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Denied Claim For Osa With Cpap



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.


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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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