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Diagnosed W/sleep Apnea, But Doc Won't Sign Dbq


gtdac

Question

I have been diagnosed with sleep apnea and issued a CPAP machine. However, the prescribing doctor is not willing to say one way or the other on the DBQ if the sleep apnea is attributed to my current SC lung condition. What is the best way to move forward? Help!

Glen

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gldac,

You will probably have to find a private sleep disorder doctor (ENT or Pulmonologist) who would be willing to provide you with an IMO (Independent Medical Opinion). Unless there is clear and convincing medical evidence linking your OSA to your SC lung condition, you may be fighting an uphill battle trying to find a doctor willing to provide the IMO. Any doctor who provides you with an IMO will have to be able to justify their opinion with reasonable medical rationale.

If you would post more info regarding your SC lung condition and why you believe your OSA is caused by your SC lung condition, Hadit members will be in a better position to offer their suggestions and opinions. JMO

GP

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GP,

Thanks for the reply. However, the Doc in question is my pulmonary doc and his office also conducted the sleep study. He said that it's not his responsibility to make a determination if the OSA is secondary to my SC lung condition. He feels adamant that the responsibility lie with the VA. He stated that he only has to provide medical evidence reflecting that I have a lung condition (which is already SC'd) and that I've been diagnosed with OSA.

R,

Glen

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Georgia is on the money bud. Docs are not required to fill out DBQs. I have had atleast 10 DBQs required by RO for Claims, and only one Doc filled it out. I could not even get Civilian Docs to fill them out for SSDI. Get the IMO or just file a claim with the VA and give it a shot. Good luck

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I found out that a big if it's not in the service record, then they don't want to say but look the other way. I have had 5 DBQ's and even one from a Chief Neurologist at the VA state that he reviewed my Medical records that show sleepiness etc... even put the date of service and still the VA ignored and denied. But i think the VA pulled a scapegoat on this.. i was trying to have my OSA that was diagnosed way after service connect to be secondary to a injury of a broken nose/fall, well the Rater or VA stated that even if there was proof of this, sleep apnea can not spin off from a broken nose.. So it's hard to create that Nexus, but i believe that there are Dr. that are willing much more now to fill out a DBQ for you so don't give up.. I am not giving up on my sleep ap claim in fact, i might have realized that the VA will not relate a injury in service and connect it to OSA, one last think i am going to try is.. ....

All of the Sudden.. my X rights me a email about me snoring in the Service as she was with me during this time, she sent me a email just to talk about how i am doing and on and on.. well She indicates in a email, that i always denied my snoring, my stop breathing my headaches that happened after the Injury.. and she continues to provide supporting info.. i only hope that the VA can create the nexus with this letter.. Ill keep you all posted and comment as you please...

Good Luck

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DBQ's seem so hit or miss. My rheumatologist filled it out for the primary condition I suffer from the RO wanted me to have other ones filled out but it just east happening. I really wish they would put something out highly encouraging the VA docs fill them out. It doesn't even have to be something done with a 3 day turn around. The DBQ's are involved it's not like writing a script, and it's not even anything beneficial to the Vets treatment that other docs can reference etc.

I think if DBQ's maybe became a standard form that Va docs need to fill out every 6 months - a year then a addendum form in case of a major change would smooth the whole process out.

If I was a doctor I wouldn't want to have to fill it out over and over it kind of requires research and work

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  • HadIt.com Elder

The VA does (by it's past practices) not want PCP's to fill out DBQ's, dispite anything in writing to the contrary.

PCP's are too often already overscheduled and overloaded with "paperwork" as it is.

Edited by Chuck75 (see edit history)
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Is it typical for the VA to deny a claim even when a DBQ is submitted relating the issue is more likely than not related to time served in a combat zone? Also can Sleep Apeana be filed secondary to TBI?

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  • HadIt.com Elder

Is it typical for the VA to deny a claim even when a DBQ is submitted relating the issue is more likely than not related to time served in a combat zone? Also can Sleep Apeana be filed secondary to TBI?

It's typical for the VA to deny claims, at least on the first time around. Myself and many other veterans believe that it's been easier and faster to get a denial through the claims process

than an awarded claim. Once the RO decides to deny, then they may or may not give a plausible reason. You have to look at denials very carefully, and decide if errors are present, and what to do

next. (Appeal or not to Appeal!)

Edited by Chuck75 (see edit history)
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Some VA Clinicians are very reluctant to comply with their VA Regulation DBQ responsibilities. With that said, the old Squeaky Wheel gets the Grease may work. Use your VA MyHealthyVet Secure Message to email your PC Dr, Sleep Dept Chief Clinician, and Patient Advocate as well as your Pulmonary Dr that's giving you trouble. Start laying a paper trail. You don't push, you won't get. The SA 50% SC is definitely worth getting, right. If there is the slightest chance of your SA being Secondary to your lung condition, a "as likely as not" is all you need.

I went through (3) VA Neurologist, over the course of 4 years before I got 1 that refused to tow the VA line on Idiopathic Peripheral Neuropathy and Agent Orange. Nobody said VA claims would be easy.

Semper Fi

Gastone

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  • Moderator

You are hinging this all around "ONE" doctor's opinion. The obvious answer is to get another doctor's opinion because doctor's vary widely in their opinions. If you dispute this doc's opinion, you have every right to a second opinion. You can either try another VA doc's opinion, or an IME/IMO.

Your story reminds me of the average built man who went to the doctor. After the exam, the doc responded that the man was obese and needed to lose weight.

"I want a second opinion" said the patient.

"Very well." the Doc responded, "You are not only fat, but you are ugly, too. So, there is your "second" opinion"

The point is we dont have to accept an unfavorable doctor's opinion. The Veteran's "benefit of the doubt" would mean a second doctor's favorable opinion would decide the outcome in your favor, reminding you that your old doc did not opine against you, he simply declined an opinion at all on the matter.

Edited by broncovet (see edit history)
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