Jump to content
VA Disability Community via Hadit.com

VA Disability Claims Articles

Ask Your VA Claims Question | Current Forum Posts Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users

  • hohomepage-banner-2024-2.png

  • 27-year-anniversary-leaderboard.png

    advice-disclaimer.jpg

  • donate-be-a-hero.png

  • 0

Nod Or Reconsideration?

Rate this question


pog

Question

I filed PTSD and sleep disorder 2 years ago. I was granted for PTSD at 50%. Denied for Sleep disorder b/c of a lack of diagnosis. (What my decision letter says)

My 1 year deadline is up on the 24th of February. I enlisted the help of a DAV VSO, who said that I could not appeal the sleep disorder denial, with my clinical diagnosis of "sleep apnea" because she said I had filed sleep disorder secondary to PTSD. And that they had taken my trouble sleeping into account when they granted my PTSD claim for 50%.

She then explained that she would file a request for reconsideration of the "sleep disorder" claim and request that they reevaluate my claim because I should have filed for Sleep Apnea.

My question is... What are the chances they will accept my request that they reevaluate my claim of sleep disorder as sleep apnea. I have a diagnosis from a MD who ordered a sleep study and prescribed a CPAP and I am certain that it is service connected. But what are the chances they will make the effective date of the decision the same as my PTSD claim?

Link to comment
Share on other sites

  • Answers 15
  • Created
  • Last Reply

Top Posters For This Question

Recommended Posts

If the VA said denied due to no diagnosis-

I dont see why the way you worded the claim(as secondary due to PTSD) would matter.

You could appeal that there is in fact a diagnosis.

Can you scan and attach here (cover personal info) the decision as to exactkly how the VA worded the decision?

"I have a diagnosis from a MD who ordered a sleep study and prescribed a CPAP and I am certain that it is service connected. But what are the chances they will make the effective date of the decision the same as my PTSD claim?"

Did the VA receive that MD's diagnosis and list it as evidence prior to making their decision?

Did the MD (or could the MD ) make a statement that it is more than l;ikely the sleep apenea is due to your PTSD?

I dont feel a Reconsideration request will be process in time - as your NOD date is running out.

You can attach any evidence whatsoever that helps this claim to the NOD but it would help us to know exactly how the VA worded that denial.

If the rep files the reconsideration request make sure it is also considered as a NOD if the request is not acted on expeditiously (and make sure a NOD is filed separately too-in time- one year after the decision date you are nodding.

The recon request will need some evidence they havent seen yet or have but never considered in the decision.

Link to comment
Share on other sites

From another post.

One would need to have a doctor agree to write

the veteran has a SC'd condition of XXX.

It is my medical opinion the veterans SAP is secondary

to the SC'd disability of XXX due to, XXXXX

and a little narative that shows fully supported medical rationale.

Medical treaties that are specific to the populace in general

will not be adequate to get the claim granted.

VBA will need something specific to the veteran and the veterans situation.

jmho,

carlie

Link to comment
Share on other sites

and make sure you file that NOD with a certified mail return receipt or get a date stamp on your copy of the paperwork...you have to be able to prove that you met the NOD deadline set by VA.

Link to comment
Share on other sites

If the VA said denied due to no diagnosis-

I dont see why the way you worded the claim(as secondary due to PTSD) would matter.

You could appeal that there is in fact a diagnosis.

Can you scan and attach here (cover personal info) the decision as to exactkly how the VA worded the decision?

"I have a diagnosis from a MD who ordered a sleep study and prescribed a CPAP and I am certain that it is service connected. But what are the chances they will make the effective date of the decision the same as my PTSD claim?"

Did the VA receive that MD's diagnosis and list it as evidence prior to making their decision?

Did the MD (or could the MD ) make a statement that it is more than l;ikely the sleep apenea is due to your PTSD?

I dont feel a Reconsideration request will be process in time - as your NOD date is running out.

You can attach any evidence whatsoever that helps this claim to the NOD but it would help us to know exactly how the VA worded that denial.

If the rep files the reconsideration request make sure it is also considered as a NOD if the request is not acted on expeditiously (and make sure a NOD is filed separately too-in time- one year after the decision date you are nodding.

The recon request will need some evidence they haven't seen yet or have but never considered in the decision.

No I just received the diagnosis a few weeks ago. I attached the medical records from the sleep study that I got on my own. On the 15 FEB I'm visiting my doctor to request a Nexus letter. When I booked the appointment his receptionist said he has written nexus letters before. I'm very clear on what I need to get from my private MD as far as a nexus letter.

What I am less clear on is if I should file an NOD. My VSO was very sure that because I had claimed "sleep disorder" and not "Sleep Apnea" the VA had not evaluated me for sleep apnea and their decision would stand. She said my only chance was to file a request for reconsideration because I had claimed the wrong condition. And to submit the recent diagnosis and nexus letter. Should I listen to her? If I file a NOD won't it negate the request for reconsideration?

Thank you for your answering...

Link to comment
Share on other sites

  • HadIt.com Elder

The NOD may negate the reconsideration but you are going to run out of time. You have one year to file a NOD. If that runs out and you lose the reconsideration you are going to lose your effective date. You may be better off opening a new claim for sleep apnea. How are you linking sleep apnea to PTSD? Is there medical literature that links PTSD with sleep apnea. What is your nexus from PTSD to sleep apnea? If you are obese the VA is going to say that is the cause of your sleep apnea. I understand a sleep disorder due to PTSD. I don't understand sleep apnea due to PTSD. Probably my ignorance. As far as I know the VA has to complete the reconsideration before the one year for the NOD. With four weeks left in February that is uncertain at best.

Link to comment
Share on other sites

The NOD may negate the reconsideration but you are going to run out of time. You have one year to file a NOD. If that runs out and you lose the reconsideration you are going to lose your effective date. You may be better off opening a new claim for sleep apnea. How are you linking sleep apnea to PTSD? Is there medical literature that links PTSD with sleep apnea. What is your nexus from PTSD to sleep apnea? If you are obese the VA is going to say that is the cause of your sleep apnea. I understand a sleep disorder due to PTSD. I don't understand sleep apnea due to PTSD. Probably my ignorance. As far as I know the VA has to complete the reconsideration before the one year for the NOD. With four weeks left in February that is uncertain at best.

I'm not linking it to PTSD unless my MD can do this. I was going to ask him to make the connection that the allergic rhinitis I was treated for while on active duty is as likely as not to have aggravated my sleep apnea.

I was also going to ask him about the likely hood of my PTSD med's contributing to my mild obesity, that caused or aggravated my SAP.

The ultimate truth of the matter is I did not have Sleep Apnea before I was on active duty. But during active duty I would wake up chocking and gasping for air. I thought this was a result of the nightmares I was having. It was not until I discovered what sleep apnea was that I realized what I had. But I had already filed the claim for sleep disorder.

I got my own sleep study done privately and just received the diagnosis.

My VSO wrote the request for reconsideration to the VA as follows:

"Request for reconsideration for decision dated 2/18/2009, regarding the denial of entitlement to service connection for sleep disorder. Mr POG did file a claim for sleep disorder, but he was suffering from sleep apnea. Please re-develope the claim for sleep disorder as sleep apnea.

It is respectfully requested all appropriate action be taken to assist in the development of the facts pertinent to this claim pursuant to the regulatory provision of 38 CFR etc. Should thorough and contemporaneous examinations be deemed necessary to ascertain eligibility for the benefit(S) sought, then we ask they be scheduled in accordance with regulatory provision of 38 CFR etc.

Once complete records have been obtained and reviewed by the rating board, we ask a determination be rendered which is considerate to the regulatory provision of 38 CFR etc. We further ask that any additional pertinent regulatory provision, statutory guideline, or holding by the US court of appeals for veterans claims applicable to this claim be utilized in the determination."

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Guidelines and Terms of Use