tdiu Denied Initial Claim For Sleep Apnea

[navydoc2]

I recently received my denial letter from the VA a few days ago. I had started a claim for sleep apnea with C-PAP secondary to weight gain from psych meds namely abilify which put more than 70 pounds on me in the year and half I took it. I am currently TDIU service connected at 80% with 70% major depression, 10% left knee, 10% tinnitus. I was seen by my psych nurse practitioner initially in Sept 09 where she first suggested I talk to my primary care Doc about sleep apnea. I did that and was scheduled for a sleep study in late Nov 09. I was issued a C-PAP and then started a claim. This the reasons and basis for the denial.

EVIDENCE:

* Service Treatment Records Feb 1990 - Dec 1998

* VA Form 21-4138 statement in support of claim received Nov 10

* Outpatient Treatment Records May 10

REASONS AND BASIS FOR DECISION:

We have denied service connection for sleep apnea with CPAP related to weight gain due to depression medication. Service Treatment Records are negative for complaints, diagnosis, or treatment of sleep apnea.

In your statement received Nov 10 you informed us you were claiming this because of your significant weight gain due to medication for depression. Outpatient Treatment Records obtained and received in connection to this claim presented you reporting you have sleep apnea. Entry dated Jun 10, presented you reporting you get headaches if you do not wear use CPAP. Entry dated May 11 shows you were issued replacement CPAP supplies.

The evidence does not show that sleep apnea with continuous positive airway pressure (CPAP) related to weight gain is related to the medication you take for service connected condition of major depression, nor is there any evidence of this disability during military service.

Attached is the sleep study I was sent to by my primary care doctor at the VA. How could they say there is no outpatient record of it; when it is the VA docs who sent me for a sleep study to rule it out? Also I was issued the CPAP by the VA after the sleep study.

Please help or guide me in the right direction after reviewing information. Thanks in advance.

/doc

Edited August 3, 2011 by navydoc2

[navydoc2]

osa edit2.pdf

[Berta]

"he evidence does not show that sleep apnea with continuous positive airway pressure (CPAP) related to weight gain is related to the medication you take for service connected condition of major depression, nor is there any evidence of this disability during military service."

In my opinion you would need an IMO to support that the weight gain is due to the SC meds.Did you send them any strong internet print outs that show the med you take causes this type of weight gain?

Even if you did send them that as evidence, however, they would be more willing to consider tat type of evidence if it came from a doctor in support of your claim- with a full medical rationale.

Also the nexus is missing per the VA.

Is there anything in your SMRs that they overlooked? In your 201 file?

Any documentation you were late for duty due to oversleeping? Or fell asleep on duty?

Do you have any buddy statements saying you snored loudly in service?

[carlie]

In my opinion you would need an IMO to support that the weight gain is due to the SC meds.Did you send them any strong internet print outs that show the med you take causes this type of weight gain?

Even if you did send them that as evidence, however, they would be more willing to consider tat type of evidence if it came from a doctor in support of your claim- with a full medical rationale.

Also the nexus is missing per the VA.

Ditto on Berta's post above.

I also notice in one section of the upload, it states something to the effect of,

that with ENT evaluation, the apnea might be corrected by removal of the tonsils.

[71M10]

I would agree that a stronger medical opinion will most likely be needed. But the examiner did list the depression as a co-morbid condition along with the weight gain. The dots are there and a reasonably inteligent person can see the applicability to VA regulation, but unfortunately the VA will try to require that you have a doctor explicitly connect them.

I am currently waiting on a SOC for a DRO on restrictive lung encompassing kyphoscoliosis (from SC thoracic back), Apnea (diagnosed after service but letter from doctor pointing out in-service medical findings that indicate it started in service) and secondary on Apnea due to aggravation by SC conditions (back pain, opiates, phrenic nerve irritation) When I hear, I will share with the board.

Best regards,

Tyler

[navydoc2]

Thanks all for the replies. Berta I'm not sure what you mean by "nexus is missing per the VA." I do have the progress note from my VA psychiatrist, saying he was d/c the abilify because of significant weight gain and it not working.

"The evidence does not show that sleep apnea with continuous positive airway pressure (CPAP) related to weight gain is related to the medication you take for service connected condition of major depression, nor is there any evidence of this disability during military service."

In my opinion you would need an IMO to support that the weight gain is due to the SC meds.Did you send them any strong internet print outs that show the med you take causes this type of weight gain?

Even if you did send them that as evidence, however, they would be more willing to consider tat type of evidence if it came from a doctor in support of your claim- with a full medical rationale.

Also the nexus is missing per the VA.

Is there anything in your SMRs that they overlooked? In your 201 file?

Any documentation you were late for duty due to oversleeping? Or fell asleep on duty?

Do you have any buddy statements saying you snored loudly in service?

[navydoc2]

I understand your point Carlie, however wouldn't the BOD rule play into this. I don't know if getting my tonsils out will help as long as I'm close to 300lbs.

Ditto on Berta's post above.

I also notice in one section of the upload, it states something to the effect of,

that with ENT evaluation, the apnea might be corrected by removal of the tonsils.