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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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Denied Claim For Osa With Cpap

Question

Hello,

I filed a claim for OSA w/CPAP in June 2009 and received a denial letter just last week stating that it was not S/C. I am going to appeal but I will provide details on why I filed a claim. Any assistance will be greatly appreciated.

I was in service from June 1998 to May 2007. During this time I was unaware of what sleep apnea was and the symptoms related to it. I've always snored and have been fighting morning fatigue for quite some time. My wife of 7 years even complains to me about my snoring keeping her awake. Of course at the time, I didn't know that was a symptom of sleep apnea or I would have gone to a doctor. I was diagnosed with sleep apnea after a sleep study referred by the VA clinic I go to in April 2008. They attempted to give me mouth pieces for sleeping, anxiety pills and none of those worked. I finally went back to speak to my doctor at the VA and they gave me the CPAP machine in May 2009. After speaking with a former supervisor in the Air Force, who I found out has sleep apnea and uses the same machine, he mentioned that I should file a claim. I did so and received the letter stating that it is not service connected so I am denied for compensation.

Now my question to you is...is there a set date on when it has to be diagnosed for it to be S/C? I've heard from my DAV rep that it has to be diagnosed within a year of separation. Is this true? And what should I put in my appeal letter as a starter? Thanks in advance.

Mike

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The DAV rep is confusing this-

if you had one of the chronic presumptive disabilities,listed in Title 38 and 38 CFR and it manifested to at least 10% disabling within the first year after your service- you could attain SC under the presumptive regs. 38 CFR 3.303.

I dont see sleep apnea listed as one of the chronic presumptives.

Or maybe he is confused with the one year filing date- a claim filed within one year after service , that succeeds in gaining SC, has a EED (retro date) back to the day after discharge for payment of compensation.

I imagine the VA denied saying your SMRs were silent for sleep apnea.

Do you have copies of your SMRs? Is there anything in service -such as documented sleep problems,unusual fatigue, etc that is documented and that could be the nexus of the apnea?

If you can get some buddy statements that you snored a lot in service this could possibly help the claim.

We can help more if we know the exart reasons and bases that VA denied with.

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You are going to need something called a Nexis. It is made by Toyota ....no just kidding. A nexis is a statement made by a doctor which links your medical condition to military service. What the VA is looking for is the doctor saying something like this:

"The Veterans Sleep Apnea was at least as likely as not due to __________ condition (or injury which occurred) during military service"

The doctor could say something like, "Veteran has had symptoms of OSA for 8 years, which includes his military career"

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