hypertension Nexus Letter Help

[FHL Dad 0]

I was wondering if i could get some opinions from the experts on this letter from my primary doc.

I was denied SC for Apnea . Retired mar 2002, diagnosed at civilian doc with sleep anea Aug 2002, who didn't refer for sleep study, then sleep study May 2013

I submitted lay statements from wife and sister, attesting to snoring and stopping breathing and i also submitted the following.

I have recently been seeing and taking care of Mr x for the past several months, and he has been seen by other medical providers while being a patient in our clinic. While being a patient he was diagnosed with Obstructive sleep Apnea. Upon review of his medical records during his time in the Navy, he had signs and symptoms consistent with OSA. these signs and symptoms included an elevated BMI (31.46 on 28 Jan 99) neck size of 17.5" chronic fatigue with poor exercise tolerance, repeatedly elevated blood pressure despite treatment, history of laryngeal swelling and irregular nasal septum which required surgery, history of smoking and EKG changes with evidence of possible LVH. these signs and symptoms are all consistent with a diagnosis of OSA. Based upon review of his STR from the Navy and the fact he was diagnosed shortly after his retirement, it is my opinion that he had some form of OSA while serving on active duty that was not diagnosed .Furthermore this was likely contributing to some of his medical conditions especially in regards to fatigue, hypertension and heart disease. I suspect his medical condtion developed at some point in his Navy career and not after retirement.

Also the same rater denied my Heart attack (CAD) as not service connected, but I am 0% for Hypertension.

[toddt 105]

I would imagine that Gastone will reply with better help however, right off the bat you need to submit the DX from Aug 2002. Then you need a definitive statement from your doctor as to whether your SA is related to a specific incident during military service, the opinion should be expressed as follows:

1. “is due to” (100% sure)
2. “more likely than not” (greater than 50%)
3. “at least as likely as not” (equal to or greater than 50%)

[Buck52 3,082]

FHL Dad

This being the Christmas Holidays it maybe a while before anyone can help you they maybe with Family's? ect..ect.. just hang in there buddy!

NOD or Appeal the decision!''

Remember a diagnoses does not mean they will approve a decision they usually need a Dr stating '' its likely to as not'' cause from his military service and render him totally disable.

The only thing about the sleep apnea IS he went a long time 11 years before the sleep study was done that maybe why they denied? and never looked at the other evidence?

Maybe a CUE is due?

others will chimm in Ms Berta ? Asknod, georgiapapa? N Kelly? Gastone?. Phillip Rogers, Ms Carlie, broncovet, Chuck75?? John999 anyone?

[georgiapapa 737]

You were diagnosed with OSA in 2002 (5 months after discharge) by a civilian doctor.

Questions:

Is the doctor who diagnosed you in 2002 the same doctor who conducted your sleep study in 2013 and provided you with the IMO you referenced in your post?

If not, have you attempted to obtain an IMO from the doctor who made your OSA original diagnosis in 2002?

Do you have copies of the records of your 2002 diagnosis and did you submit these records?

Did you submit buddy statements from your military buddies (bunk mates) stating they actually heard you exhibiting symptoms of OSA (snoring, stopped breathing, gasping for air, snorting, fatigue during day, concentration problems, etc.) during your military service?

Have you obtained and submitted all medical records (military, VA and civilian records) showing any OSA symptoms and/or OSA diagnosis?

Some suggestions, if you have not already done so:

Try to get IMOs from any doctors involved in your OSA treatment and diagnosis (2002-2014) using the IMO format available on the Hadit website.

If you have not done so, obtain as many military buddy statements as possible to support your OSA claim. Statements from your wife and sister help but buddy statements are more credible. The statements should list the OSA symptoms witnessed and when they were witnessed. You need statements showing OSA symptoms during your military service.

If you had any vehicle accidents as a result of falling asleep, especially during your military service, you need these records.

Based on your statement that a civilian doctor diagnosed you with OSA five months after your discharge and the comments from your current doctor stating your SMRs included signs and symptoms of OSA, I think you have a good chance of winning your OSA claim, especially if you submit properly formatted IMOs, strong buddy statements, all relevant medical records (especially 2002 diagnosis records), relevant vehicle accident records, if any, etc.

Good luck to you and your family and Happy Holidays.

[FHL Dad 0]

Georgiapapa,

Unfortunatly the doc who diagnosed me in 02 has since moved on. He was great and would have given me an excellent IMO. I did go through my STR and civilian health record, found anything remotely related to OSA, highlighted it and submitted it, with this letter. My sister is a physical therapist which kind of puts her in the medical field, and her statement went back to the early 90's. I have an appt with my VSO, so hopefully we can formulate a strategy. Like I said they denied my heart attack, which should have been automatic since I'm rated for hypertension.They decided this Dec 19 so I'm thinking they were in a rush to close it because it was 16 mos old. Especially after the director of the Philly RO testified to Congress in Oct 2014 claims were averaging 4 months