Your Help Would Be Greatly Appreciated

[Jayco]

Received a decision letter in July with a rating of 40%. A catch up payment was deposited to my bank and monthly payments are coming in. In the decision letter VA said they did not receive proof of marriage and therefore did not include that in my monthly payment. Sent proof in July, but DAV says it will take a year for VA to process. I was surprised it would take that long on something I consider minor.

VA also said in the decision letter they did not receive a questionnaire related to diabetic neuropathy and requested it. That's been sent . I assume that the fact they requested the questionnaire means my rating might change and that the present rating is just to get something going money wise.

My question on the above two items is this. Do I need to be doing something else or just wait? Do I need to file new forms of any kind at this point? I ask because not being familiar with the process I may let time slip away on any appeal process that might be necessary.

My second question is this. In my original claim I listed sleep apnea as a health problem, but did not list it as service connected. At the time did not see it as being service connected and listed it on the claim out of ignorance of the process. VA denied it. I was surprised that they even addressed it since I did not list it in the area listing service connected health issues. I've since read where sleep apnea is being approved as service connected. Should I go back and file an appeal on sleep apnea?

Third and last question. I have diverticulitis and have had for several years. It was originally discover 15 or 20 years ago. Kept having a pain on my left side. My doctor was stumped since there were no major organs in that area. Finally he sent me for a colonoscopy and that is when the cause of the pain was discovered. Doctor said should be okay, so no pills or treatment of any kind. Just have to watch my diet. I have a pain in that area off and on. Sometimes mild, sometimes fairly severe. Should I file a claim?

Sorry for this being so long.

Thanks.

[Computer Tech]

Jayco,

Like free spirit said you should be able to get your CPAP and supplies from the VA regardless of whether your sleep apnea is service connected or not but the VA will want to do a sleep study before they do.

For us oldtimmers it's kind of hard to get sleep apnea service connected maily because it wasn't called that in the 60s and 70s. But if you can get buddy letters saying that you snored and were tired all the time it can be done.

Rick

[john999]

If a vet has service connected DMII then there is a great many other diseases that can be connected as secondary with a little application of effort. DMII affects so many body systems from your eyes to your feet.

[free_spirit_etc]

Jayco,

When did you get your notice on your claim? You have one year from that date to file a NOD (Notice of Disagreement). I would suggest you disagree with the denial of the sleep apnea. Though you said you didn't claim for it as a SC condition - they must have treated it as an implied claim. You don't have to disagree immediately, but you do need to file your NOD within one year of receiving the notice. If there is a possibility of getting it SCed, you would want to explore that. You might be able to show it stated in service, that you had symptoms in service, etc. Or you might be able to get it connected as it could be related to you diabetes. If you disagree, and it is later granted - you will get paid all the way back to when it was initially claimed. If you don't disagree - and then later try to get it SCed, they will only pay back to the date you re-opened the claim.

So I would advise you to go ahead and appeal the decision within the time-frame - and you will still have time to explore the different ways it might be service connected.

Thank you for your service! And bless your friend that let you know that as a Vietnam Vet you could get SC for your diabetes and heart disease!

[Jayco]

Going to file a NOD form 21-0958 on the sleep apnea being secondary to the type 2 diabetes as recommended by a few members in this thread. From reading various material on the internet there seems to be enough information supporting the connection. Want to submit with the form support documents, but not sure what to submit.

Going to try to get a statement from my doctor stating that he agrees there is a connection. Haven't talked with him, so maybe he doesn't agree.

Want to attach copies of any information I find on the internet that would support the connection. Information from organizations such as the American Diabetes Association, studies, etc., but do not want to send too many items that would be considered overkill.

VA should have a copy of a sleep study done in 2006 that determined severe sleep apnea.

Is what I have listed above enough support and the kind of support they are looking for or is there something else I should provide? The above is the only things I know to send as support at this point unless someone else has suggestions.

Thanks.

Edited October 21, 2013 by Jayco

[free_spirit_etc]

There are a range of articles that cover the connection between the two. Make sure you send articles that make the connection you want to make (i.e. that sleep apnea can be secondary to diabetes.) rather than articles that just discuss that people can have both, or that sleep apnea can worsen diabetes. You are going for showing what caused what here. I suggest that you read each article thoroughly and make sure there isn't anything in the article they can pick out and hold against you. (They have an uncanny ability to pick one sentence out of an article that can hold against you, rather than reading the part you want them to read.)

Actually, to get started, you can even just send in excerpts of articles (just the part you want to send) and you can always send the complete article later. They won't pay a whole lot of attention to the articles anyway -- and will call them generic articles that don't relate specifically to your own case - and then they will say you are a lay person who cannot offer a medical opinion.

So you will NEED an Independent Opinion from a doctor for this claim. If you just send a few articles -- they might seek a medical opinion from a VA examiner on the issue. Expect it to not support your claim. You might get lucky - but don't expect to. But you can submit a medical opinion that supports your claim. Even if you get a medical opinion that supports the claim, they most likely will still seek a VA examiner's opinion. So your doctor will need to write a good solid argument for your case. However, the standard of proof for a VA claim is at least as likely than not. More likely than not is better. So your doctor doesn't have to state that he is 100% certain your sleep apnea is secondary to your diabetes, He does have to state it is more likely than not, or at least as likely as not, the case.

You will also want to get a copy of your service medical records and so your doctor can review those (and state that he did). It doesn't actually seem like it would matter if they review those for a secondary connection -- but the VA likes everyone to say they looked at them. If he didn't review them, you can point out that it wasn't needed to make the claim. But it is often better just to give them what they want in that regard.

Edited October 21, 2013 by free_spirit_etc

[Jayco]

I need to file a NOD for sleep apnea in the next 2 months before the one year mark is reached. I've delayed filing a NOD because of one other item still in the works with VA that might affect my rating. Does not look like they are going to make a decision anytime soon, so need to file the NOD before time expires. I have not filed any NOD's previous to this one.

I'm located in Bangkok. Have an American general practioner working in Bangkok that will write an opinion. He nor I have copies of my medical records. Since he is not a specialist, as far as I know, and we do not have copies of my records, should I get him to write the opinion? The only other alternative would be to contact my doctor in the US who did the sleep study and is a specialist and see if he can wrtie.

If the opinion letter has to be filed with the NOD, then time is short. If the opion letter can be filed after the NOD, then maybe I have time to contact my doctor in the US.

Thanks.