I Have A Good Question About Sleep Apnea

[CITY BOY]

I was diagnosed with Chronic Sinusitis in the service and had a bunch of problems with this condition since I got out. In the year 1999 I had to have nasal surgery due to polyps, swollen and infected turbinites, which they cleaned out most of the inside of my head per se. After the surgery every thing went down hill fast, headaches, ear pain and the worst of the surgery was the severe Obstructive sleep apnea that started three months after the surgery. I applied for Chronic Sinusitis in January 2007 and received 10% then got it upgraded to 30% back to the effective date of Jan 2007. My question is this, under the reasons section of this decision the VA said, "The 30% evaluation seems to most closely approximate the level of your disability, as your condition has caused you to undergo surgery use a CPAP machine for OSA and request medication to help you sleep due to you chronic symptoms". Does this statement mean that the VA acknowledges that the OSA is secondary to my Chronic sinustitus?

[Pete53]

It could be.

[CITY BOY]

It could be.

I guess we will find out soon, I am awaiting for the new decision this month or September.

[Bonzai]

..."The 30% evaluation seems to most closely approximate the level of your disability, as your condition has caused you to undergo surgery use a CPAP machine for OSA and request medication to help you sleep due to you chronic symptoms"...

Are you missing a comma between the words surgery and use? It seems like there should be one there, and then it would read clearer.

[Berta]

"The 30% evaluation seems to most closely approximate the level of your disability, as your condition has caused you to undergo surgery use a CPAP machine for OSA and request medication to help you sleep due to you chronic symptoms". Does this statement mean that the VA acknowledges that the OSA is secondary to my Chronic sinustitus?"

It looks to me that they acknowledged it but forgot to pay you for it.I think they lowballed you too on the 30%.

In reading the sinustitis regs below-I dont see anything as to how they can use the OSA as part of the 30% rating they gave you.As a matter of fact maybe they should have awarded 50% due to the surgery under the chronic sinusitis ratings.

Did you file a NOD on this decision?

If I were you I would make formal claim as to the OSA being secondary and they should compensate that.And ask them for a rating that is more appropriate to the rating schedule for your chronic sinusitis.

Was VA fully aware of the surgery you had for this?

This sure is a good question-

others might have a different take on what I stated here.

Under DC 6512, which contemplates chronic frontal sinusitis,

a noncompensable evaluation is warranted for findings

detected by X-ray only. A 10 percent evaluation is warranted

with evidence of one or two incapacitating episodes per year

of sinusitis requiring prolonged (lasting four to six weeks)

antibiotic treatment, or three to six non-incapacitating

episodes per year of sinusitis characterized by headaches,

pain, and purulent discharge or crusting. A 30 percent

evaluation is assigned with evidence of three or more

incapacitating episodes per year of sinusitis requiring

prolonged (lasting four to six weeks) antibiotic treatment,

or more than six non-incapacitating episodes per year of

sinusitis characterized by headaches, pain, and purulent

discharge or crusting. Id. A 50 percent evaluation is

assigned with evidence of following radical surgery with

chronic osteomyelitis, or near constant sinusitis

characterized by headaches, pain and tenderness of affected

sinus, and purulent discharge or crusting after repeated

surgeries. Id. Note: An incapacitating episode of sinusitis

means one that requires bed rest and treatment by a

physician. 38 C.F.R. § 4.97, Part 4, DC 6512 (2008).

[CITY BOY]

Are you missing a comma between the words surgery and use? It seems like there should be one there, and then it would read clearer.

Good catch. No comma after surgery.

[CITY BOY]

"The 30% evaluation seems to most closely approximate the level of your disability, as your condition has caused you to undergo surgery use a CPAP machine for OSA and request medication to help you sleep due to you chronic symptoms". Does this statement mean that the VA acknowledges that the OSA is secondary to my Chronic sinustitus?"

It looks to me that they acknowledged it but forgot to pay you for it.I think they lowballed you too on the 30%.

In reading the sinustitis regs below-I dont see anything as to how they can use the OSA as part of the 30% rating they gave you.As a matter of fact maybe they should have awarded 50% due to the surgery under the chronic sinusitis ratings.

Did you file a NOD on this decision?

If I were you I would make formal claim as to the OSA being secondary and they should compensate that.And ask them for a rating that is more appropriate to the rating schedule for your chronic sinusitis.

Was VA fully aware of the surgery you had for this?

This sure is a good question-

others might have a different take on what I stated here.

Under DC 6512, which contemplates chronic frontal sinusitis,

a noncompensable evaluation is warranted for findings

detected by X-ray only. A 10 percent evaluation is warranted

with evidence of one or two incapacitating episodes per year

of sinusitis requiring prolonged (lasting four to six weeks)

antibiotic treatment, or three to six non-incapacitating

episodes per year of sinusitis characterized by headaches,

pain, and purulent discharge or crusting. A 30 percent

evaluation is assigned with evidence of three or more

incapacitating episodes per year of sinusitis requiring

prolonged (lasting four to six weeks) antibiotic treatment,

or more than six non-incapacitating episodes per year of

sinusitis characterized by headaches, pain, and purulent

discharge or crusting. Id. A 50 percent evaluation is

assigned with evidence of following radical surgery with

chronic osteomyelitis, or near constant sinusitis

characterized by headaches, pain and tenderness of affected

sinus, and purulent discharge or crusting after repeated

surgeries. Id. Note: An incapacitating episode of sinusitis

means one that requires bed rest and treatment by a

physician. 38 C.F.R. § 4.97, Part 4, DC 6512 (2008).

The VA knows everything about sinus surgery and secondary problems.

Thanks Berta. Thats what I thought. I did put if for NOD on the Sinusitis because they forgot to put in for the daily headaches that are associated with the Sinustitis. And to make the VA think twice about denying me , I also put a disability claim in for Migranes Headaches as secondary to Sinustitis that I get 2-3 times a week. The VA has me on high Amitriptyline dosage of 50mg a night for migraines. So they have to acknowledge the headaches, which the VA doctors say diffinetly connected to my Service connected Chronic sinustitis. I also put in a disability for the Sleep Apnea as secondary to the Sinustitis and I will find out everything with in a month or so.