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Got Another Brown Envelope...


joeyjoeyb

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Well my NOD came back after 18 months and was denied sleep apnea again. I had asked to be at the De Novo review, but was never contacted. In a nut shell, I was diagnosed with sleep apnea 89 days after I retired. I have nothing in my SMR about sleep any sleep problems. They looked at all my evidence (letter from friend, letter from wife, letter from primary care manager, letter from sleep doc and my statement)...and this is what the SOC says:

The cited evidence gives a history and diagnosis of OSA: however, there is no objective evidence that demonstrates this condition incurred during your active military service. The cited evidence appears to be a general conclusion based on your subjective history which is unsupported by clinical evidence and, as such, is considered inadequate for determining service connection.

So I guess my question is what happens next? I am going to fill out the form 9 and send it in and wait in line. Should I get more buddy letters? Should I cite other BVA cases that were awarded with less evidence than I have? How should I write it up? When I went to my TAP class 3 months before I retired, a VA rep said that you have I year to claim anything that is not in your SMR. I should have never listened to that guy!! Any help would be great.

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  • HadIt.com Elder

First of all, you don't get invited to a "de novo review" for it is, as it implies, an "informal" review conducted by the VARO, now a DRO review, that you get to go to.

Secondly, WHO diagnosed you with sleep apnea, and HOW did they diagnose you (sleep studies, etc.)? For, if I read you correctly you were denied due to "the cited evidence appears to be a general conclusion based on your subjective history", which indicates to me that there was no actual medical evidence indicating that you have sleep apnea, or, at least, the VA didn't see it, if there was any.

So, if you have been disgnosed as suffering from sleep apnea by a qualified medical professional, and there is adequate "lab work" to prove your case, then you need to file an NOD and make doubly sure that the VA has this in their possession. Which brings to mind, WHAT DID THEY base their decision on..............what evidence did they cite for their reasoning? And, did this list of evidence include all the above? For, if it did not, then you need a qualified medical professional to give a diagnosis of sleep apnea, citing something other than your subjective history, and then connecting the sleep apnea that you have now with you service by prodiding a nexus.

just sayin.............

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First of all, you don't get invited to a "de novo review" for it is, as it implies, an "informal" review conducted by the VARO, now a DRO review, that you get to go to.

Secondly, WHO diagnosed you with sleep apnea, and HOW did they diagnose you (sleep studies, etc.)? For, if I read you correctly you were denied due to "the cited evidence appears to be a general conclusion based on your subjective history", which indicates to me that there was no actual medical evidence indicating that you have sleep apnea, or, at least, the VA didn't see it, if there was any.

So, if you have been disgnosed as suffering from sleep apnea by a qualified medical professional, and there is adequate "lab work" to prove your case, then you need to file an NOD and make doubly sure that the VA has this in their possession. Which brings to mind, WHAT DID THEY base their decision on..............what evidence did they cite for their reasoning? And, did this list of evidence include all the above? For, if it did not, then you need a qualified medical professional to give a diagnosis of sleep apnea, citing something other than your subjective history, and then connecting the sleep apnea that you have now with you service by prodiding a nexus.

just sayin.............

Sorry LarryJ,

Yes, I was given a sleep study and then another for my CPAP setting. This was all done within 3 months after retirement. So the VA has a copy of the sleep study and the diagnosis or course. The letter from my sleep doc (not the one that gave me the sleep study) has seen me since and was nice enough to write up something for me with his opinion.

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Joey, you need to look for the results of the apnea like High Blood Pressure, daytime sleepiness. Then you need a Sleep Doctor to look at the record, (all) and have them to opine that your OSA had its onset during your military service.

J

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  • HadIt.com Elder

Do you need a CPAP or BIPAP Machine at night. Has one been prescribed to you. You have a solid claim just need to firm it up a bit.

Good Luck

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Yes, I have a CPAP machine that was prescribed right after my sleep study. I do have a opinion from the doctor that I am seeing now about my apnea. He was able to get a better mask for me to use with my machine. He wrote up an opinion for me. Not the strongest letter, but not bad either.

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