Sleep Apnea And Asthma Combined

[chiefhouse00]

Greetings

I may have ask this question once before but here it is again. Can asthma and sleep apnea be combined as one single rated service connected disability? I was first rated at 30 % for asthma. Later when the VA approved my sleep apnea claim, both conditions were combined and rated at 50%. After nearly one year of filing the NOD (both aliments should be rated separately), I got a denied decision again and statement of the case (SOC) from the VA. What should I do...should I complete the SOC or just leave it alone. What say you????

Best Regards

Chiefhouse

[Jim MAC]

Greetings

I may have ask this question once before but here it is again. Can asthma and sleep apnea be combined as one single rated service connected disability? I was first rated at 30 % for asthma. Later when the VA approved my sleep apnea claim, both conditions were combined and rated at 50%. After nearly one year of filing the NOD (both aliments should be rated separately), I got a denied decision again and statement of the case (SOC) from the VA. What should I do...should I complete the SOC or just leave it alone. What say you????

Best Regards

Chiefhouse

Chief

I am rated 50 percent for sleep apena. I say fill the form 9 out and go to the BVA nothing to lose.

Jim

[Guest jstacy]

Is the Sleep Apnea secondary to the Asthma? This must be the way they rated it. I would appeal and get it to the BVA. It needs to be separated. If you are using a CPAP or Auto PAP machine it is a 50 percent rating. The Asthma should be rated separatly or if not it should reflect the percentage of actual disability you have.

[Vike17]

Take a look at, I think, 38 CFR §4.96. The two conditions can't be given different evaluations under the current law! However, your rating can be given the next higher level under this provision of the regulation.

"A single rating will be assigned under the diagnostic code which reflects the predominant disability with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation."

There isn't any basis to appeal the decision on. The only thing I would do is see if your disability qualifies you for that next higher evaluation.

Vike 17

[chiefhouse00]

Greetings

Here is the VA Reasons and Bases (short version):

Our records show a 30 % disability evaluation assigned for bronchial asthma effective Dec 2002. Our Rating Decision dated Sept 2005 granted service connection for sleep apnea and included this evaluation in the evaluation for bronchial asthma. Effective Feb 2005, a 50% disability evaluation was assigned to bronchial asthma with obstructive sleep apnea. "Sleep apnea was the predominant disability providing the a higher disability evaluation than the asthma.

So should I close the book on this issue and let it be.

Best Regards

Chiefhouse

[chiefhouse00]

(a) Rating coexisting respiratory conditions.

Ratings under diagnostic codes 6600 through

6817 and 6822 through 6847 will not be combined with each other.

Where there is lung or pleural involvement, ratings under diagnostic codes 6819 and 6820

will not be combined with each other or with diagnostic codes 6600 through 6817 or 6822

through 6847. A single rating will be assigned under the diagnostic code which reflects

the predominant disability with elevation to the next higher evaluation where the severity

of the overall disability warrants such elevation. However, in cases protected by the

provisions of Pub. L. 90–493, the graduated ratings of 50 and 30 percent for inactive

tuberculosis will not be elevated.

6602 Asthma, bronchial:

FEV-1 less than 40-percent predicted, or; FEV-1/FVC less 100

than 40 percent, or; more than one attack per week with

episodes of respiratory failure, or; requires daily use of

systemic (oral or parenteral) high dose corticosteroids or

immuno-suppressive medications............................

FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 60

to 55 percent, or; at least monthly visits to a physician

for required care of exacerbations, or; intermittent (at

least three per year) courses of systemic (oral or

parenteral) corticosteroids...............................

FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 30

to 70 percent, or; daily inhalational or oral

bronchodilator therapy, or; inhalational anti-inflammatory

medication................................................

FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 10

to 80 percent, or; intermittent inhalational or oral

bronchodilator therapy....................................

Note: In the absence of clinical findings of asthma at time

of examination, a verified history of asthmatic attacks

must be of record.

6847 Sleep Apnea Syndromes (Obstructive, Central, Mixed):

Chronic respiratory failure with carbon dioxide retention 100

or cor pulmonale, or; requires tracheostomy...............

Requires use of breathing assistance device such as 50

continuous airway pressure (CPAP) machine.................

Persistent day-time hypersomnolence........................ 30

Asymptomatic but with documented sleep disorder breathing.. 0

Just based on what you say the sleep apnea could not be the predominant disability. You already had 30% for the asthma before the sleep apnea was even considered. That is an indication to me that you received 20% for the apnea. Which makes no sense based on the seperate ratings allowed.

Also as someone has stated if you use a cpap machine then that would warrent a 50% rating.

If the va rates the conditions combined then then it should be rated as:

asthma w/sleep apnea 60% ( this is because the next higher rating for the asthma is 60% not 50%)

or:

sleep apnea with asthma 50% as it is rated.

I would nod the decision request clarification concerning which is the predominate disability. Because it really seems as if you only received 20% for the apnea, and that just does not seem right.

You never indicated if you use a cpap machine. If you do not then I think you are ahead of the game. If you do then you are not being rated properly. Either way the rule is clear they cannot be rated seperately.

Hope this helps

Greetings

Yes, I use the CPAP nightly and take meds for Asthms.

Best Regrads

Chiefhouse

"Sleep apnea was the predominant disability providing the higher disability evaluation than the asthma.