Starting A Fdc Need Some Guidence

[Navy ELT to EMT-P]

Hi all.

Last year with the help here my wife was upgraded from 40 to 100% We couldn't have done it without this group. Now I am reaching out for help with a claim for myself. I want to file as a FDC and while I will use my county VSO, I want to drive the boat on this. Here is my story.

I served from 1999-2005 in the Navy aboard submarines. I was healthy through most of my service except for allergies and some sinus infections. In early 2005 i began to have a lot of sleep issues and started drinking to help fall asleep. On submarines any use of sleep aids was disqualifying so I didn't seek treatment. In mid 2005 I was concerned about my alcohol use and sought help. I was first dx with insomnia and prescribed Ambian. I was then referred to substance abuse where they prescribed trazadone for sleep and dx me with depression/anxiety and alcohol dependence. Also while not officially diagnosed my BPs were all pre-hypertensive with diastolics in the 90s.

Since I have gotten out sleep has been continuously an issue and I was on ambian and lunesta for several years. My blood pressure has continued to rise. No issues with any substance abuse however. I recently moved and switched providers. I went in for a physical and had blood pressures around 200/120. My doc started me on 2 BP meds and referred me for a sleep study. My sleep study showed severe sleep apnea and I have been prescribed a CPAP. I asked my doc if I likely had sleep apnea that was undiagnosed since I was in the Navy and she said defiantly and its very possibly at least partially causing your high blood pressure.

So, after swallowing lots of pride and at the instance of my wife I am starting the claims process. I felt un entitled because I work and don't want to admit that I'm not 100% healthy. I want to file a FDC and have read hundreds of posts about the process. I am wondering if I should only file for the Sleep Apnea and if its approved add the HTN. Or should I look at filing for everything at once. Also my doc is willing to fill out my DBQ and write a Nexus, however she hasn't written a VA letter before and has asked me if I know what it should look like. Given my situation any thoughts?

Thanks all.

[Berta]

The nexus factor and other important points she should cover are found in our IMO forum...I believe the topic I wrote is called Getting an IMO....

"I am wondering if I should only file for the Sleep Apnea and if its approved add the HTN."

I would file both both now...claiming the HTN as secondary to the SA.

"I went in for a physical and had blood pressures around 200/120."

Did the doc give you an EKG? Was this at the VA?

Can you tell us the breakdown of the 100% you get now?

It always pays to claim something under more then one theory.

The HTN could have another cause ,as well as being secondary to the SA.

[Berta]

Here is the link you need:.....

[TiredCoastie]

Approach your doc and ask if she would be willing to fill out the DBQs. You're going to need a written statement from her that indicates that, after reviewing your service medical records, it is as likely as not/more than likely that your conditions started while on active duty and that you were more than likely misdiagnosed with insomnia. Insomnia can be a symptom of OSA. Then I'd go with whatever she's willing to put in writing in terms of stand alone conditions versus one secondary to another. If you can't get any help from your doc, then you'll need either another doc or Berta's link to IMOs above.

IMHO, I'd want to have them separate. Someone at the RO could decide that if you get your OSA under control, your BP will reduce under HTN limits, esp if you're early in the treatment.

If you read through many of the OSA posts here, a common trend you'll see is that if you weren't diagnosed while on active duty, you will likely need some additional evidence such as a letter from your wife or from a shipmate who slept in your berthing area that it sounded as if you stopped breathing, heavy snoring, etc back during those active duty days. This is often refered to as a "buddy letter." This is particularly true if it's been more than a year since you discharged.

When did you get out of the Navy? If you're within a year of discharge, then things are MUCH easier.

Regarding your OSA, do your best with the CPAP. I don't like sleeping without mine, even if I take a nap. Keep working with whomever's issuing it out to you to get mask and settings you can sleep with. Don't give up. HTN is only one of the things that can come from it. Get a handle on it now. This is actually your biggest concern above what and how to claim the conditions...getting those conditions under control is primary.

[john999]

OSA can cause a stroke or heart attack. I have it and I struggle with the Cpap. I had tooth implant surgery recently and I could not tolerate the mask and cpap for a while. My sleep turned to crap fast. I came down with a sinus infection and I think all that gasping for air might have helped me get sick. You could claim a sleep disorder and it does not have to be apnea. You have a record of a DX for depression and anxiety. That I would claim for sure. You could claim insomnia and the depression/GAD without proving OSA. They will lump all the emotional disorders together and rate you.