Kind Of An Out There Question About De Novo Review

[joeyjoeyb]

I filed an NOD back in Jan of this year for sleep apnea. This is what I submitted:

Notice of Disagreement This is a Notice of Disagreement with your rating decision dated 12 November 2008, which denied my claim for obstructive sleep apnea. I request my claim be afforded a de Novo review by a Decision Review Officer. I would also request I attend that review.

I believe my claim should be approved. Although there was not a diagnosis of sleep apnea while in service, there was a clear diagnosis shortly after being discharged (89 days after retirement date). Sleep Apnea takes time to progress and there is enough evidence of record that indicate the symptoms began while in service.

I received the "we received your request"....yada yada yada

I called the VA a few weeks ago to see if there was anything going on with my NOD. There was nothing going on, but the lady at the 1-800 number said that someone would call me. I received that call on Friday and basically the lady said that I was in a longggggg line and that it would be looked at in the order it was received. I asked her if I was going to be able to come to the review. She said no. Now I am kind of confused on how all this works. I thought that I would be able to be at the review, if and when that happens. Am I just totally wrong here? I did send in new evidence after I requested the review. Can someone help me out with the order of events. It is at the Atlanta VA regional office if that makes a difference. I really did not know that this could take 2 or more years. Thanks

[joeyjoeyb]

Pete53,

I did ask for reconsideration the first time and was denied because they said it was all lay statements. Here is what it said and I quote " Although the statements you have submitted were reviewed and considered, lay testimony, will not satisfy that burden." Kind of stinks that they will not consider my wife's statement who saw first hand for 10 years how much problems I had sleeping.

[john999]

First, shoot your VSO. Then follow the advice you got here from Pete and 12R3G. Just kidding about the VSO, but that is poor advice. Does the VA believe you developed sleep apnea within 89 days of discharge?

[broncovet]

JoeyJoey

Well, I wouldnt shoot your VSO, just rough him up a bit. No, what you need, you are getting here. KNOWLEDGE. It is power. To get your claim Service connected, you need a Nexis. You can get one of those at your Toyota dealer....just kidding again. What you need is a Nexis Doc statement, that something very similar to this:

"JoeyJoey's sleep apnea is most likely due to military service because..........."

If you dont have a nexis, you probably wont win your claim until you get one. If you cant get a VA doc to write you such a statement then you may be able to get a private doctor to write you one. Its called an IME (INdependent Medical Exam). An IMO (Independedent Medical Opinion) helps, but the money is in the IME. REASON: A doctor who gives an IME without seeeing you, and just looking at your records and offering an opinion something like, "I reviewed JoeyJoeys medical records and in my professional opinion his Sleep Apnea is most likely due to military service" is good, but much better is a doc who says "I examined the Veteran and reviewed his medical records and In my opinion JoeyJoeys sleep apnea is most likely due to military service.

That is, an IMO without an exam could fail if the VA doc examined you and said other wise.

By law, if 2 docs who examined you offer differing opinions, the VA is required to go with the one most favorable to the Veteran.

Medical evidence is compelling, and the VA rating specialist cant say the doc is full of crap, because it will be struck down upon appeal. Basically neither a rating specialist, nor a judge is qualified to give an opinion that overrules a doctor who is qualified to give a medical opinion in his area of specialty. No, you cant have your Psychiatrist friend give you a nexis on your back injury, unless the Psych doc is also qualifed as an ortho pedist.

[joeyjoeyb]

Broncovet,

So that letter that is in my other post from my sleep doc will not work? Not sure if I can get another letter from him, but he would probably add, "more than likely" ???

[jbasser]

Have him put a time line on the OSA and state that your OSA was diagnosed 89 days after service and it definatly had its onset while you were in service.

That should do it.

J

[joeyjoeyb]

Jbasser,

What do mean by timeline? Like when does he think it started?