep. The hospital exam show that I have a moderate condition. The question is, Can I request another sleep study exam? If so, How long I have to wait? Maybe if my condition is worse I can get a 100% when I get retired.
  4. Hello HadIt Community, TL:DR Skip down to bold section “So that brings us to today….” I've been a bit of lurker on the forums, searching and researching information already presented, hence the lack of postings. I was not quite sure where to post this, in the “Appeals” section or the “Disability and Claims” section.” I decided on the “Appeals” section due to the fact that the claim was already submitted and decided on, and so the next step logically would be an appeal. Moderators, if it needs to be moved, please move it to the correct section. I know that there is a lot of postings, questions, and information in regards to sleep apnea and trying to get it service connected, namely to PTSD and/or TBI. I hope that by sharing my path/progress it will help others who are in a similar situation. I am SC for TBI (70%), PTSD (50%), Mechanical neck pain syndrome (10%), tinnitus (10%). Total combined rating with fuzzy math puts me at 90%. This path of medical issues and nuances began in 2007 when I was in the Marine Corps, and it has taken my up until this year to really get most of my issues addressed and sorted. What delayed the entire process would be attributed to not knowing the secondary effects to injuries. Certain things were obvious (a head injury has secondary consequences like memory issues), but other things (namely the PTSD) were not. The VA, for me, has done an excellent job in diagnosing things, as well as the therapy afterwards. I know that this is not the case for everyone, but I was persistent and proactive towards trying to learn about myself and the changes I was going through and had been through. Not having considered PTSD as a problem for me (denial maybe?), I had attributed everything (headaches, poor sleep, attention problems, behavioral changes) to the head injury. Turns out that a lot of the symptoms of TBI are shared with PTSD, making treatment harder. Is the poor sleep because of the head injury or the PTSD? If the memory and lack of focus because of the head injury or the PTSD, etc. It took me a year and a half, after 6 months of initial therapy, to go through the medicine trial run. Try different medications, see if I feel any different. If I do, do I feel better? Once the right medicine is found, then it’s about finding the best dosage for me. Because everyone is different, and we are all wired differently, no 1 chemical will react the same way for everyone. At times, it felt that nothing was really working, and it didn’t help that the trial period takes time for your body to adjust to the new drugs. But with an open line of communication with my psychiatrist made it easier to track changes and make the changes so that I felt better. For me, it’s been a night and day difference. Looking back and remembering how I felt, it was almost as if my brain was in a constant fog. I was awake and aware of things, but almost as if things were in a dream-like state. I don’t know how else to describe it, but it felt like the drag I had on my mind and shoulders was eased. There are still bad spells and moments, but that is where the discipline and focus really comes into play. It hasn’t been easy, and I can’t even begin to imagine how it is for those who have a bigger challenge than I. But what I do know, is that you need to be wanting to make things better for yourself. It’s a bit of a process. Therapy isn’t the easiest, as you need to revisit certain areas in your life that you don’t want to. It takes time, and you feel quite low during certain times. In some ways, it allowed me to learn more about myself, and what I needed to do and go through to make myself better (know yourself and seek self-improvement…). But it gets better, I promise. Biggest takeaway from disability claims with the VA, is to make sure you have your paperwork in order BEFORE you submit things. At the beginning I did not know what I had, how the VA system worked, or anything at all. So my first claim consisted of: neck pain, lower back pain, headaches, memory problems. Very broad and generic symptoms. They were denied, but through the intake process, I did learn that I should talk to the VA clinic, namely the poly-trauma area to have my TBI assessed. From there, it was evaluation after evaluation to try and get an answer as to why I was having problems. TBI led to tinnitus and neck problems. TBI therapy then lead to depression screening which led to PTSD screening. PTSD screening then led to therapy. Once those two main areas (TBI and PTSD) were stable enough for me, I started to address other issues, namely sleeping problems. Headaches every day when I wake up, cold sweats every other night (changing sheets couple time a week….), nightmares. I had attributed all those symptoms to the head injury, but that was when I had learned that it could be partially the head injury, and partially the PTSD. More research lead to asking for a sleep study done. I figured that if there is something going on while I sleep, maybe it’ll show up on the results and give me a better idea to what’s going on. Having a better idea, it would allow me to attack the problem from a different angle. I found that throughout the entire VA process (starting in 2007), the best way to tackle things is to focus on it like a puzzle. Define the problem, get a better idea of what it is, and this then leads to knowing how you can attack it head on. I don’t know what exactly I was expecting out of the sleep study, but I certainly did not think that I would have an issue with breathing while I sleep. I had assumed that my combination of injuries was manifesting itself while I was sleeping (my most relaxed state). Long story short with my sleeping habits from the past, the sleep study showed that I had mild sleep apnea, namely obstructive sleep apnea. CPAP machine was then issued. Now to me, that didn’t make any sense at all. I don’t fit the OSA poster-boy, at all. Overweight? Thick neck? Older? I’m 28, 6’, 165 lbs. But I had some answers. My shallow breathing would cause decreased oxygen intake which causes an increase in CO2 in my blood. Heart pumps faster, fight/flight response starts, body is working harder to supply blood to muscles, cold sweats start to try and dump CO2. Then I wake up and I have to go use the bathroom, 1-2 times per night. I just figured I was well hydrated…haha… With the answer of sleep apnea of the obstructive kind, I started to research causes for it, and correlations to different injuries. One thing leads to another and there are correlations between head injuries and PTSD. So at that point (more answers…yay), I go back to VA research and learn that there can be claims filed for OSA. Since I was diagnosed with OSA outside of service, then I would need to either prove it happened while I was in (no evidence, so scratch that), or have a secondary connection to a service connected disability. Seeing that I was SC for TBI and PTSD, that would be the route I would take. What this meant was that I would need to present information to the VA showing a correlation between the injuries, and have the weight of a doctor behind it. I made sure to file an Intent to File notice so that my date was locked in for retroactive pay. With this date locked in, I needed to go about finding information on IMOs. Researching and learning, I decided to go with Dr. Anaise and get an Independent Medical Expert Opinion. $1500 later I had a nice sizeable book with him stating (and with evidence too) that he opined that it is more likely than not that my sleep apnea is secondary to my service-connected PTSD, TBI and tinnitus. With my new information and medical opinion in hand, I submitted a Fully Developed Claim, since I had no more information to submit (IMO from private doctor, and the VA had all my medical records including the sleep study). 6 months of waiting and checking eBennies (torture….) and it finally finished and showed that a decision had been made. Paperwork comes in the mail and the claim is denied… Frustrated? Not really, since I had expected that it would be denied. Most claims, unfortunately seem to be denied the first time around. Bit let down sure. But it is what it is, I can’t change that, so now time to look at how to keep pushing forward. So that brings us to today…. I do plan to submit a Notice of Disagreement to have it reviewed again. I have been told that the reviewal process is in the time length of 2-5 years (frustrating but backpay will be nice…). My posting on HadIt is based on wanting to get other people’s input and a fresh set of eyes on the information I have and what the next steps are, different viewpoints, and maybe anything I missed/am missing, as well as posting my information and path on here for others to read and learn from. Medication: Venlafaxine 300mg for PTSD Zolpidem Tartrate 5mg for sleep (Ambien) -------------------------------------------------------------- VA Decision letter verbatim: Issue/Contention sleep apnea Explanation The evidence does not show that sleep apnea is related to the service-connected condition of traumatic brain injury, nor is there any evidence of this disability during military service. Service connection for sleep apnea is denied since this condition neither occurred in nor was caused by your service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show an event, disease or injury in service. The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. The VA examiner stated that your current sleep apnea is due to the airways in your throat relaxing too much to allow normal breathing and closure of your muscles than your service connected TBI, tinnitus, and/or PTSD. ------------------------------------------------------------------------------ VA Examination I was not there for the exam because verbatim: [X] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. Verbatim: MEDICAL OPINION SUMMARY ----------------------- opinion ---OSA 2/2 to PTSD LESS LIKLEY THEN NOT THE OSA IS 2/2 TO PTSD -- RATIONALE --OSA IS A OBSTRUCTIVE DEFECT Obstructive sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These muscles support structures including the soft palate, the uvula ? a triangular piece of tissue hanging from the soft palate, the tonsils and the tongue. When the muscles relax, your airway narrows or closes as you breathe in and breathing may be inadequate for 10 to 20 seconds. This may lower the level of oxygen in your blood and cause a buildup of carbon dioxide. Your brain senses this impaired breathing and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it. You can awaken with a transient shortness of breath that corrects itself quickly, within one or two deep breaths. You may make a snorting, choking or gasping sound. This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you'll probably feel sleepy during your waking hours. People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, many people with this type of sleep apnea think they slept well all night /es/ *Name removed* FNPC PRIMARY CARE PROVIDER -------------------------------------------------------------------------- IMO excerpts verbatim “After reviewing the veteran’s c-file and the pertinent recent medical literature, I opine that is more likely than not that the veteran’s sleep apnea is secondary to his service connected PTSD, TBI and tinnitus” “After reviewing all of the veteran’s medical and military records, it is my expert medical opinion that it is more likely than not (50% or more) that the veteran’s sleep apnea is secondary to his service-connected PTSD and TBI. The scientific observation that the derangement of REM sleep prominent in the PTSD patient is the cause for sleep apnea is of particular importance in this case. It is more likely than not that the veteran’s sleep apnea is secondary to his service-connected tinnitus.” --------------------------------------------------------------------- The report is 7 pages long with 5 5 exhibits of evidence (scientific journal reports). If needed for better clarity, I can scan the 7 pages in (edited for privacy). I can also post the findings from the sleep study if needed as well. I don’t want to provide my thoughts and input on this just yet, as I would like to see what the community’s thoughts are on where things are so far, based on what there is. What I ultimately am looking for, besides getting my claim granted, is to gain a better idea of what route I should take based on what I have. The VSO who I was working with suggested a simple medical statement that says my medication for PTSD affects my OSA (throat muscles relaxing), was also recommended to have a DRO review the case (instead of a RO?) since it might speed up the process because it was more ‘in-house’. De Novo review? CUE? Thank you in advance for your thoughts, view points, and suggestions The CPAP machine, took a bit of time getting used to, but it is a night and day different (no pun intended ha). The nightmares are less, the cold sweats are essentially gone, morning headaches aren’t there, and I feel rested now when I wake up and throughout the day. Getting sleepy while driving isn’t there anymore. I wanted to see its effectiveness, so I decided to try sleeping 2 nights without the mask, and the first night, instantly the prior symptoms came back. Headaches, cold sweats, over tired all day. My conclusion, from my personal experience, is that if you have PTSD, TBI or both, get a sleep study done. There is strong enough correlation between the three to have symptoms overlap and exacerbate one another. I may not know the exact scientific workings behind it, but logically it makes sense. PTSD or TBI, get testing and therapy done to better understand the challenge that YOU have, and how to better work through/around/over it. If they recommend medication, ask why. Not to push back against it, but so that you understand what the purpose of it will be, how it will help you. Self-knowledge and self-learning are very important in order to have a better grasp of things pertaining to you. Be patient with medication, and be honest with your prescribing doc. Everyone reacts differently to medication, and only YOU can determine how you feel. I might even recommend keeping a small journal of how you FEEL throughout either therapy or medication trials. Be patient with your meds. Medicine doesn’t work overnight, especially finding the right one and dosage. Be patient with therapy. Not during therapy necessarily, but in the length of things. It takes time depending on severity. You will feel worse some days more than others. Therapy, like medicine, is unique to YOU. What worked for me, may not work exactly (or at all) for you. But you need to be honest with yourself and with your guides (therapists and docs). I had a small ‘good luck charm’, a grounding tool, that I would touch and hold when my mind would start to wander. Helped to keep/bring me back to reality. Grounding techniques worked wonders, but you need to be disciplined about it. My good luck charm was a 550 cord bracelet I made when I was in. Feeling the knots and mentally talking to myself kept me ‘here’. Doesn’t have to be something big. Just a small item that has meaning and significance to YOU. You don’t even have to tell people what it is or does or anything. But it gets better, I promise.
  5. Good Evening Team HadIt and the Community Members, It has been a LONG TIME since I've posted or commented. Been staying busy and trying to Live "One Day at a Time" Question, this past June I applied for a Few New Service Connected Disabilities and to re-open a Claim for Sleep and Hemoroids. Well, the Great News is that (1) one of my Disabilities has increased from 10 to 20, received a New Rating for one @ 10% and another @ 20%. Honestly, I didn't think either one of those would get rated and that the Sleep and Hemoroids would. I was Denied Service Connected for Sleep and Hemoroids and when I originally Filed in August 2005, I was denied after receiving my Rating in 2006 - BUT, I did not appeal the Decision during that (1) one year period due to "Lifestyle" Choices I made - i.e. Drug & Alcohol Abuse, Homelessness, etc. So, I had no idea how to appeal, couldn't get to a VA Facility if I could, and Honestly, never received a Letter to Appeal. I just finished combing through my Military Medical Records, because I knew I had been seen for Sleep and Hemoroids/Rectal Bleeding while in Service - and wouldn't you know it, I found at least (1) complaint of me telling the Doctor I had problems sleeping and Mulitple about Rectal Bleeding. I'm going to make copies and HIGHLIGHT those notes on my Medical Records and send in my Letter of Disagreement. Is there anything else I need to do or anything else I need to know about? Do I need to get a Service Representative? This will be my first appeal and have had Success with all my other Claims and Increases. I'm currently rated at 90% - and I believe the Sleep & Hemoroids would put me over the Edge and at 100% - for me, it's not about the $$$, but the VA and Military Recognizing that this is a Service Related/Connected Issue. Thoughts?
  6. The Veteran is SC'd for TBI. A VA sleep study indicated central sleep apnea. Assuming a nexus has been medically determined between the TBI and the central sleep apnea: Questions: 1) Is central sleep apnea (CSA) a separate ratable neurologic brain disorder apart from TBI or is it rolled into the TBI rating? and, 2) While obstructive sleep apnea (OSA) is considered and rated as a respiratory condition, why is that the same for CSA, which has it's etiology associated with an organic brain dysfunction?, Should CSA be considered a "chronic sleep impairment" to be rated analogous to a sleep impairment a mental health condition like PTSD, depression or an anxiety disorder etc. might cause? ( 6847) Sleep Apnea Syndromes (Obstructive, Central, Mixed)
  7. While this isn't particularly new news, there is a large story in USA Today 07/23/2014 page 6B by reporter Nanci Helmich mentioning solid medical research that links sleep deprivation to weight gain: "Losing sleep doesn't just leave you tired--- it can make you fat." This is due to how sleep deprivation affects certain hormones namely increasing ghrelin and decreasing leptin. Therefore, the connection of sleep apnea causing weight gain and even diabetes should be a no brainer and service-connecting weight gain/obesity or perhaps diabetes and hypertension as secondary conditions to a sleep disorder could be claimed. I realize that this is sort of a what came first issue: the chicken or the egg? However, if you started out thin/normal weight and then developed sleep apnea which led to weight gain, it would seem that there may be the basis for a well-grounded claim in the absence of other weight causing factors. Remember, not all sleep apnea is OSA / obstructive...there are also central or complex/mixed types as well. More info on this issue at: http://health.howstuffworks.com/mental-health/sleep/disorders/sleep-apnea.htm Also see slide #19: http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0CCMQFjAB&url=http%3A%2F%2Fweb.stanford.edu%2F~davesv%2FWeight%2520%26%2520OSA.ppt&ei=-krQU9ydIs6iyATHiIHwCg&usg=AFQjCNFnDNcnaMb34bJh1yZoccIA9kQB7Q&bvm=bv.71667212,d.aWw
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