hypertension Building A Test Case: Diabetes Ii Secondary To Sleep Apnea

[Snake Eyes]

Several people here have posted regarding diabetes II service-connection being only open to Vietnam vets. They're thinking of the presumptive connection Vietnam vets enjoy because of exposure to Agent Orange.

It is possible to develop diabetes in-service, though unless you're in Twilight, you probably wold be medically discharged. In my case, un-treated sleep apnea in-service may have contributed to the development of diabetes post-service. I received a provisional diagnosis in-service for the sleep apnea before being deployed to Korea. After that, a brief tour to Hawaii and then retirement.

The VA reopened the original claim and rated the sleep apnea recently. During the time I was researching for a possible appeal, I discovered that there have been several BVA cases where a vet's claim to diabetes II as a secondary to sleep apnea was approved based on the growing body of research supporting sleep apnea as a cause of diabetes -- or in one case, an aggrivating factor. The more well known association goes the other way around, but I have at least three BVA citations that show the diabetes II secondary to sleep apnea... but who wants to fight through the appeals process? Not me (though I may have to). :-)

I'm sure there are vets who've won diabetes service connection as secondary to sleep apnea without going through the appeals process, but if there are, none have spoken up here. I'm creating this thread mainly to document my process of developing a FDC to get SC for diabetes secondary to sleep apnea, along with several other complaints that are caused by either sleep apnea or diabetes -- or both. The first step in this process, as advised by my VSO is to seek out doctors for IMO/Nexus letters. I've faxed all three treeting physicians during the period where the sleep apnea was confirmed with a sleep study, along with diabetes indicators over time. Weight fluctuated, and doesn't seem to track evenly with the development (and that's consistent with two of the cited studies in the BVA appeals.

Remaining Steps:

• Get complete Diabetes DBQ workup from VA PCM doc
• Get EMP tests done
• Get DBQs for the complications (there are several from hypertension to glaucoma)
• Coordinate the IMO/Nexus letters for the treating docs who agree to do this (get SMR, VA Treatment and Claims File info for their review
• File FDC with two or more STRONG nexus letters with citations of research studies (and provide copies of the cited studies) as well as the medical opinions confirming that my case matches those study examples

Wait. And then wait some more.

On a separate but sort of related note: My VSO stated that if I submitted the claim -- even an FDC online -- it could take a year or more to complete, but if he submitted it, the claim could complete in as little as 125 days. Anyone know WHY the VA processes VSO submitted claims faster than vet claims? Or is the VSO giving me questionable info.

[Snake Eyes]

No intellectual curiosity from my VA PCM doc. I presented her with three BVA cases which ruled in favor of diagnoses showing diabetes secondary to sleep apnea.... and two papers citing a combined 70 independent studies also making the connection. Her answer, as VSOs and many on Hadit.com was that only Vietnam vets can get SC for diabetes.... Yes, she said that after I showed her thre actual cases where non-Vietnam vets were SC.

This was fully expected, so I'm not particularly disappointed. It is merely the first of many steps I'll have to take to see this process through to award or appeal.

Finding open minded doctors is a challnge as they do not listen to patients, much less research for which they did not get funding or had no part in publishing. That's the nature of the beast in many professions, so I'm not knocking doctors here :-) So where would I find doctors familiar with the research who are giving it serious thought? I contacted one of the guys who wrote the pape in American Journal of Medicine in December of 2009. Coincidentally, he is a VA doctor in Connecticut and one of his colleagues received a grant for the VA to do this research. I will post PDFs of two of the papers (the ones I showed my PCM) in a separate post.