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Denied Sleep Apnea / Need Advice For Nod

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AmicusBrief

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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Sorry to harp on this, did they list the ime/imo/doctor's letter in the evidence section of the decision. This is a fairly important fact/status to ascertain.

The EVIDENCE section does list supported letters and sleep study to include letters from veterans (three buddy statements).

Denial reason and Explanation is listed below:

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 condition.

Thanks to all for responding in preparation to write the NOD.

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I've noticed that Dr. Bash name has been mentioned on this forum. My question, "Who is he and should i use him for my appeal?"

I engaged Dr Bash. He's thorough and has helped numerous folks through the process. I had my original SMR's which he went through and worked up the IMO.

For the sleep apnea he worked mine as secondary. I submitted all paperwork a few weeks ago.

He's expensive, but I guess that's a relative term. I was extremely satisfied with what he provided, but truth will be in the pudding when I get decision from VA

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Rover in your NOD be sure to point out that there "IS A CURRENT DIAGNOSED DISABILITY", Sleep apnea was Diagnosed by Dr. XXXX on MM/DD/YY, and this medical fact was communicated to the Veterans Administration in the letter/medical opinion dated MM/DD/YY that is listed the Veterans Affairs decision dated MM/DD/YY, under evidence. I would immediately request a post decision hearing, Ask them to grant this hearing immediatley. Indicate an immediate hearing is necessary so you can decide the best way to move forward with your claim.

Its crap like this that really pisses me off! There should be some kind of penalty assesed to VA empolyees that so completely and totally screw up a decision this bad. Since the fool that rated this can't or won't read (as evidenced by a declarative statement they made that is totally contradicted by the evidence they have listed), a vet gets to spend another 3-5 years working this through the appeals process.

Don't give up!

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