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

[Guest]

I have been looking for a hobby to fill some of my time. They have lit a fire under me this time and I will immerse myself in VA regs and info. All the information that I've read has said that obesity is a major contributor for sleep apnea. Let me know how things go. Good luck.

Navydoc, have you went to a sleep evaluation specialist at the VA to explain why you have sleep apnea? This could be a medical evaluation that could be in your favor. It is where the specialist will review your sleep study, ask you some questions and then give you an exam and make a diagnosis of your condition and put it in your progress reports.You can also ask your mental health doctor to put in your records that your sleep apnea is cause by or aggravated by your service connected depression and medication.

[navydoc2]

Thanks Pete. No I have not had a sleep specialist evaluate me. I will do request that at my next primary care appt. That is coming up in the next few weeks.

/doc

[Phil35]

Another Sleep Apnea denial right here folks. I put the claim in 3 years after getting out because I heard another Veteran talking about issues he had. I never knew of the condition before and am now paying the piper for it. They denied me and said where I was stating insomia that wasn't the same thing as sleep apnea or could be confused as such. Whats the deal, idea some useful insight needed...soon