ptsd Va And Sleep Apnia

[mojo13]

A friend just called me and said that the VA is now approving claims for sleep apnia due to PTSD??? this was told to him by his attorney, does any one hear of this ?????

[carlie]

here are some article for you to show your doctor to help you in your nexus letter.

http://www.chestnet....p-and-breathing

Here is a case that it as done in.

http://www.va.gov/ve...s01/0102100.txt

As I posted earlier, VA grants claims on medical evidence.

I believe the attorney referred to by the OP, just kind of made a generalized / blanket

statement that by itself, is not supported by any USC laws or 38 CFR regs.

This could clearly and easily lead to belief of an untruth.

"He has ptsd and waqs denieed sleep apnia and gotim self a lawyer she called him told him they are approving sa for vets secondary to ptsd who have shown symptoms and use a cpap."

Just so the OP can see what I'm talking about Im going to use this BVA case you posted the link to.

It's a good case to use for example.

"Citation Nr: 0102100

Decision Date: 01/25/01 Archive Date: 01/31/01

DOCKET NO. 99-22 315 ) DATE

On appeal from the

Department of Veterans Affairs Regional Office in St. Louis,

Missouri

THE ISSUE

Entitlement to service connection for sleep apnea as

secondary to service-connected post-traumatic stress disorder

(PTSD).

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Richard A. Cohn, Associate Counsel

INTRODUCTION

The veteran served on active duty from April 1970 to December

1971.

This matter comes before the Board of Veterans' Appeals

(Board) on appeal from an August 1999 rating decision of the

Department of Veterans Affairs (VA) Regional Office in St.

Louis, Missouri (RO) which denied service connection for

sleep apnea as secondary to service-connected PTSD.

FINDINGS OF FACT

1. The record includes all evidence necessary for the

equitable disposition of this appeal.

2. There is competent medical evidence linking current sleep

apnea to the veteran's service-connected PTSD.

CONCLUSION OF LAW

The veteran's sleep apnea was aggravated by his service-

connected PTSD. Veterans Claims Assistance Act of 2000, Pub.

L. No. 106-475, 114 Stat. 2096 (2000); 38 U.S.C.A. § 5107,

38 C.F.R. § 3.310(a) (2000).

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The veteran attributes sleep apnea to his service-connected

PTSD. The veteran does not contend that he incurred or

aggravated sleep apnea during service and there is no

evidence of sleep apnea or other sleep disorder in the

veteran's service medical records SMRs.

Procedurally, this appeal is developed fully and ready for

Board adjudication. The RO has verified the veteran's period

of service; there is no issue as to the substantial

completeness of the veteran's application for VA benefits;

the veteran has undergone VA examination pursuant to the

application; the RO has requested and associated with the

claims file all available service and postservice medical

records pertinent to this appeal; VA is unaware of other

unrequested records pertinent to this appeal, and; the

evidence is sufficient to permit the Board to proceed with

appellate review. See Veterans Claims Assistance Act of

2000, Pub. L. No. 106-475, 114 Stat. 2096, (2000).

A veteran may be entitled to service connection for a

disability under either a direct or secondary analysis.

Direct service connection is warranted for disability

resulting from disease or injury incurred or aggravated in

service. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. §

3.303 (2000). Secondary service connection is warranted both

for a disability caused by a service-connected disorder and

for a disability aggravated by a service-connected disorder.

38 C.F.R. § 3.310(a) (2000). In the latter case,

compensation is limited to the extent to which the service-

connected disorder increased the severity of the secondary

disorder. Allen v. Brown, 7 Vet. App. 439, 448 (1995); Jones

(Wayne) v. Brown, 7 Vet. App. 134, 136-37 (1994). A service-

connected secondary disorder becomes part of the original

disorder. 38 C.F.R. § 3.310(a).

The veteran is a decorated former Army combat soldier whose

PTSD has been service-connected since July 1995. SMRs

include no evidence of a sleep disorder in service and the

veteran claims none.

VA medical records confirm that the veteran underwent sleep

studies in February and October 1998 from which he was

diagnosed with sleep apnea. A VA psychiatric progress note

from February 1999 briefly reviewed the studies' findings and

applicable research and concluded that PTSD and its treatment

"in all probability has aggravated the obstructive sleep

apnea." The note further states that "it is certainly as

likely as not that this veteran's sleep apnea is directly

related to his PTSD." The VA physician who examined the

veteran in July 1999 identified two likely causes of his

sleep apnea: enlarged tonsillar tissue and obesity. The

physician found no etiological connection between PTSD and

enlarged tonsillar tissue. However, he acknowledged that

"an argument could be made" linking the veteran's obesity

with PTSD although the veteran's medical records did not

include another medical opinion to that effect.

In the Board's judgment the record presents adequate evidence

upon which to base a finding that the veteran's PTSD

aggravated his sleep apnea. The opinion expressed in the

February 1999 progress note is neither ambiguous nor

equivocal on that point. The July 1999 examination report is

more tentative -- finding only a medical possibility of

attenuated causality under a different rationale.

Nevertheless, the July 1999 opinion does not refute the

February 1999 opinion, and it is well established that VA

itself may not refute expert medical conclusions in the

record with its own unsubstantiated medical conclusions.

Colvin v. Derwinski, 1 Vet. App. 171, 175. (1991).

Therefore, absent medical evidence actually denying a causal

linkage between PTSD and sleep apnea in this case, the Board

reads the two opinions together as providing, at minimum,

evidentiary equipoise which must be resolved in the veteran's

favor. See 38 U.S.C.A. § 5107(b). Accordingly, the Board is

constrained to find that service connection for sleep apnea

is warranted here under a secondary analysis. See 38 C.F.R.

§ 3.310.

ORDER

Service connection for sleep apnea is granted secondary to

service-connected PTSD.

WARREN W. RICE, JR.

Member, Board of Veterans' Appeals"

TO MOJO,

Had this veteran NOT had medical evidence in the opinions,that connected his SA secondary to his PTSD, the claim would not warrant service connection. Example:Vet is SC'd for PTSD.Vet has a sleep study and is diagnosed with SA and RX'd a CPAP.If there is no medical evidence of record that connects the SA to the PTSDeither one of two things will happen.1) The claim for SA will be denied and the vet has the avenue to NOD/Appeal.2) The VA decision maker will request a C&P be scheduled to determine themedical cause of the veterans SA.If the examiner opines that the SA is not related or a result of the veteransPTSD, the issue will remain denied. The veteran would need to obtain medical evidence to the contrary that connects.the two conditionsThis would at least garner application of the BOD, to get the issue granted.The simple%

[broncovet]

Correct, OSA can be SC provided you have the nexus. The Veteran in the case Carlie cited met all 3 Hickson elements:

1. He had a current diagnosis of OSA.

2. He had documented PTSD (service connected)

3. He had a "nexus" statement from his doc linking the two.

In my experience the hard part is getting a VA doc to provide this nexus. The rest is mostly waiting, appealing and persistence. PTSD and sleep apnea are no different than the other maladies.

If the doc says they are connected, then the Va will be hard pressed to try to refute what the doc says. It is all about the medical evidence.

[mojo13]

Thank you all so much for your comments, I will keep you informed. The lawyer still saids its a new thing that they are giving those ptsd case who meet the requirments of Sleep apnia, who knows but again thanks and you guys are the best.

[Gulfvet45]

you still need to get a nexus from your doctor to get it as a secondary. that is what we are all telling you. with out it you will not win.

get the study that the article is talking about and show it to your doctor and get your letter. send that letter and the study in with your claim. then maybe you will win.

http://www.reuters.com/article/2011/10/28/us-sleep-ptsd-idUSTRE79R35S20111028

Thank you all so much for your comments, I will keep you informed. The lawyer still saids its a new thing that they are giving those ptsd case who meet the requirments of Sleep apnia, who knows but again thanks and you guys are the best.

[mojo13]

Thanks gulfvet he has the letter from VA docter, sleep study results, and 2 articles. He is 30% ptsd and 2 PH, lets see what happens will let you guys know. Thanks again.

[militarynurse]

PTSD and obesity linked - BVA decision: http://www.va.gov/vetapp00/files2/0010958.txt