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Current Mallampati Score Indicative Of Sleep Apnea In Service?


K9MAL

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I'll try to make this as succinct as possible. I've been out of the military for 10 years and have been diagnosed with sleep apnea (OSA) and use a CPAP daily now. While in service I had the typical monster snoring issues along with stopping breathing in my sleep that many have. However, the only thing in my medical records in regards to sleeping issues is my exit physical where I checked "frequent trouble sleeping" on the form and the person wrote "difficulty sleeping on ship" in regards to that.

1. Recently submitted claim for sleep apnea and was denied 6 months ago. VA says nothing in my medical records to indicate sleep apnea.

2. Saw VA ENT doctor (ear, nose & throat) for possible sleep apnea surgery. Doctor stated I have a Mallampati score of 4.

3. Would the combination of a single complaint and the Mallampati score be indicative of sleep apnea in service?

Would this be an avenue to pursue in combination with an IMO? The structure and height of the mouth, in combination with the distance from the tongue to the roof of the mouth, would not have changed due to being a fully developed adult. The Mallampati score of 3 or 4 is highly indicative of sleep apnea and there's plenty of studies that validate this.

Roommates and girlfriends constantly complained of my snoring, stopping breathing and I exhibited many of the signs that are related to sleep apnea. However, I was a young guy, didn't know anything about sleep apnea and didn't worry about it at the time. I would be able to get several buddy statements to support the sleep issues during service as well.

This seems like a similar case and references the Mallampati score as well: http://www.va.gov/vetapp11/files1/1101174.txt

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The question here is not whether you have OSA but whether you had OSA during your military service. Showing a nexus between your OSA and your military service will be difficult without documentation of your OSA in your SMRs but not impossible. You have nothing to lose and a 50% rating to gain if you win by submitting new evidence for your claim.

I would gather statements from your military buddies and family members who witnessed your OSA symptoms while you were in the military. The statements should be as detailed as possible especially when describing the symptoms they witnessed. Symptoms include but are not limited to snoring, snorting, stopped breathing frequently during sleep, sleepiness during the daytime, constantly tired, etc. Review your SMRs again to see if there is any notations citing OSA symptoms even if you were being seen for another condition. Prescription records might also be helpful if they show medication being prescribed for sleep problems (e.g.- ambien). First, you want to use these statements and any other evidence you have to convince your ENT doctor to provide you with a good IMO stating that it was "at least as likely as not" that you had OSA during your military service. If your VA ENT doctor will not give you an IMO, try to get a private ENT or pulmonary doctor who specializes in sleep disorders to provide you with an IMO. JMO

Good luck to you.

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K9MAL,

I would also provide a copy of the BVA decision to anyone who is going to provide a statement in support of your claim so they will have an idea as to the type of symptoms experienced by OSA patients. This is not to put words in their mouths but to make sure they don't leave out anything in their statements regardless of how insignicant it may seem. JMO

Good luck.

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Typo when I spelled "insignificant".

Sorry...

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Thanks for the good advice GP. I think I may consult with an attorney on my case. My current VSO, DAV, hasn't done squat other than mailing my stuff for me.

If I can get this locked in with another rating I'm trying to have upped from 10% to 60% I'll be at 100% schedular. I think the attorney fees would be worth the cost if this can happen.

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