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

[jbasser]

Sleep APnea most likely did not preceed service for this man. When you are in service you are fairly fit unless you have been in for a long while and nearing retirement.

Im My opinion : This is a secondary claim to ptsd and should be connected as such.

Hold the phone. The Rater just hung himself.This ticks me off to no avail.

He stated you were using a CPAP machine and then he said you were not.

Send in a NOD of this and ask them to rate this claim correctly. Also ask them how can this possibly be correct if the rater admitted you were using a Cpap just sentences above.

Show them both statements. Big, Bold. Ask them to please fix this CUE right now. It is a CUE.

The ro has admitted CPCP use and CUED for not applying the proper rating criteria thus issuing a lower rating to the Vet at the 30 percent criteria.

You should be 50 percent for Sleep Apnea. That is your Max unlss you have right side heart failure.

If the decision is final, File off a Cue claim ASAP. Copy the rating criteria for 50 percent, Send it in with the RO's statement.

If you have 100 percent single rating and other ratings totalling 60 percent you qyalify for housebound or SMC S. Around 300 per month.

J

Edited August 19, 2008 by jbasser

[Ricky]

The questions that I would have after reading your post would be:

-When did you develop OSA?

-Did you have OSA which was not service connected and then your ptsd aggravated it then you filed a claim for aggravation?

-Or did you develop it, file a claim for it as secondary to your ptsd? Big difference in aggravation and secondary to!

If you were attempting to claim osa secondary to your ptsd then they misunderstood what it was you were trying to do - also this doc statement that your ptsd AGGRAVATED your osa did not help clarify things.

The way they rated it is as though you developed osa which was not service connected then you filed a claim stating that your ptsd has now aggravated it. Then they provided that your medical evidence provided that you were on cpap for this non-service connected osa (which would have been rated as 50 percent, the max for cpap use) -----then you filed a claim and ask that it be service connected because your ptsd aggravated it. They agreed but the max allowed for cpap is 50 percent. Under the aggravation rules they must deduct the prior level of disability for a non-service connected disability from the max allowed if they service connect it. The max sc percentage for osa with cpap is 50 percent so as already provided 50-50 = 0.

If you were claiming it as secondary then you need to reword your claim, get a new imo indicating that it is SECONDARY and due to your ptsd and not aggravated by.

[jbasser]

Ricky you on Key. I May add that the VA in Agravation cases states that claims are only awarded to the extent of the agravation.

Get a Doc to clealr this one uo,

J

[LarryJ]

The questions that I would have after reading your post would be:

-When did you develop OSA?

-Did you have OSA which was not service connected and then your ptsd aggravated it then you filed a claim for aggravation?

-Or did you develop it, file a claim for it as secondary to your ptsd? Big difference in aggravation and secondary to!

If you were attempting to claim osa secondary to your ptsd then they misunderstood what it was you were trying to do - also this doc statement that your ptsd AGGRAVATED your osa did not help clarify things.

The way they rated it is as though you developed osa which was not service connected then you filed a claim stating that your ptsd has now aggravated it. Then they provided that your medical evidence provided that you were on cpap for this non-service connected osa (which would have been rated as 50 percent, the max for cpap use) -----then you filed a claim and ask that it be service connected because your ptsd aggravated it. They agreed but the max allowed for cpap is 50 percent. Under the aggravation rules they must deduct the prior level of disability for a non-service connected disability from the max allowed if they service connect it. The max sc percentage for osa with cpap is 50 percent so as already provided 50-50 = 0.

If you were claiming it as secondary then you need to reword your claim, get a new imo indicating that it is SECONDARY and due to your ptsd and not aggravated by.

Or, like I said.........NOW, that it's just, simply, "a wash". 50% minus 50% = NADA.

[Ricky]

Or, like I said.........NOW, that it's just, simply, "a wash". 50% minus 50% = NADA.

Larry your post did not show on my computer - sorry- you are right it is a wash but he needs to decided what he was trying to do.

[Ruffcreek]

The questions that I would have after reading your post would be:

-When did you develop OSA?

-Did you have OSA which was not service connected and then your ptsd aggravated it then you filed a claim for aggravation?

-Or did you develop it, file a claim for it as secondary to your ptsd? Big difference in aggravation and secondary to!

If you were attempting to claim osa secondary to your ptsd then they misunderstood what it was you were trying to do - also this doc statement that your ptsd AGGRAVATED your osa did not help clarify things.

The way they rated it is as though you developed osa which was not service connected then you filed a claim stating that your ptsd has now aggravated it. Then they provided that your medical evidence provided that you were on cpap for this non-service connected osa (which would have been rated as 50 percent, the max for cpap use) -----then you filed a claim and ask that it be service connected because your ptsd aggravated it. They agreed but the max allowed for cpap is 50 percent. Under the aggravation rules they must deduct the prior level of disability for a non-service connected disability from the max allowed if they service connect it. The max sc percentage for osa with cpap is 50 percent so as already provided 50-50 = 0.

If you were claiming it as secondary then you need to reword your claim, get a new imo indicating that it is SECONDARY and due to your ptsd and not aggravated by.

Ricky

My OSA was diagnosed in October of 2007. In that same month I filed a claim "for Sleep Apnea secondary to and/or aggravated by service connected PTSD."

In January 2008 my doctor, a Pulmonary Specialist wrote a letter for me stating it is his opinion that my sleep apnea is as least as likely as not aggravated by my service connected PTSD. He also stated that it at least as likely as not that my PTSD is aggravated by my obstructive sleep apnea.

So I guess what you are saying is that I will need to get my imo stating that it is secondary and due to ptsd and not aggravated by ptsd correct?

Thanks for everyone's help.

Ruffcreek