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Question About Decision And Septum, Also Sleep Apnea


yelloownumber5
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Question

I have a few questions of course and please bear with me.

VARO Decision Dated 28 Feb 2005

My decision I attached. First the three I'm asking about were not appealed because of my lovely County VSO.

Item 7 of my decision is Approval for Allergice Rhinitis and they say "septum was midline". It also states about my septoplasty surgery.

Item 9 of my decision is Denial for Deviated Septum, which it states denied because not shown caused from trauma. However, it does say on this a cyst was "more than likely the cause of

sinus infectons"

This cyst is still there

Item 10 of my decision is Denial for Sinusitis, which it states "ct in Nov 2002 did not show chronic sinusitis was the cause of sinusitis", The main cause of sinusitis was deviated septum"

(not to be anal but I did not have a CT in Nov 2002 but a MRI in 2001.......my doctor did write a note in Nov 2002 on my med form 800 or whatever wondering if I had a cyst or polyp......)

I'm still confused because same exam right....Item 7 says septum midline then Item 10 says deviated.

Enclosed is a ENT exam dated 27 Sep 2005 (not Feb that I named the file)

The ENT States Septum Midline

Enclosed is my Septoplasty copy

I also have a question about my sinus surgery. While on active duty I did have surgery because of Daytime Fatigue, problems breathing but

does anyone know what the Pre Op and Post Op diagnosis of SAA Stands for?

Finally I attached a copy of my sleep study........

A concern was under the assesment the doctor put "weight" then"nasal obstruction" but under the sleep eval he notes i have a deviated septum with no history of a fracture but had septoplasty surgery in the past. That part kind of concerned me the VA would say sleep apnea is due to deviated septum.

I do have some documentation as long with the surgery note........

Quesitons are

What is up with that decision in regards to the "deviated" and "midline" septum. Is that some kind of error? Can I send my ENT's notes in as new evidence or what should I do? I did want to get sinusitis approved. With the honesty factor I did and do have a deviated septum. I also have cysts and wonder if the cysts can make my septum deviated.

With enough documentation while on active duty should my sleep apnea claim be okay........or another way this deviated septum won't get in the way will it.

Thanks.

2_28_2005_VA_Decision.pdf

2_27_2005___ENT___Septum_Midline.pdf

9_3_2003___Septoplasty___Daytime_Fatigue___SAA.pdf

11_15_2006_Sleep_Study___Weight_and_Nasal_Obstruction.pdf

Edited by yelloownumber5
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On other question..................

No where does it say that

6510 Sinusitis, pansinusitis, chronic.

6511 Sinusitis, ethmoid, chronic.

6512 Sinusitis, frontal, chronic.

6513 Sinusitis, maxillary, chronic.

6514 Sinusitis, sphenoid, chronic.

Must be from this or that............I've been dx' with Pansinusitis, maxillary, ethmoid and sphenoid all chronic............if a doctor ENT dx's you with this, why in the world can the VA say "I think it's due to cysts or deviated septum" and why would this matter what the cause of it is? I have pansiusitis, maxillary, ethmoid and sphenoid .........all while on active duty and all now.........and even if this so called fix it septoplasty surgery I still have this crap.

I guess I should have claimed them separately not as "sinusitis"

Thanks again........

Edited by yelloownumber5
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I will keep my opinion to the deviated septom and chronic sinusitis. I feel your claim may well have been poorly presented and poorly evidenced.

1. You will need a current ENT IMO to show first that you do indeed have a deviated septum and that the deviated septum was the result of the septoplasty or better still, failed septoplasty surgery. Secondly, you will have to show and have it stated in the IMO, that the deviated septum, as a result of the septoplasty causes a nasal obstruction to both nasal passages of at least 50% or one side of 100%. Otherwise your claim will have no chance of being won.

If you win, then this type of claim is only worth a 10% evaluation.

2. Once you have won this claim, then you can try to get the chronic sinusitis evaluated as secondary or as a result of the deviated septum and obstruction of the nasal passages, but here again you will need a IMO both diagnosing you with chronic sinusitis and that the cause was as likely as not the result of your, hopefully now, SC deviated septum with nasal obstruction.

You could present these claims at the same time, but it might be better to go after the deviated septum and obstruction first and then with this new and seperate IMO, open a new claim for the chronic sinusitis. Unless you want to and can present your appeal with the new IMO, prove your claim for deviated septum and obstruction before your year is up, you can then appeal the chronic simusitis without having to reopen a new claim.

The trauma that the VA is refering to can be covered by the sinoplasty, if you can get the IMO to say that it was this that caused your present deviated septum and obstruction.

Good luck, but without a good sound IMO to support these facts, I don't see your claim advancing towards approval.

Rockhound Rider :angry:

SC 10% for obstructive nasal passages and deviated septum due to trauma, Secondary claims for painful nasal scars to each side of nose and chronic sinusitis/rhinitis. Secondary claims rating results being written up as this discussion unfolds. Results unknown at this time. :D

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Rockhound,

None of the enclosed was my evidence for sinusitis. My evidence for sinusitis was treatment for years of sinusitis and still post active duty being treated.

However, in the denial letter they said my septum was deviated...........but then he said it was midline.........just yesterday looking thru my record I found that ENT

letter that said in Sep 2005 (7 months after this decision) my septum was straight. My question are these DAMN IDIOTS (VA) playing with me or WTF is going on.

I kind of would like to know if that sleep study would fly or are these idiots going to say it's because of your deviataed septum that is there, not there, there and maybe there againa.

Also, can someone give me the VA's definiation of "Trauma", not websters but the VA's.

Thank you.

Edited by yelloownumber5
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Rockhound,

None of the enclosed was my evidence for sinusitis. My evidence for sinusitis was treatment for years of sinusitis and still post active duty being treated. Even with the history of sinusitis, unless it is diagnosed as chronic sinusitis and was caused by a SC condition, you have insufficiant evidence for approval.

However, in the denial letter they said my septum was deviated...........but then he said it was midline.........just yesterday looking thru my record I found that ENT

letter that said in Sep 2005 (7 months after this decision) my septum was straight. My question are these DAMN IDIOTS (VA) playing with me or WTF is going on. Forget all the past reports as to whether your septum was deviated or not. You must get a current ENT IMO that not only determines that you have a deviated septum, but it was the result of the septoplasty surgery in the service. Then you need to determine if the deviated septum causes your nasal obstruction to be either 50% obstructed on each side or 100% on one side. With out this you have nothing to support your sinusitis claim.

I kind of would like to know if that sleep study would fly or are these idiots going to say it's because of your deviataed septum that is there, not there, there and maybe there againa. This one is probably a tougher nut to crack. Without SCing the nasal obstruction and deviated septum, you can't use it as a contrubuting factor, since their appears to be no other evidence as to the cause for the sleep apnea, with the exception of your weight. Someone with better and more knowledge here will be needed, but I noticed when I read the sleep study, that your weight was also a contributing factor and it was recommended that you loose some weight. Should you loose the weight down to the recommedation, then have the sleep study done once again and it doesn't improve, then you won't have to fight over the weight issue during your claim.

Also, can someone give me the VA's definiation of "Trauma", not websters but the VA's.

Thank you.

Just for your concideration. I noticed that you got a scar SC'd. If this scar causes you pain, you can submit a claim for increase from 0% to 10% if the scar causes you pain and discomfort. If you have documented that you have complained that the scar causes you pain and discomfort, it would help to better your claim.

Rockhound Rider :D

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I worte a response but just deleted it.

I guess i"m just screwed.

I due have medical evidence for my last three years of "chronic sinusitis" and after service. I posted the ENT note only because he said "septum straight" that was the ONLY reason I posted this and said that in the text. I did not post any of my evidence I used for my claim on here. I just has specific questions about the denial and thought I posted something that I did not use as evidence that rebutts what the VA said.

Edited by yelloownumber5
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