ptsd Sleep Apnea

[Ruffcreek]

I received a rating of 50% for PTSD in 2006. (This has been recently increased to 100%)

I submitted a claim for sleep apnea secondary to and/or aggravated by service connected PTSD on October 23, 2007.

On my recent decision this is what they wrote:

Service treatment records do not show treatment for or dianosis of sleep apnea in service. The medical report from DR.XXXX relates that your sleep apnea was aggravated by your PTSD. Copies of sleep studies you submitted shwo that you are currently on a CPAP machine at night. VA respiratory examination was normal.

The effective date is October 23, 2007, the date of claim.

Service connection for sleep apnea has been granted because this condition, which was not incurred or aggravated in military service, permanently worsened as a result of a service connected condition. The difference between disability evaluations before and after military service determines the degree of disability subject to service connection. Prior to aggravation by a service connected condition, the disability was considered 50% disabling based on evidence that showed you had obstructiive sleep apnea and were placed on a CPAP machine. Following aggravation, the total disability is 50% disabling because this evaluation granted for being on a CPAP machine. The preaggravation percentage is always deducted before assigning any service-connected evaluation less than 100%. So as the preservice aggravation was 50% disabling and the current condition is 50% disabling, service connection for sleep apnea as aggravated by your PTSD is granted as 0%. Your current condition does not meet the criteria for the 100% evaluation as shown below.

The rating criteria for sleep apnea is: An evaluation of 30% is assigned for persistent day-time hypersomnolence. A higher evaluation of 50% is not warranted unless a breathing assistance device, such as a continuous airway pressurer (CPAP) machine, is required. A higher evaluation of 100% is not warranted unless there is chronic respiratory failure with carbon dioxide retention or cor pulmonale, or a tracheostomy is required."

If anyone can clarify for me what they are saying about how they are figuring the %, I would appreciate it.

Thanks,

Ruffcreek

[Pete53]

They rated you at 30% cause you do not use a CPAP machine but they opened the foor for you to go to 50% if they give you a machine at the VA.

If you have sleep apnea a CPAP would be a good thing for you. Does not mean you will get any more money though.

[Ruffcreek]

Pete53,

But as stated in 4th paragraph down I am on a CPAP.

Ruffcreek

[LarryJ]

"Service treatment records do not show treatment for or dianosis of sleep apnea in service. The medical report from DR.XXXX relates that your sleep apnea was aggravated by your PTSD. Copies of sleep studies you submitted shwo that you are currently on a CPAP machine at night. VA respiratory examination was normal.

The effective date is October 23, 2007, the date of claim.

Service connection for sleep apnea has been granted because this condition, which was not incurred or aggravated in military service, permanently worsened as a result of a service connected condition. The difference between disability evaluations before and after military service determines the degree of disability subject to service connection. Prior to aggravation by a service connected condition, the disability was considered 50% disabling based on evidence that showed you had obstructiive sleep apnea and were placed on a CPAP machine. Following aggravation, the total disability is 50% disabling because this evaluation granted for being on a CPAP machine. The preaggravation percentage is always deducted before assigning any service-connected evaluation less than 100%. So as the preservice aggravation was 50% disabling and the current condition is 50% disabling, service connection for sleep apnea as aggravated by your PTSD is granted as 0%. Your current condition does not meet the criteria for the 100% evaluation as shown below."

Well, actually, what they are saying is:

1. Your SMR's do not show treatment for sleep apnea in service.

2. They are granting you sleep apnea, not because it occurred in service, nor worsened in service, but because it "permanently worsened due to the result of a service connected condition.

3. They are saying that, PRIOR to aggravation by a service connected condition, that upon evidence that you had sleep apnea and were placed on a CPAP machine, PRIOR to Aggravation By

A Service Connected Condition, and that your disability was considered 50%.

4. Then they say that, seeing as how you now have an Aggravation, caused by a service connected condition, that that Aggravation is ALSO rated at 50%, and, seeing as how they have to take into consideration the amount of (percentage of) disability BEFORE your service connected disability caused your CURRENT amount of disability, and seeing as how they have determined that you were "considered 50% disabled" BEFORE your service connected disability caused you to be rated at 50% disabled NOW, that it's just, simply, "a wash". 50% minus 50% = NADA.

Now, I have a headache, and I'm gonna take two Tylenol, and if you're not better, then don't call me in the morning, for I will have had a PRE-existing aggravated, non-prior to service connected disability of 0% percent..........ahh, heck, Larry, just have a beer. OKAY! Doc, think I will just have me another of those big orange drinks.....!

SHEEESH!

[LarryJ]

That is SOME convoluted reasoning, I know. Kinda like their reasoning for NOT granting me TDIU. YES, it's true that you have a 20% service-connected disability.

YES, it's true that you have a 70% service-connected disability.

BUT, you could "get better", then you wouldn'd have a 20% or a 70% service connected disability, you could just have a 10% or a 30% instead of the 20% that you could have even if the 70% turned into a 50% or 30%, someday, maybe, in the future so you can't have TDIU because you could get better, or you could just freakin die, in which case don't you see how much better off you'd be, just getting 20% and 70%?

You DO UNDERSTAND, don't you?

:P

[Ruffcreek]

Larry,

I'll drink to that!!

Couldn't have said it better myself!

Thanks

Ruffcreek

[LarryJ]

In their denial, they are making the determination that you had sleep apnea prior to you being diagnosed for sleep apnea. Let me see if I can make this any clearer (for me, not for you!).

You must have had sleep apnea, BEFORE induction. They (the VA) must have had some kind of evidence that you had sleep apnea prior to service. If this is the case, then they are saying that the sleep apnea that you had, prior to service, was as bad as the sleep apnea that you now have.

IF, on the other hand, you DID NOT have sleep apnea prior to service, then the Presumption of whatever-they-call-it, comes into play, meaning that you MUST have been just fine, health-wise, otherwise why would they have allowed you to enlist? And, if that is the case, then your sleep apnea could have been rated at no more than 0%, BECAUSE THEY ACCEPTED YOU INTO THE MILITARY, THEREFORE THERE WASN'T ANYTHING WRONG WITH YOU.

However, if they are saying that you were being treated for sleep apnea, while you were in the service, then you didn't "get" sleep apnea FROM the service, that it just apparently "occurred", not fault of theirs.

But, then, that argument does not hold up, BECAUSE THEY HAVE DIAGNOSED YOUR SLEEP APNEA AND THERE MUST BE A "NEXUS" BETWEEN YOUR SLEEP APNEA AND YOUR PTSD, OTHERWISE HOW CAN THEY SAY THAT YOU HAVE SLEEP APNEA AND YOUR DESERVE 50% DISABILITY, BECAUSE IT IS AGGRAVATED OR CAUSED BY YOUR SERVICE CONNECTED DISABILITY, PTSD. But, because you were being treated for sleep apnea in the first place, then the sleep apnea that you now have is NO WORSE than the sleep apnea that you had to start with.

Who the HECK was/is treating you for sleep apnea, BTW? I mean, BEFORE you actually had sleep apnea, service-connected-wise?

Anyway, you need to ask for a de novo DRO review and get your Service Organization or your POA, whichever, involved. Because this is going to require a "I see your face" meeting of the minds, simply because it is NEVER going to be able to be handled via the written word.....BECAUSE their reasoning is INCOMPREHENSABLE as it now stands.

All the above is just a fig newton of my imaginary powers and should not be construed as anything understandable, and I didn't come here so I ain't leavin'!