hypertension Nexus Letter Help

[FHL Dad]

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.

[FHL Dad]

Berta,,

I am 0% sc for hypertension. The way I read 38 U.S.C 5107(b) any myocardial occlusion is service connected if service connected for hypertension. I do have a pretty good cardiologist, so maybe he can link both into one letter, since OSA leads to unexplained hypertension and heart disease. Yes the VA had that letter and STR's with highlighted entries about my septum BMI, fatique, HBP and depression, plus a letter from my wife and sister. Like I said, I think they were in a hurry to close it. Thanks for the help and advice

[Berta]

I do have a pretty good cardiologist, so maybe he can link both into one letter, since OSA leads to unexplained hypertension and heart disease."

That would be a good idea.

But I think your cardiac disability would be more likely due to the HBP which you already have a SC rating for.

The OSA is a separate issue.

Did the VA ignore the medical statement above as to:

"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."

This IMO has some weak points. The last statements seem to be speculative.

A valid IMO needs to follow the criteria here in our IMO forum:

A strong IMO from a real cardio doc could possibly address the affects of the OSA issue to your heart disease.(as aggravating the heart disease) That would not matter however, until the OSA is service connected.

BUT , as Georgiapapa stated,

"Your OSA claim would also be strengthened by doing the leg work to obtain as many buddy statements as possible as I suggested above."

OSA claims most often need leg work.

Even documented instances in your 201 military personnel file of being tardy or sleepy on the job ,in the Mil, can help prove inservice manifestations of OSA.

Edited December 29, 2014 by Berta

[Buck52]

Why do ''some VA PCP seems to get upset when a veteran ask them to render there opinion about his service related condition and in his/her opinion should I seek Compensation? Most VA Dr's don't want to help out a veteran I just don't see why they won't help out like that.

Some VA if ask this Will state there opinion in a different context not to be favorable.

They make a veteran think they will but say other wise in there report.

Edited January 2, 2015 by Buck52

[Fat]

Good information.

[georgiapapa]

Buck52 is exactly right. VA doctors are often reluctant to write an IMO or complete a DBQ even after they have told the vet their condition is probably service related. I always get of the VA examiner's report after my exam because I have found some VA examiners will tell a vet one thing and then write something entirely different in their reports.

[georgiapapa]

I left the words "a copy" after the word "get" in my second sentence. Sorry but my hands work faster than my brain and I usually fail to proof read my comments before I hit the "Post" button.