ptsd Sleep Apnea SC route to take

[USMC_VET]

Ok Folks, so this is the start of my thread for my sleep apnea claim and i will keep it update as things progress.

As it currently stands i am in the process of gathering evidence to support a SC claim for sleep apnea.

(As a Note i would purchase Chris Attigs book "PUT IT TO SLEEP" regarding sleep apnea claims, it is superb)

I had issues with sleeping while i was in the Marine Corps but never had a DX or a in service note in my Med record of sleep issues.  This is a major hurdle that will have to be jumped over.  A DX in service is a golden ticket for your claim, short of that a note in your records of anything sleep related "difficulty sleeping" "fatigue" "tired during the day" can be the evidence you need to help make a claim.

I dont have that at all, i went to BAS 4 times in 4 years.  1 was for bursitis of the hip in boot camp, 1 for pink eye in boot camp, 1 for pink eye in the barracks, 1 for back pain (PT was ordered) after second deployment.  I didnt realize then of course how important it was to note everything and on my exit exam i only noted what i had gone in for back pain and shin splints as a "issue" that was reported or unreported.  i didnt realize that i could say other things + i was ready to get out and go back to the 1st CIV DIV and start my new exciting life without reveille at 0530!

Anyways

I had my sleep study dont at the end of the month and i was diagnosed with mild OSA (obstructive Sleep Apnea).  I believe this is tied to my PTSD as there is a wealth of evidence that PTSD/mental health issues and Sleep Apnea are closely related.

I have attached 4 files that related to sleep disorders and comorbidity with Active Duty/PTSD

 

In my sleep study it was noted my weight was an issue.  I am technically listed as "obese" by the BMI ratings they have for heigh and weight.  Problem is i used to work out a lot.  I dont work out much anymore but according to the military and med i am supposed to be aroudn 160-170 lbs.  Well i am around 190 at the moment (fluctuate between 185-199) and i am considered "obese".  I admit i have a bit to lose around my waistline but i have been a 34 inch waist since i got out of the Marine Corps and started working hard.  and still am.  Since i dont work out anymore i probably have 10-15 lbs i could lose, but with the yard work i can do i do still maintain a lot of the muscle i had.  anyways that being said, it doesnt matter, the VA considers my BMI to high.

This can be a major issue with Sleep Apnea as the VA often just denies claims saying "you are a male with a larger neck and a few lbs to lose so thats the cause of it"

I am going to attack this claim with a pincer move on both flanks.

I am going to include all the studies that link it to PTSD as well as any BVA/CAVC decisions that have supported this (none at the moment but will link to them below as i find them)

I am also going to attack the "its not SC because you have a big neck and a few lbs to lose" by including all the side effects of the medications i have been prescribed over the years.

Many of these from Naproxen, IBprufen, Robaxin for my headaches and back all list that Sleep disturbance and weight gain are side effects. 

 

I am trying to figure out the best way to attack the SA Service connection issue.  I am convinced its a PTSD/TBI issue.  The fatigue issues didnt come into play until around 2005.  that was the end of my second deployment and where i got hit by the IED.

I have not been DX'd with TBI so i am wondering what peoples ideas on the route i should take, i am NOT going to file under secondary to, just regular and let the VA make that decision but should i ...

1) PTSD route

2) TBI route (but then i would have to wait for TBI to be DX'd in my next claim to go up)

3) medications as in the very least aggravating it.

 

Personally i want to just file this at the same time as my TBI claim in the next few months and just send all the literature and evidence of it being linked to PTSD and/or TBI along with the medications and their side effects as well as of course my lay statements of the sleep issues my wife has seen in the last 5 years since being married, and importantly buddy statments from what htey say when i was in at that time.

 

My worry is that if i bring up the medications that they will jsut DX it for the medications then try to drop it once i move off those meds at some point (hopefully get off them?)

 

Prevalence of Sleep Disorders Among Soldiers With Combat-Related Posttraumatic Stress Disorder - Orr.pdf

Sleep Disorders and Associated Medical Comorbidities in Active Duty Military.pdf

Sleep Disorders in US Military Personnel.pdf

Association of Psychiatric Disorders and Sleep Apnea in a Large Cohort.pdf

[Jeffersonrl68]

I had NOTHING in my medical records!!!!!  Because of my service connected injuries I was able to show excessive weight gain during service, numerous complaints from roommates with loud snoring, gasping for air during my sleep habits, able to show I had requested numerous sleep studies from the VA but was denied during my 1st year out(important you make sure you have them DATE STAMP ALL CORRESPONDENCE BETWEEN YOU AND THE VA).  I had an IME from Dr Bash(don't listen to the rumors...call him because each case is different!!!!!  His IME along with my Dr. Riad Dahkell Board Certified Pulmonary disease and Sleep Medicine EXPERT here in Maryland did it for me and I am grateful!!!!!  Dr. Bash was able to use Dr. Dahkell write up and link the 'in service' connection which gave me 12yrs of retro!!!!!!

[USMC_VET]

I have actually decided to stop "guessing" based on others notes here on what he would cost and have contacted him as well as other IME folks.  If i can get him for a reasonable price i would definitely pay it.

[Slick]

Slick can you go into more detail on your claim and how you got them to recognize the link.

did you have inservice DX for sleep apnea? was it years after you got out?

What evidence did you submit to link the two?

Did you have an IME?

did you have inservice DX for sleep apnea?   No 

was it years after you got out? Yes- 5 years

What evidence did you submit to link the two? Looked up BVA cases linking SA as secondary to PTSD and Dr Bash did IMO for that and some other disabilities

Did you have an IME? see above

[Corpsman8404]

USMC_VET,

 

I too am looking at using Dr. Bash to try and possibly get things secondary to PTSD (like Sleep Apnea discussion in a thread of mine).

The problem is, I have now emailed him twice in the last 3 1/2 weeks, and no reply.  Anyone else having an issue in getting in touch with him?

[dvikings]

I got my NOD back today. My appeal was granted. ebennies has my appeal complete since last week. Now i just wait until VA does there thing.The worse is over. This should take me to 100%. Thank you to all, reading everything on this has been helpful while I waiting thru the process. The biggest surprise was that 21 Sept was my hearing with the judge and decision was made last Friday. It went so fast it scared me. The end is near and hopefully they rate me correctly.

[Andyman73]

After reading what everyone has been saying about sleep apnea and service connection....I will have to go the "sleep disturbance issues" route. 

I do have at least 1 entry in my STR, from early in my enlistment, where I mention trouble sleeping.  And I have been DXd by my private insurance Dr., since January of 2014, with SA.  And I use a CPAP every night, since then.

  My recent C&P for MH was pretty shady, from what the examiner wrote in his notes(blue  button on myhealtheVet.), so unless the RO gives my evidence considerable weight, and gives my current DX from VA MH Dr. some real value...may well end up being the road to nowhere...