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C&p Results - A Few Questions.

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K9MAL

Question

I received my C&P exam results and had a few questions pertaining to it. Any advice, words of wisdom or recommendations would be appreciated.

1. I left the service in 2001 and had not been diagnosed with sleep apnea until last year. The VA ordered the sleep test, verified that I had OSA and has issued me a CPAP that I use. There is one note in my medical records stating I have problems sleeping, but that's it. I filed for sleep disturbance related to the Persian Gulf due to insomnia, waking up, etc.

The doctor's opinion is "The conditioned claimed was less likely than not…" Rationale: The veteran has OSA. Sleep apnea is due to airway closure/blockage during sleep. I am unaware of any Gulf War event/exposure which may cause airway closure/blockage during sleep."

The doctor's statement later in the report is as follows: "He states he has problems with sleeping ever since service. He was seen for this in service, states no treatment was given."

My question pertains to him stating I was seen in service for the issue. Would this be enough to tie in the OSA to being service related? I know it's a guess and up to the rater but it seems like a positive statement to me or at least some ammunition to fight the battle if it gets shot down.

2. IBS - My private gastro doc stated "more or less constant abdominal stress" on a DBQ but the C&P doc marked "frequent episodes". Which will carry more weight? Does the "tie" go to the veteran in this case? There were several other issues where I feel the C&P doc was trying to minimize the severity like on range of motion measurements.

Unfortunately I have to cut this short here but will add more later today. Positive news is ebenefits moved my claim from "gathering of evidence" to "prep for decision" after a year. I know it's not very accurate but it did give me some hope.

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I'm a bit confused on whether you filed for sleep apnea or sleep disturbance? My understanding is that they are 2 different rating codes. Sleep disturbance falls under mental health ratings with a maximum rating of 30%. The way you described it above, it sounds like you filed for sleep disturbance, but all your evidence was for sleep apnea. Am I missing something here? I wonder if that's why the C&P doc didn't give you the nexus?

Rather than NOD that, what about filing a new claim for SA "secondary" to one of your other service connected conditions. Get your own nexus statement from an IME doc from that list on imenet.com

My contention was sleep disturbance due to Gulf War service. However, he did quiz me about the sleep apnea as if that's what the problem was. I relayed to him my issues of insomnia, somnolence, wakening and not being able to go back to sleep, etc.

I'm guessing I'll be getting the envelope this week and then I'm gonna need your help and the rest of Hadit's to devise a game plan. I do like your IME doc and refiling it as SA secondary… I'll need to think this one through for a little bit and develop a strategy.

Currently I'm SC rated for R ankle, R knee, R shoulder and migraines but I did just go to psych for my first visit this past week and the doc said I was depressed… Not sure if this'll be linked to my pain issues but I did try to express that to him. I'm gonna try to get the notes this week and see if he mentioned it or not and if I can claim depression as secondary to SC injuries.

Thanks NavyWife!

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Maybe if you get lucky, they will schedule a new C&P for sleep disturbance, so you can get the nexus...

On your IBS C&P-was the VA doc a gastro specialist or what are his qualifications?

You already sent in a DBQ by a gastro, any ideas why they scheduled you for C&P also for the same contention?? Did your private gastro doc write a nexus statement on the form?

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I'm hoping they bump me to 90%. When I reviewed everything that's what I think it should've came out to… Then again, maybe wishful thinking on my part.

The VA Doc was not a gastro and when I asked what his specialty was he said family medicine. I think he did a good job for the most part and was very personable. However, I also feel like he didn't record all the measurements properly, left knee especially, and he tended to kind of gloss over stuff after reading the C&P results.

I have no idea why they scheduled the C&P after the private gastro guy. There was not a nexus per se, but, he did write that he'd reviewed my service records where IBS symptoms are documented in-service. Also, I am a Gulf war vet so I know it's covered under the presumptive mandate… Hopefully they'll get it all figured out soon.

This is what I initially wrote for the sleep disturbance:

Dear Sir or Madam:
I am filing a claim for a sleep disorder as a presumptive illness due to my service in the Gulf War as per section 3.317 of title 38 of the CFR.
Before and during my active duty military service I never experienced problems with sleep prior to serving in Southwest Asia during the Gulf War in 1998 and 2000.
My sleep disorder keeps me awake throughout the night, several nights a week. I wake up in the middle of the night and can't get back to sleep. I feel exhausted and still can't fall asleep or stay asleep to get a good night's rest. I feel fatigued, worn out and my ability to concentrate is greatly diminished.
My wife complains of my constant snoring and that I will stop breathing intermittently throughout the night while sleeping. She has also complained of me coughing violently and waking myself up.
Thank you for your kind consideration of my request.
Respectfully,
K9MAL
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