ptsd Need Advise For Hearing

[Ruffcreek]

I was diagnosed with PTSD in February 2006. In October 2007 I was diagnosed with sleep apnea for which I submitted a claim for Sleep Apnea secondary to and/or aggravated by service connected PTSD. In August 2008 I was granted 0% for sleep apnea aggravated by my PTSD. I filed a NOD for DeNovo Review on 8/19/2008 and April 2009 I received a decision to continue at 0%.

I appealed and have a hearing at DRO next Thursday.

The SOC says “ Prior to aggravation by a service connected condition, the disability was considered 50% disabling based on evidence that showed you had obstructive sleep apnea and were placed on CPAP machine. The difference between disability evaluations before and after military service determines the degree of disability subject to service connection. Prior to aggravation by a service connected condition, the disability was considered 50% disabling based on evidence that showed you had obstructive sleep apnea and were placed on CPAP machine. Following aggravation, the total disability is 50% disabling because this evaluation granted for being on a CPAP machine. The pre aggravation percentage is always deducted before assigning any service-connected evaluation less than 100%. So as the pre service aggravation was 50% disabling and the current condition is 50% disabling, service connection for sleep apnea as aggravated by your post traumatic stress disorder is granted as 0% Your current condition does not meet the criteria for the 100% evaluation shown below.”

The state VSO says I will need a letter from my Plumonary Specialist saying that in his opinion that absent PTSD it is as likely as not my sleep apnea would not warrant a CPAP. The CPAP is there because of the PTSD.

This is where I disagree with the state VSO's strategy: 1) I didn't have sleep apnea before and the army wouldn't have accepted me if I had sleep apnea. 2) I wasn't diagnosed with sleep apnea until almost 2 years AFTER being diagnosed with PTSD. I want the hearing officer to show me the evidence that I had sleep apnea and was placed on a CPAP machine prior to aggravation by a service connected condition. (see first sentence)

I'd like to hear anyone's opinion as to what I should do and do I have to accept the VSO's strategy or can I demand we do it my way?

[sixthscents]

Ruffcreek,

I think the pivot here is that you state you were diagnosed with PTSD prior to the sleep apnea. Now the rater may have just looked at the VA records and not service medical records. Was this two years part of your military service medical record?

You state the decision states "Prior to aggravation by a service connected condition, the disability was considered 50% disabling based on evidence that showed you had obstructive sleep apnea and were placed on CPAP machine"... now if you can prove this is false, clearly false... then I think you may have grounds for a CUE claim... BUT it must be clearly demonstrated that this statement made by the rater is incorrect - clearly so in you medical records, either VA or Service or both.

The rater seems to be attempting to say that the combination of the two adds to 50% - which just isnt the way the VA must rate illnesses. If one is secondary to the PTSD which is service connected then it is a seperate illness and must be rated on its own merits, not simply slapped on as a symptom of the other.. which is what the statement says to me.

I'm going to ask Pete and some others to chime in here, has the VA changed how they rate sleep apnea recently? I've been out of service for a bit... so I want confirmation that what I am saying is correct.

Bob Smith

Edited August 23, 2009 by sixthscents (see edit history)