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Qq To Dr. Tayo - Sleep Apnea Claim

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bob_abad

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I would like to do this upcoming Reopen Claim correctly.

You think I will be okay to reopen claim for Obstructive Sleep Apnea(OSA) as secondary to DM-II, Diabetic Neprhopathy, Tinnitus, & Hypertension service connected? My ED(SMC) was recently approved also.

Been diagnosed with Sleep Apnea since Y2002. VA has all my sleep related medical records, and they have been supplying me w/ masks/tube/filters parts as needed. I am also scheduled to receive a new CPAP equipment(VA=>Apria Health Care=>Bob) this coming Friday(12/26/08). I was originally denied(NOD) less than 2 years ago, as I applied for OSA as secondary to AO exposure..Lesson learned from this one!

Hope to hear from you or from others also. Thanks in advance.

From Bob,

4th Inf. Div; Central Highland Campaign

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Before I ran into hadit(two years ago), I found numerous info from internet(searched "sleep apnea secondary to Agent Orange"=>google, others..). There were so many things I did not know about at that time. Like the VA internal search, WARMS, forums, few advocate sites, cybersarge, etc..

Saw this one after I submitted my original claim...This was my similar claim thought process.

http://www.va.gov/vetapp03/Files/0317109.txt

From Bob,

4th Inf. Div; Central Highland Campaign

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Before I ran into hadit(two years ago), I found numerous info from internet(searched "sleep apnea secondary to Agent Orange"=>google, others..). There were so many things I did not know about at that time. Like the VA internal search, WARMS, forums, few advocate sites, cybersarge, etc..

Saw this one after I submitted my original claim...This was my similar claim thought process.

http://www.va.gov/vetapp03/Files/0317109.txt

This case is a denial. However, it does mention that it MAY be plausible had the veteran submitted direct medical evidence of an association between AO exposure and OSA. Can you the evidence that you referred to?

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Hello,

I read both of your correspondences. I must admit that I don't know much about AO.

However,,, lets talk about OSA possibly secondary to DM-II, Diabetic nephropathy, Tinnitus and HTN.

First,,, lets eliminate the Tinnitus. I personally cannot find a connecting.

Now, the diabetic nephropathy is because the DM-II.

HTN and OSA,,, maybe there is a possibility but,,, once again,,, that is hard to associate HTN and OSA.

That leaves DM-II. Lets look at DM-II as adult onset diabetes. With that said,,, if caught early and depending on A1C count, etc.,,, treatment can be diet and exercise. Okay,,, if that doesn't work,,, then pill, then insulin.

With that in mind,,, Normally, not all,,, patients with DM-II are a little over-weight. Remember, not all.

That brings about weight. As with DM-II, OSA can also be associated with weight gain. But, still,,, that does not make OSA secondary to DM-II.

What makes me think is that OSA would be more secondary to weight gain or other ailments like hypothyroidism, etc. etc. etc.

I'm sitting here thinking but,,, I can't figure out how to associate the two. Even if you are not holding a few extra pounds and still developed DM-II,,, I'm trying hard,,, but I still can't see the connection.

Maybe you should ask your Endocrinologist or primary care-giver if they can find a strong correlation,,, meaning, OSA secondary to DM-II.

I am so sorry. I will also look in my books to see if I can find something. Does anyone else have any ideas?

Tayo

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