hypertension Denied Secondary Sleep Apnea

[tanker267]

Today I received what I had hoped to be "Good News". But Noooooo! I was denied!!

Sleep Apnea, bi-lateral knee increase and Hypertension now 0 percent service connection (only plus). I had to retire under disability from the USPS with 33 years because of my service connected disablities. I submitted a claim for Obstructed Sleep Apnea and Hypertension secondary to my knees and having had Sarcoidosis in my lungs, and 18 months of prednisone treatments in the early 80's. The VA Doctor who did the C&P in Aug at the Albany, VAMC stated "The veteran had a pillar procedure in an attempt to correct a flaccid soft palate. This, rather than central fat deposits, was more likely than not the cause of the Veteran's obstructive sleep apnea."

I am SC 40%, 30% for bi lateral Osgood- Sclatter's Disease, 10% for tinnitus , Sarcoidosis 0%, 0% for hearing loss. I submitted various VA-4142's, VA 21-4138 from my wife along with 2 sleep studies, one conducted at the VA.

My Family DR. wrote it up "as least as likely as not" caused by Service Connected Bi-Lateral Osgood- Sclatter's Disease and lateral meniscus tear/right knee. Due to his physical limitations he is unable to participate in cardio-vascular exercise, this has led to his weight increase, obstructive sleep apnea and hypertension.

To add another bit of info, I had the Pillar Procedure done in May 2006 for severe snoring at the VA which helped for several months, it wasn't successful. The C&P Dr even stated that it "failed".

I met and was treated in the VA Hospital in 1981 by my family Doctor! He was a resident there. He has been my PCP since then, so he is completely familiar with my medical history.

The denial letter said that my Doctor didn't review my SMR and the C&P Doctor did. WTF????

The decision also stated that I was seen at the Buffalo VAMC, wrong.

They left out thePillar Procedure done at the Albany, VAMC completely. They didn't review the VA clinic notes which showed my BP on two separate occassions over 100 distolic. Instead they showed the C&P BP = 125/ 90, 122/92 and 125/95 ( on medication )

They stated that I had arthroscopic surgery to repair my lateral meniscus tear /right knee - Not True

I feel I have been, like many here completely let down by the system. There were many other technical mistakes made in the decision and C&P. What are your suggestions? I haven't been able to get a hold of my VSO. Please Help! Thank You!!

[Vync]

Pick apart everything that was screwed up.

I had a claim where the C&P doc commented on my back, but the VA RO commented on my knees. Big error there. They often do get in a hurry and make mistakes.

If the C&P doc said the pillar procedure failed, if it says you were seen at the wrong VAMC, definitely point it out.

Regarding a NOD, reconsideration, or escalating to the next step, others might want to comment in on the recommended course of action.

[tanker267]

Pick apart everything that was screwed up.

I had a claim where the C&P doc commented on my back, but the VA RO commented on my knees. Big error there. They often do get in a hurry and make mistakes.

If the C&P doc said the pillar procedure failed, if it says you were seen at the wrong VAMC, definitely point it out.

Regarding a NOD, reconsideration, or escalating to the next step, others might want to comment in on the recommended course of action.

Thanks Vync,

I plan on listing point by point every discrepency they made. I had a copy of the C&P Doctor's report and I thought it read in my favor. But the rater saw only what he wanted and rated unfavorabably.

[Vync]

Thanks Vync,

I plan on listing point by point every discrepency they made. I had a copy of the C&P Doctor's report and I thought it read in my favor. But the rater saw only what he wanted and rated unfavorabably.

Get a big red marker and point out the problems. Be sure to highlight everything in your favor in a different color. Tear up their report like your 10th grade English teacher.

[*Bergie*]

Today I received what I had hoped to be "Good News". But Noooooo! I was denied!!

Sleep Apnea, bi-lateral knee increase and Hypertension now 0 percent service connection (only plus). I had to retire under disability from the USPS with 33 years because of my service connected disablities. I submitted a claim for Obstructed Sleep Apnea and Hypertension secondary to my knees and having had Sarcoidosis in my lungs, and 18 months of prednisone treatments in the early 80's. The VA Doctor who did the C&P in Aug at the Albany, VAMC stated "The veteran had a pillar procedure in an attempt to correct a flaccid soft palate. This, rather than central fat deposits, was more likely than not the cause of the Veteran's obstructive sleep apnea."

I am SC 40%, 30% for bi lateral Osgood- Sclatter's Disease, 10% for tinnitus , Sarcoidosis 0%, 0% for hearing loss. I submitted various VA-4142's, VA 21-4138 from my wife along with 2 sleep studies, one conducted at the VA.

My Family DR. wrote it up "as least as likely as not" caused by Service Connected Bi-Lateral Osgood- Sclatter's Disease and lateral meniscus tear/right knee. Due to his physical limitations he is unable to participate in cardio-vascular exercise, this has led to his weight increase, obstructive sleep apnea and hypertension.

To add another bit of info, I had the Pillar Procedure done in May 2006 for severe snoring at the VA which helped for several months, it wasn't successful. The C&P Dr even stated that it "failed".

I met and was treated in the VA Hospital in 1981 by my family Doctor! He was a resident there. He has been my PCP since then, so he is completely familiar with my medical history.

The denial letter said that my Doctor didn't review my SMR and the C&P Doctor did. WTF????

The decision also stated that I was seen at the Buffalo VAMC, wrong.

They left out thePillar Procedure done at the Albany, VAMC completely. They didn't review the VA clinic notes which showed my BP on two separate occassions over 100 distolic. Instead they showed the C&P BP = 125/ 90, 122/92 and 125/95 ( on medication )

They stated that I had arthroscopic surgery to repair my lateral meniscus tear /right knee - Not True

I feel I have been, like many here completely let down by the system. There were many other technical mistakes made in the decision and C&P. What are your suggestions? I haven't been able to get a hold of my VSO. Please Help! Thank You!!

First gather all the facts, then gather all their mistakes and put together a timeline of the facts and mistakes starting from the beginning, the first sign of disease/illness. Follow up with your doctor explaining the situation and ask for their advice and help if you need to see a specialist. Take your time you have a year from the date on the SOC. Gather as much info as possible then file a NOD, remember take your time and think it through. I also recommend you NOT take any meds (B/P or otherwise) for several days prior to any C&P exams that may make you look healthier than you really are. Because as you just found out they don't see the whole picture only the little view they get at the time of your C&P exam. Also, when you file the NOD I recommend you ask for a DRO hearing not a review. The hearing gives you the oportunity to state your case. Also, at the hearing you will need to bring "everything" you have pertaining to the case and you can submit any documents that have been "lost".

I did a time line for my neck injury from the time I first felt pain to the present covering everything thats happened and presented it at my recent DRO hearing. I also brought every document even the ones previously submitted and good thing because they had infact "lost" some of my documents. I showed that I was very organized and prepared, so I suggest the same to you.

Sorry so long, but good luck,

Bergie

[Teac]

First gather all the facts, then gather all their mistakes and put together a timeline of the facts and mistakes starting from the beginning, the first sign of disease/illness. Follow up with your doctor explaining the situation and ask for their advice and help if you need to see a specialist. Take your time you have a year from the date on the SOC. Gather as much info as possible then file a NOD, remember take your time and think it through. I also recommend you NOT take any meds (B/P or otherwise) for several days prior to any C&P exams that may make you look healthier than you really are. Because as you just found out they don't see the whole picture only the little view they get at the time of your C&P exam. Also, when you file the NOD I recommend you ask for a DRO hearing not a review. The hearing gives you the oportunity to state your case. Also, at the hearing you will need to bring "everything" you have pertaining to the case and you can submit any documents that have been "lost".

I did a time line for my neck injury from the time I first felt pain to the present covering everything thats happened and presented it at my recent DRO hearing. I also brought every document even the ones previously submitted and good thing because they had infact "lost" some of my documents. I showed that I was very organized and prepared, so I suggest the same to you.

Sorry so long, but good luck,

Bergie

I am all for the va examiner seeing the true picture of a veterans health... but to tell a veteran not too take his BP meds (or other meds) is totally irrresponsible. In fact if a veteran were to take such advise and had a heart attack, or other serious medical emergency then what... Its one thing to tell a veteran not to jump up on the exam table, its another to tell a vet to take his life in his owm hands.... JMHO but I think your advice is just plain wrong.

[halos2]

You are still at an elevated rate for diastolic b/p.( greater than 90). You must continue on your medications and especially your b/p meds...you have the diagnoses and you take antihypertensive medication and to not take it could potentiate, as teac stated, a stroke or further problems and could be fatal.

I am sure in your records there is evidence of the documentions showing your hypertension, and elevations.

Make several copies of your soc.

Get a couple of different colored highlighters, be sure you can read that which your highlight.

Use a different color for each ailment/body system ie yellow b/p cardiovascular; green knees; pink sleep apnea, etc.

Copy your valid documentation you have and what you sent to the VA with the same color for the soc list.

Match these up and note dates, treatments, medications, any evidence you have that they denied/changed that which was submitted so that when you request a DRO and DeNovo review and may want to request a personal hearing with the DRO to present all the factual evidence you have.

Read these papers over and over. Leave them a day or few, and go back and read them again...alot of the times you can find more errors too that you can rebuttle too. I know it is a tough blow, but you must continue and fight this quest so eventually you will win. You did get 0% for hypertension, so some opening their eyes with your evidence, will most likely get you a monetary %. Hang in there. :(