ptsd Is It Cue?

[abhusal]

Hello everyone,

Under Benefits Delivery at Discharge (BDD) Program, I filed claim for PTSD, Short Term Memory Loss, and Unspecified Sleep Disorder. I had C&P only with VA contracted Mental Health Provider. I never had C&P for the unspecified sleep disorder claim. I was awarded 30 % for service connection for anxiety disorder NOS (also claimed as short memory loss and sleeping disorder). Symptoms (reported to physicians and documented) related to sleep disorder while in service continued after discharge and documented well on VA medical record. After 5 years discharged from service, I had sleep study and diagnosed as Sleep apnea (ICD-9-CM 780.57). I am using APAP now.

My concern is: With same symptoms in service continued after discharge and diagnosed with Sleep Apnea. When I filed a claim for sleep disorder 5 years ago, if VA had conducted sleep study on me, I would have diagnosed with Sleep Apnea while in-service. VA failed to do it.

Isn’t it a CUE?

[Philip Rogers]

I agree, it is not a CUE, but and this is just an educated guess, I think you can win a claim for Sleep Apnea and eventually win a retro date, to your original claim "but" it'll take you 4-10 yrs to do it. You'll need to win the SA claim and then go for an EED.

A while back the VA won a court case that established that they do not need to deny all claims that were originally claimed because if the claim was not mentioned in the decision, then it is considered denied. I'm not sure what case it was but I feel it was a real setback for claimants. jmo

pr

[abhusal]

I agree, it is not a CUE, but and this is just an educated guess, I think you can win a claim for Sleep Apnea and eventually win a retro date, to your original claim "but" it'll take you 4-10 yrs to do it. You'll need to win the SA claim and then go for an EED.

A while back the VA won a court case that established that they do not need to deny all claims that were originally claimed because if the claim was not mentioned in the decision, then it is considered denied. I'm not sure what case it was but I feel it was a real setback for claimants. jmo

pr

Thank you very much Phillip Rogers for reply.

This is the details of the claim I filed:

Decision by the VA:

Could you please look at the attached and your suggestions please!!!

[carlie]

Thank you very much Phillip Rogers for reply.

This is the details of the claim I filed: Claims filed to VA.png

Decision by the VA: Decision.png

Could you please look at the attached and your suggestions please!!!

That makes it very clear that a claim for SC of OSA was not of record for consideration.

Also, very clear that a sleeping disorder was considered, SC'd and compensated for

as a part of your anxiety disorder.

OSA is a completely different issue and going from the decision posted, a claim for SC of OSA

was not before the VBA decision maker, as a part of the rating decision.

[Philip Rogers]

What I see is they combined the sleep problems w/the anxiety disorder and you didn't appeal it. Now, you have to win the OSA claim and then pursue the earlier effective date(EED). You can try combining the OSA and the EED but most times it's easier to win the OSA claim and then go after the EED. jmo

pr

[abhusal]

Thank you very much Carlie and Phillip Rogers for your replies.

Back then I didn't know what the OSA is, so I just applied for Sleep disorder. Now I am diagnosed with OSA , Unspecified Sleep apnea (ICD-9-CM 780.57). Now my question is:

Should I still file for Sleep Disorder or Sleep Apnea. Which has the best chance to win based on my symptoms-Medical Record Summary.pdf

Thank you very much.

[carlie]

Thank you very much Carlie and Phillip Rogers for your replies.

Back then I didn't know what the OSA is, so I just applied for Sleep disorder. Now I am diagnosed with OSA , Unspecified Sleep apnea (ICD-9-CM 780.57). Now my question is:

Should I still file for Sleep Disorder or Sleep Apnea. Which has the best chance to win based on my symptoms-Medical Record Summary.pdf

Thank you very much.

If you have medical evidence DXing the OSA and the doc reviews your SMR's

and states something like - they have done this and in their opinion your OSA

is at least or more likely than not, related to active duty as evidence by

XYZ shown on active duty records dated XX/XX/XXXX (medical rationale),

you should be good for direct SC.

It would not hurt at all if the doc also stated something in regards to your

anxiety disorder continues to be inclusive of sleep interference, but in their opinion

your OSA is a separate issue from that due to XYZ, (medical rationale).

The doc's opinion and rationale would be different for OSA secondary to a

SC'd issue.

Just for the record - pr was my mentor :-)