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!!!!

[vaf]

"Do you have first hand experience with hypothyroidism? or with sleep apnea?"

Yes, both my husband and I suffer from hypothyroidism, both using synthroid. His was the result of a pituitary brain tumor (the pituitary gland controls the "master switch" for the entire endocrine system). He also suffers from sleep apnea, which we just received notice of two days ago that the VA service-connected. The Rating Decision stated,

"Service connection for obstructive sleep apnea has been established as related to the service-connected disability of status post transspenoidal hypophysectomy for pituitary tumor."

The connection was made due to the use of testosterone intramuscular therapy that became necessary after surgery for a pituitary tumor. Sleep apnea is a potential complication of testosterone therapy.

[yelloownumber5]

VAF,

Congrats on getting the SC.

I will address the sleep apnea and hypothyroirdism with my endo as she has been willing to write an IMO for my hypothryoidism, I just have to gather the C&P examin and rating criteria for her.

I never heard about hypothyroid and sleep apnea but nice to know.

My wife is a doctor and she will tell me not to wear my androderm and not to take synthroid when I'm really swollen. I did have the low testerone around the same time..........it's a shame you have to complain of tiredness all the time before things are checked.

Do you know about Serum amyloid A (SAA) protein, I'm looking for a biochemist to answer some specific questions.

Thanks again,

YN5

"Do you have first hand experience with hypothyroidism? or with sleep apnea?"

Yes, both my husband and I suffer from hypothyroidism, both using synthroid. His was the result of a pituitary brain tumor (the pituitary gland controls the "master switch" for the entire endocrine system). He also suffers from sleep apnea, which we just received notice of two days ago that the VA service-connected. The Rating Decision stated,

"Service connection for obstructive sleep apnea has been established as related to the service-connected disability of status post transspenoidal hypophysectomy for pituitary tumor."

The connection was made due to the use of testosterone intramuscular therapy that became necessary after surgery for a pituitary tumor. Sleep apnea is a potential complication of testosterone therapy.

Edited July 16, 2009 by yelloownumber5

[vaf]

You might find the following link helpful, but there's a lot of information on the internet regarding the association between OSA and hypothyroidism:

http://ajrccm.atsjournals.org/cgi/content/full/158/5/1379

VAF,

Congrats on getting the SC.

I will address the sleep apnea and hypothyroirdism with my endo as she has been willing to write an IMO for my hypothryoidism, I just have to gather the C&P examin and rating criteria for her.

I never heard about hypothyroid and sleep apnea but nice to know.

Thanks again,

YN5

[yelloownumber5]

VAF,

Congrats on getting the SC.

I will address the sleep apnea and hypothyroirdism with my endo as she has been willing to write an IMO for my hypothryoidism, I just have to gather the C&P examin and rating criteria for her.

I never heard about hypothyroid and sleep apnea but nice to know.

My wife is a doctor and she will tell me not to wear my androderm and not to take synthroid when I'm really swollen. I did have the low testerone around the same time..........it's a shame you have to complain of tiredness all the time before things are checked.

Do you know about Serum amyloid A (SAA) protein, I'm looking for a biochemist to answer some specific questions.

Thanks for that link as well....appreciate it.

Thanks again,

YN5