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USMC_HVEQ

Need Dr For Imo For Sleep Apnea Secondary To Ptsd, Also Dmii Secondary To Ptsd

Question

I'm wondering if anyone can recommend a Dr. in the Boston area or where ever that has done/will do an IMO/IME (Whatever is required) for Sleep Apnea (OSA) secondary to SC'd PTSD.

I am medically retired Marine as of 2007...I complained for years about sleep issues and was told that I snored extremely loud. Others said I stopped breathing. I said maybe I have sleep apnea, i dont know, but I want a sleep study. Well the Marine Corps, never got me one as I was on my way out. It is noted in my exit physical that I had complained and have continously complainted since getting out finally in August of 2007. I know that other than that I had no service records of sleep issues. Upon finally getting the green light for a VA sleep study in 2009, I filed a claim as secondary to ptsd in 9/2009. It was denied in 8/2010, even though once I had the sleep study they said I have sleep apnea and even issued me a CPAP. I appealed in 2011, which is where that appeal is still sitting at the RO. I am currently 90% combined. I have been on meds since 2007. I understand that I need to have the dots connected for the VA to approve that sleep apnea as a secondary that was either caused or aggrevated by my service connected PTSD. sorry for the long back story.

I am looking for others that have had this approved as a secondary to PTSD and a doctor familiar with VA procedures, PTSD, OSA for an IMO.

I also was diagnosed last 2/2013 with type 2 diabetes (DMII). I'm wondering if that can be service connected. I have not filed a claim for that. I'm not trying to claim everything under the son but i also want to make sure everything is covered. I'm currently sc'd for PTSD 70% (have an appeal pending for schedular 100%, last c&P on 6/2013 for 3/2013 reevaluation) examiner thought I should be 100% but due to some work in the past, he lowered it to 70%. I also put in a claim for TDIU in 12/2013. I have not worked since 12/2012. Once again, sorry to go off on another tangent. I get side tracked easily. I'm also sc'd for HTN (10%), Tinnitus (10%), Bilater Factor for left and right dislocations (20%,20% Combined 40% with bilateral factor for those 2. I was told in the Marines I was prediabetic, but they never treated nor did anything for me. It was kind of off the cuff when I was going through my exit physical.I'm just curious if it is possible to service connect my recent type 2 diabetes (DMII) to secondary for ptsd or alone on its own. I currently take metformin pill and was increased from 1 pill once a day to 2 pills per day. I know that would fall under the 20% for DMII due to taking medication, even without the bump from my ptsd, either schedular 100% or IU...having SA & DMII service connected would get me to 95% which rounds to 100% schedular.

So any info people can shed I appreciate it. Someone mentioned Dr. Bash. I emailed but never got a response and I'm not even sure he would be the right person for my case. I'd love to know who was successful in service connecting DMII as secondary to ptsd or stand alone (no in service diagnosis) and successful for Sleep apnea (OSA) secondary to ptsd.

I know I droned on and on. I thank each and every one who takes the time to even read my post, let alone respond with some help.

thanks and I look forward to hearing from you all.

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Why are you set on getting SC secondary to PTSD. You may be better off claiming direct service connection especially if trouble sleeping was noted on your exit physical. You really should have pushed VA for a sleep study in that first year.

you need to screen your medical records for low hemacrit (anemia), high blood pressure, repetative sinus infections (indicator of gerd), GERD, and any neck measurements that are over 17 inches. Less likely enlarged right atrium. All of these are possible medical indicators of sleep apnea happening. High blood pressure is one of the first other conditions that medically shows up (usually even before problems sleeping). Rounding up some buddy statements about the snoring couldn't hurt either. When getting your IMO ask them to look at direct connection (anything in your records that indicates you more likely than not had it in service), secondary to PTSD or meds for PTSD, and last of all would the medication you are taking for PTSD make any existing Sleep Apnea worse (maybe you had it but didn't need a CPAP until you were started on PTSD meds). Cover all your bases and prevent your local VARO from trying to do the suicide squeeze on you!

The link below is for the American Board of Sleep Medicine. If you contact them they should be able to give you a listing of members in your community. If you cannot get an ABSM Diplomate then Just look for a Pulmonologist in your area.

http://www.absm.org/listing.aspx

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why i said PTSD, was cuz that is what I was medically retired from the Marines Corps. I gained like 150lbs due to my ptsd and depression. I asked the corpsman all the time that my sleep was jacked up and they were like go tell the VA. then the VA was like oh you need to ask your PCP, then my PCP was a bosnian guy who was never there and hardest clinic to get to in Boston. I had so much working against me. I complained for 5 yrs before my current PCP set up a sleep study.

My neck has always been over 17". I'm currently 20".

I'm service connected for High Blood Pressure, Tinnitus , Bilateral shoulder dislocations, PTSD....I'm diagnosed but not yet service connected for : Sleep Apnea (2/2010) (OSA)-my cpap is on 13.0, started on 10.0....DMII as of 2/2013, Arthritis (in shoulders), Pain (in shoulders)

I'm on Sertraline, Buproprion (fairly new), Gabapentin, Prazocin, Lisinopril, Astrostatin, Metformin

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J. Gila Lindsley, Ph.D.

Lexington

MA

Psychology

3/31/1984

Cynthia M. Dorsey, Ph.D.

Belmont

MA

Clinical Psychology

4/29/1991

Charles Czeisler, M.D., Ph.D.

Boston

MA

Sleep Disorders Medicine

3/4/1982

John W. Winkelman, M.D., Ph.D.

Newton Center

MA

Psychiatry

4/19/1993

Jeffrey E. Silver, M.D., Ph.D.

Wellesley

MA

Internal Medicine

3/26/2004

Theodore L. Baker, Ph.D.

Boston

MA

Neuroscience

10/30/1981

The list above is what I pulled off the main list for my area. Who would you recommend I try of the list? how and what do you do? Like call and ask for an IMO/IME? something else?

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I had an outside pulmonologist who was also an accredited sleep disorders specialist. He reviewed my records and gave me an IMO that cited inservice medical evidence as an indicator my apnea began in-service.

I would look at the sleep disorders medicine person first.

Did they list a medical reason for you hypertension onset or was it listed as essential hypertension?

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Hypertension (HTN) I was diagnosed with HTN in the Marines and for 4 yrs was left untreated. I had was only diagnosed finally after getting multiple different opions by corpsman which were clearly wrong. I produced all my readings while in service and post service. I take Lisinopril. I used to take a dual pill Lisinopril/HTCZ.

I'm in process of spring cleaning and digging through containers of stuff thats been sitting in closets. I'm going to organize my personal c-file or what I have. C&P's, treatment records, claims, Military medical records, MED boards, PEBs. I will report back when I find the claim that had the HTN on it and what it says. Sorry if Im being ambiguous.

thanks for your help.

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