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Phone Consult, Sleep Apnea Claim, What To Say?


aplcr0331
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Question

I have a phone consult with VA doc next week. I have a claim opened (re-open for OSA) right now and they are calling about that. I was sleep tested in 2004. The results were mixed (original claim was denied because it was not a definitive diagnosis) so that claim was denied. Instead of giving me the definte diagnosis of OSA they had me get a Septoplasty in 2004 after the sleep study. Which I completed while still on active duty. I left active duty shortly thereafter and did not get another Sleep Study done, nor was an additional Sleep Study ordered when I filed my intitial claim back in 2004.

I continued to have sleep problems until August of 2013 when I went in for another Sleep Study. I was diagnosed with Severe OSA at that time and re-opened my claim for OSA since I believe that I've had OSA the entire time and that it should be granted Service Connection.

What should I tell them? How will they determine if it is SC or not? Has anyone done a phone consult like this before?

Thanks!

C

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aplcr0331

Good Luck I'm having the same thing happening (I think) with the same people. I was diagnosed with OSA in the Army at Madigan Army Hospital in 2002 and it has progressed to Severe OSA. Despite the fact that I was diagnosed OSA in the Army and have a huge amount of evidence from military doctors, I still have to spend even more time proving it to a CP person? This is part of my first ever claim and this may just be routine to do that? So, you can realted it's a very tough condition. I've had 3 sleep studies and my condition is getting worse also. My wife says it's very scary to watch me struggle trying to breath at night? The good news is that I'm actually working with a group of the best OSA doctors on the West Coast and the USC Medical School to find a solution. I've tried everything and cannot wear a mask for a number of reasons. There's another option for guys like you that I'm pursuing the VA's help for the Inpsire II whihc is surgically implanted in your body to send a signal to your throat to open up. One guy on this forum said it's changed his life. Can you imagine a full nights restful sleep. Anyway, how long has it been since the VBA order the appointment until you got it? Anyway, let's keep in touch and we'll compare notes...

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I had a phone consult once after I had a C&P and somehow the examination notes got lost, so the doc called to redo the exam, basically, over the phone. It was no big deal. A C&P for OSA is really Q&A anyway. When I had mine done, although it was in person, the examiner asked me if I had OSA, when I was diagnosed and how, and if I used my CPAP. So it wasn't as if he actually examined anything.

In terms of nexus for service connection, that's a tougher question. The safest bet is to get a doctor to make the nexus connection for you and the RO in writing. What could have started as, say, a condition requiring septoplasty, is now OSA. Or the OSA could have been misdiagnosed back on active duty as you think it probably was. Unless you are a medical doctor, you are not qualified to make this connection - which the RO will wave about in their denial. Don't count on the VA making the connection either...and it's been more than 10 years since you were on active duty, so the VA has an easy out to say that OSA developed since discharge.

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If you are married put your spouse on the phone and have him/her tell VA that they are afraid because you often stop breathing and then suddenly seem to be catching your breath and you make a lot of noise. That is a sure sign of OSA. If they are wanting some sort of indication you actually have OSA. The sleep study should have shown it. In active duty military they are giving the troops a device to take home and use to show if they have OSA. Cheaper than a sleep study for sure. I know that I still stop breathing for almost a minute sometimes. This is after I had surgery. I used to have the breathing episodes all night and 50 apneas an hour. I felt like walking death. The VA is really resisting service connecting OSA.

John

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This is serious.

I had a friend that she had a snoring problem and it got worse and the family new she snored but they didn't do anything about it, one night she went to sleep and started snoring as usual the family quoted well mom must be sleeping good she back to snoring, and about 30 minutes later they didn't hear her snoring Daughter went in to check on her ..she was Dead!

Edited by Buck52
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To Whom It May Concern: Never had a Tele Redo or Do of C&P. With that said, I've been rated SC for SA 2011 as Secondary to CAD DX 2006 that was SC'd AO 2010.

I think we all agree that just about any MD or DO should be capable of making the SA DX. The problem comes down to etiology right? I know it appears to many Vets that VA Dr's more often than not seem to be looking for a ways to not SC our conditions. I don't think that's true but it is a perception. It recently took me (3) years to find a VA Neurologist that actually spent enough time going over my Neuropathy history to agree that I met the AO time frame for SC. First two didn't even want to discuss AO as a possibility.

So what to do regarding your SA and service connection. Do you know the qualifications of the VA C&P Drs? If they aren't Sleep Specialist Neurologists and even if they are, it's time to spend a couple $100.00 and get a NON VA Sleep Specialist Neurologist medical opinion. I lucked out and was initially DX'd after a 3 nite Sleep Study by exactly that type of Credentialed DR. I had a long discussion with him after I decided to file a claim and had done my research on what would be necessary for filing the claim. My Non VA Dr put the discussion we had into his Clinician notes and they appeared in my SC Award, "more likely than not caused by CAD." At that time, I was 280 with a 19 in neck.

My research on BVA Appeals indicates that any time there is a difference of opinion of Non specialists Dr vs a Specialist DR as to DX or Etiology, the Specialist's opinion Trumps that of the GP Dr's.

Semper Fi

Gastone

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Gastone is right. Don't rely on VA doctors to get this right in terms of service connection. You're going to need an outside ENT seeing as you had a roto-roooter treatment back on active duty. Our family ENT treats OSA as well as a host of other issues. Actually, I see an outside pulmonist for my OSA.

With your claim moving down the pike and on to the C&P, you'll need to get this nailed down with outside specialist relatively quickly and get the new-and-material evidence into the RO ASAP before they deny you and make you fight about it. And that's a whole other topic...

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