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AmicusBrief

Denied Sleep Apnea / Need Advice For Nod

Question

On 2 Nov 2012, I've received Sleep apnea Denial Reason: The evidence does not show a current diagnosed disability. Explanation: Your service treatment records do not contain complaints, treatment, or diagnosis for this.

I've submitted supporting documents from three buddies, wife, and medical statement from sleep doctor ( MD, Ph.D) saying: Given the findings of the sleep studies and history of weight changes (more in the past), diabetes and reported symptoms, it is more than likely than not, that the patient developed sleep apnea while in service. My sleep problems started 12-15 years ago.

Also i included documents from a current sleeping study conducted by the American Sleep Clinic, were my sleeping problem was diagnosed as Obstructive Sleep Apnea.

Note:

1) I am not able to point to any specific problems in my medical records. All three buddies attest to my sleep problems while serving in the Army. 2) The sleep study was conducted in 2011; my initial claim was filed Dec 2010 and denial letter was received on 2 Nov 2012.

3) The sleep study doctor written a detailed medical statement about the current findings, sleep apnea onset, insomnia, sleep study reports, discussed follow up visit and overall assessment.

Prior to submitting my NOD; maybe i should do a sleep lab follow up and ask for another IMO statement.

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Did they even give you a C&P for Sleep Apnea?

Did you have any hypertension in service or any other medical conditions that co-exist or are contributory to Sleep apnea?

"the evidence does not show a current diagnosed disability" If you provided them with a medical opinon from a sleep doctor that states you have sleep apnea the preceeding statement is factually wrong.

Check the evidence listing in the decision and ensure that they listed the medical opinon as evidence.

If they didn't, you need to dig out your signed receipt (post card showing who signed for it), and in your NOD point out they didn't include all the evidence that was in their possession.

If you are relying on buddy statements (no obvious medicial evidence linking besides weight gain) you need to go to BVA. If that is the case, I would advise not going the DRO route (I doubt any DRO is going to grant apnea on a buddy/ies statement).

Best of luck!

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If your SMR's do not show treatment, DX or complaints of sleep apnea, and that is what they are basing their denial on then the buddy letters are about all you have. If, however, they are saying you don't have a current DX of sleep apnea based on VA or private records that would be a factual error. The VA sure does not like to SC sleep apnea after a vet is out of the service unless he was treated for it while in the service.

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first off. they are confusing two elements of service connection.

the first is a disability. you provided evidence of that.

they say you don't have a disibility because it does not show in your smr.s totally wrong. you can be diagnosed many years after service without having complaints of the condition in service and still be service connected.

my smrs say nothing about sleep apnea but the c&p doctor related my current sleep apnea with exposure to solvents in service. i also submitted some internet articles that he referenced. I also had an imo from dr bash. all supporting service connection. will the va do the right thing?

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Rdawg

I am very interested in what Dr. Bash had to say. I, too, have sleep apnea and I believe it is due to weight gain from anti-depressants and pain meds from the VA. I also have DMI due to AO. I am wondering if I could get the apnea as secondary to mental conditions and DmII and PN (which makes it hard to exercise). I take a lot of pills from the VA that slow me down including blood pressure meds and meds for cad which SC. I just developed apnea in the last few years since these things were SC'ed. I don't mean to hijack this thread but your post really rang a bell I had not considered and I don't think Rover considered it either.

John

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Did they even give you a C&P for Sleep Apnea? No

Did you have any hypertension in service or any other medical conditions that co-exist or are contributory to Sleep apnea?

The doctor wrote the following: Although there is no prior documentation of sleep apnea, it is likely that Mr. Robinson has had sleep apnea at greater disease severity at earlier time points, when he was obese with a BMI well exceeding 30kg/m2. It is well documented, that the likelihood of having sleep apnea >10 events/hour is greater than 50 % in men (more likely than not) if the BMI exceeds 30 kg/m2. The fact he has diabetes, witnessed apneas and loud snoring increases the likelihood of having sleep apnea to >90%.

Finally, the narrow upper airway is consistent with an anatomical predisposition that may have made Mr Robinson more susceptible to the development of sleep apnea with weight gain, and it is possible that he has had sleep apnea even when he was in the 30ties. Thus, it is more likely than not, that Mr. Robinson has had significant sleep apnea while in the service.

Insomnia: Although back pain may have contributed to insomnia, we strongly believe that the insomnia is also related to Mr Robinson sleep apnea.

Also I was denial diabetes but i will address in a separate thread.

"the evidence does not show a current diagnosed disability" If you provided them with a medical opinon from a sleep doctor that states you have sleep apnea the preceeding statement is factually wrong.

Check the evidence listing in the decision and ensure that they listed the medical opinon as evidence.

If they didn't, you need to dig out your signed receipt (post card showing who signed for it), and in your NOD point out they didn't include all the evidence that was in their possession.

If you are relying on buddy statements (no obvious medicial evidence linking besides weight gain) you need to go to BVA. If that is the case, I would advise not going the DRO route (I doubt any DRO is going to grant apnea on a buddy/ies statement).

Best of luck!

Edited by Rover

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