Sleep Apnea Sc Nexus/imo Letter & Claim Help

[MLR]

I'm in need of some guidance. I'll try to give all of the details.

I was in the Army from 1989 to Feb 2000. I was medically discharged @ 10% for left knee.

Currently rated @ 40%, which breaks down as:

20% = Chronic neck pain Degenerative Disc Disease

10% = Left knee limit of extension

10% = Left knee instability, secondary to ACL deficiency

I have a claim in now for Sleep Apnea. I have had SA since 1993 or early 1994 but I do not have my full service medical records to see if there were any complaints of sleep issues. I have not requested a copy of my SMR due to them being in St Peterburg...while I'm in Atlanta & I was told that it would slow down the claim process...

I have recently been diagnosed with depression (by a VA doc) due to the chronic pain also but have not started a claim on that cuz I figured I need to see a doc a few times before filing. Is that right?

OKay onto the actual claim at hand....Slepp Apnea as service connected.

I was medically discharged Feb 2000....SA diagnosed Jun 2002 by civilain doc & sleep study. My current civilain sleep doc has agreed to write a letter for me. He was going to write it connected to my knee injury & weight gain cuz that is actually around the time it all started. I realize that the weight gain avenue IS NOT the way to go.

I do have several buddies that will write statements as to the fact that they witnessed me "stop breathing or choking" in my sleep. Those letters wiill come from my wife, my father, my mother, 2 army buddies that knew me before the onset of SA & also experienced the "stop breathing in sleep" episodes while I was still in service. 1 buddy that did not know me before the SA but did experience an episode of mine while we were at NTC in Ft Irwin approx 6 months before I got out of Army.

My "Report of Medical history" filled out for my medical board proceedings has the "frequent trouble sleeping" box checked & the physicans summary also lists "trouble sleeping" in the doctors handwriting.

QUESTION: Where do i go from here? How should I proceed with this? What is the difference between an IMO letter & a nexus letter? DO I need to connect it to to something else or can Sleep Apnea stand on it's own merit with the info I've provided thus far?

Please undersatand, I'm not trying to get over on the system BUT I KNOW that I had this condition while on active duty but I never knew what Sleep Apnea was!! I just thought that "that's just the way that I am".

Also, I was an excellent soldier BUT I did have 1 area that needed work ever since 93 or 94 & that was making it to PT or 1st formations in the morning. I recieved a few COMPANY grade article 15s for being late but they were all company level & were only kept in my local training file...unless someone knows something different on how to locate them.

I don't know if it can be connected to my c2 thru c7 issues & spinal stenosis in the same area. It really truthfully started after I hurt my knee.

PLEASE ANY & ALL help is appreciated!!!!

[dwilli12]

MLR,

Check out my posts about SA....I think they may help you. I think it's IMPERATIVE that your current sleep doctor review ALL of your medical records, especially your SMRs, so that he can issue an opinion that says he has reviewed the SMRs and in his opinion your SA began in year X. That was key to my success.

Good Luck!

Dwilli12

[MLR]

Thx dwilli12!

The decision leters & ime's that u posted in one of those previos posts, would not work for me. I know it's ALOT to ask but could u possibly re-post them or please point me in the direction to find them.

I gained some valuable info from reading thru ur posts, it is truly appreciated!

[kw34]

I did not see it in your post do you have a cpap machine. You need to be treated for the condition.

[MLR]

Oops, I forgot that.

Yes I do.

Have had a cpap since jun of 2002. Started on the pressure level of 10 back then & was upped to 14 in 2005...still on 14.

I also have leg jerks while sleeping.

[broncovet]

IMHO Sleep Apnea is a difficult claim to win. Reason: What injury did you incur that caused your sleep apnea?

To answer your question about the difference between an IMO and a nexus letter:

A SUCCESSFUL nexus letter would be someting like your VA doc saying, to the effect:

"I have examined the Veteran, and in my opinion the VEterans sleep apnea was at least as likely as not due to a facial injury incurred during military service".

An IMO, on the other hand, is usually used when your VA doc indicates that there is little/no connection between the Veterans sleep apnea/military service. You can hire a doctor to write an opinion. You want to have the doctor review your your medical records, and state so, and offer an opinion which would include: "I have reviewed the Veterans medical records and "VEterans sleep apnea was at least as likely as not due to a facial injury incurred during military service". Then your independent doctor should sign it.

[MLR]

Does Sleep Apnea need to be caused by an injury or does it just need to have "hadit's" onset during active duty? I have approx 7 people working on buddy letters now & some of those folks knew me before the onset of SA & also experienced my issues after it began.

I had no facial trauma while in but it did start after an injury, probably due to my weight gain & I also think a motor vehicle accident increased it more (had neck issues after that) & ultimately eneded up gettting discharged due to the neck issues & original knee injuries. I believe my neck isssues may have been, at least, partially misdiagnosed but I will talk to the pain mgmt people to see if i may have fibromyalgia cuz all of the symptoms of that will be in my records. I found a bva decision where SA was found to be 2ndary to fibro.

Anyway, I ordered my inpatient & outpatient SMRs yesterday thru the E-Vet-Rec website. I know that I know my body & issues better than any1 but my med records are the key to everything....& without those, I'm really just trying to get background guidance.

Broncovet, thats for the explanation of the IMO & Nexus letters. I appreciate it...

Not trying to "trick" the system here, just trying to figure out the best way to approach it.

Thanks to all that have responded!!!!