ptsd Opition

[ghillbe]

have a question for all, I origanaly filed for 3 items after my gulf war regestry exam for sleep apena,ptsd and insominia, I was denied in july 2010 I field a appeal on dec 2010. In dec 2010 I filed a new claim for 14 items under undiagnosed issues, my question is should I cansel my appeal and file a new claim for ptsd and sleep apenia and insomia secondary to ptsd? or can you add or change after an appeal or add these items to my second claim thanks

[broncovet]

I dont recommend canceling any claims or refiling, especially not if you have appealed. If you withdraw anything it will side track your claims, and hurt your effective date.

If you think they are not progressing on your claims, rather than refile, you can send a 21-4138 something like this:

I would like to know the status of the claim filed for PTSD and sleep apnea on Jan. 12, 2002.

[stillhere]

Well I feel the only reason to cancel a claim would be if you have gotten better? What is your answer to that question?

[carlie]

have a question for all, I origanaly filed for 3 items after my gulf war regestry exam for sleep apena,ptsd and insominia, I was denied in july 2010 I field a appeal on dec 2010. In dec 2010 I filed a new claim for 14 items under undiagnosed issues, my question is should I cansel my appeal and file a new claim for ptsd and sleep apenia and insomia secondary to ptsd? or can you add or change after an appeal or add these items to my second claim thanks

Sleep difficulties are rolled into the criteria for PTSD - I would not be filing for it

as a separate issue as it just junks your claim up more.

JMHO

[Gulfvet45]

There is a BVA case that a veteran got SA secondary to PTSD, but you need a doctor saying there is a nexus of it. That is where a study done showing it will help.

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

http://lawampm.com/blog/veterans-benefits/?p=451

Sleep Apnea Elevated in Veterans with PTSD

Posted on January 11, 2012 by Kara Campbell

By Crystal Phend, Senior Staff Writer, MedPage Today

VANCOUVER — Combat veterans with post-traumatic stress disorder (PTSD) almost universally suffer sleep problems — with more cases of sleep apnea than might otherwise be expected — U.S. Army researchers found.

In a group of 135 young, otherwise healthy combat veterans with PTSD, 98.5% reported sleep complaints, Nick Orr, MD, and colleagues at the Walter Reed Army Medical Center in Washington, D.C., reported here at the annual international scientific meeting of the American College of Chest Physicians (CHEST).

Despite their relatively young age (around 35) and slightly overweight physique, 54% of the PTSD patients who underwent polysomnography at Walter Reed were diagnosed with obstructive sleep apnea (OSA) — whereas, in the general population, the rate of OSA is only 20%.

It can be all too easy to dismiss daytime sleepiness and other symptoms as part of depression and PTSD, Orr explained. But these results argue for screening all military PTSD patients for sleep apnea, Orr said in an interview.

“You’ll be darned if you just keep treating it with medications, cognitive behavioral therapy, and all the other modalities you use for PTSD, when you haven’t addressed possible sleep apnea, which could get restorative sleep and kind of break the cycle for the PTSD symptoms,” he told MedPage Today.

Session co-moderator Andreea L. Antonescu-Turcu, MD, of the Medical College of Wisconsin and chief of pulmonology at the Zablocki VA Medical Center, both located in Milwaukee, agreed that the study results should justify the importance of screening for sleep problems in military patients with PTSD — even when they don’t fit the classical profile for OSA.

“As the data are coming out it probably should be part of their routine evaluations to screen for sleep disordered breathing,” she told MedPage Today. “Maybe this is part of their disorder that we have to address early on in patients with PTSD.”

The reason for the well-recognized sleep problems in PTSD isn’t clear, but recent reports have argued that these symptoms should be considered a central feature of the disorder and not just a consequence of it, Orr noted.

His group retrospectively analyzed electronic medical records for all 135 service members (91.9% men, average age 35.3) with combat-related PTSD seen at the Walter Reed sleep clinic from March 2006 through April 2010.

Orr noted that these returning soldiers were assigned to the Warrior Transition Brigades, which were asked to refer PTSD cases with with traumatic brain injury to the sleep clinic.

Not surprisingly, the majority of veterans in the current study had been injured (80 of the 135) and about 70% were traumatic brain injuries, primarily mild concussions from blast incidents.

The average body mass index (BMI) was 28.91 — putting most of the patients in the overweight but not obese category.

Comorbid psychiatric illness was nearly universal with PTSD in the study patients; 88.9% suffered from depression and 44.4% were diagnosed with anxiety.

[71M10]

GulfVet this is good information.

I notice the VA apparently has never done a study of incidence of sleep apnea in veterans in general compared to the non-veteran population. If someone has seen this please point me to it!

I have a sneeking suspicion that there is a statistically significant overall higher rate in Veterans vs the general population.

Best regards,

[Capt.]

Hello ghillbe,

I would take Carlie and Broncs advise. I agree wholeheartily. Do not withdraw anything at this point. Let your claims work thru the process that HAS to happen. Yes it is a long one. Yes you may be surprised by the answer from RO ,,,,,sometimes ....SOMETIMES they do get something partially right. Once you get the decision.....good or bad will be the time for the appeals process and then addressing each issue and considering whether you have ENOUGH Medical opinions to win your claim. MEDICAL OPINIONS and EVIDENCE WINS>>>>>>WINS>>>>>>> CLAIMS. NOTHING ELSE. Yes it may take going to the court system, but all of us here know that it is the medical opinions that will push a Veteran over the line of fairness to the GRANT position.

Even my C and P exams though I do not have them yet ,,,,were somewhat favorable and helped the Regional Office to award some of the claims that were filed. WITHOUT THE COURT. Yes that is not normal , but it does happen ,,,as it did to me. Now if the RO does award ,,,,,almost always without exception , they DO NOT GET IT RIGHT, so you will probably have to.

A. Appeal for a higher Rating or schedular.

B. Appeal for a missed disease or lack of acknowledgement of one.

C. Appeal for a missed secondary issue that is covered under the 38 CFR , M21s.

D. Request a NOD on an issue that was not carried out or just plain missed. Sometimes this will shorten the wait by giving them one more chance to get it right. Otherwise its going to the Courts ,,,,BVA or CAVA

E. Use of a good VA lawyer eventually.

I also agree with Gulfvet....... You are probably going to have to get an IMO on any of it , including the secondary problems. You have to tip the scales ......Benefit of a Doubt rule.. 38 CFR 3.142. It is only necessary to have the Doctor link it to your claim with ALL the Records and Evidence he HAS to see.

"As least as likely as not" is the wording that will get the job done. Even though there are stronger ones , which we have already discussed in older subject post....this is the one that will and has for most of us here at Hadit to get er done.

Now you should try get your wits about you. The VA is methodically cold and slow, and very patient, full of mistakes and wrong decisions. It will take a plan , carefully wording of any more communications, strong evidence such as buddy statements. environmental reports(if required), and of course a strong IMO. (Independent Medical Opinion)...and if you are fortunate .....you can also get your VA doctors to help you to add to the IMO, if ....IF ...they will.

I have 3 VA doctors who wrote Opinions and have helped me greatly . Not all of them will refuse. When you have IMOs that are strong and together with your VA doctors will usually make an unbeatable situation if you can just go thru the process they will force all of to manuever. If you get to the point that it seems like you are being bullied , or you are getting tired and cannot focus then a good VA lawyer is another route. Especially if your claim is complicated like mine is.

Last but not least ...this battleplan is proven...it works as others here have done. I am one of the few Chemical exposure Soldiers who has WON part of my claim at a Regional Office(DRO) WITHOUT the use of the court. I have used this plan because it has worked for most of our Elders, Moderators , and other Veterans. This is what I was advised many years ago. PATIENCE , TIME, EVIDENCE and of course a positive attitude that will include my opinion, as in all post , to ................................

NEVER GIVE UP. God Bless, C.C.

Edited May 16, 2012 by Capt.Contaminate