ptsd Filing a secondary sleep apnea claim secondary to PTSD

[Rocket1949]

I just recently received notice from the VA on my new rating of 80%, a bump of 10% from the previous 70%. While my claim was being processed the VA diagnosed me with sleep apnea . I'm considering filing for sleep apnea as secondary to PTSD. What would be the best way to do this? I want to start the claim before the end of the year and was going to use my E Benifits account to file. Any information would be greatly appreciated . My ratings are 50% PTSD,40% hearing,10% tinnitus,10% scars. Anyone have personnel experience with this type of claim? Any suggestions to links that would supply more information? Thanks.

[Andyman73]

Rocket1949,

Congratulations on your bump! 

Look at the decision letter, see what or how or why they DXd you with SA.  If it is caused by your PTSD, then yes, file for SA secondary to PTSD! Do it today, via eBennies, to get the date locked in!

Did they give or prescribe CPAP? If so, it's an automatic 50% rate for SA w/CPAP usage. As for what evidence to submit, their own DX is the evidence.  A copy of your decision letter showing that, VA notes from Blue button download, and any VA based treatment records(if you have any yet) for the SA also.

Good luck and God speed!  SA is a tough nugget to crack with the VA.  Many of us that suffer from SA are in a tough uphill battle over this.  However you may have it relatively easy since they DXd you very recently.

I filed a claim for sleep disturbance issues and sent in my private Dr. DX of SA with CPAP as evidence.  I had noted during a health survey, while on AD, that I had issues sleeping and used OTC sleep aids and booze to help sleep.  And my recent, yet undecided, C&P exam for depression secondary to chronic pain, the examiner DXd me with chronic sleep disturbances.  I just hope it's a strong enough link for my claim.

Semper Fi.

Andyman

[brokensoldier244th]

Its not an automatic 50% just because of a CPAP- you can develop apnea later in life not connected to service, too. It depends on the type of apnea and what it is secondary to. I was diagnosed with SA/sleep disturbance at first and given a CPAP. No ratings change because it was first diagnosed as secondary to obesity resulting from low activity due to the fact that I don't move that much and pain causing the sleep disturbance and I was already rated for pain and DDD. Not VAs fault. I later got some more sleep studies after I changed my pain medication regimen and we could separate out the pain portion (better controlled now) from the apnea and found that it was still present. I also found better records from in service showing it was probably present then, too. Then I was rated. 

You have to make sure your records can show that you had SA symptomology of some kind in service, or that the type of SA is tied somehow to what you already have going on. If its just due to obesity, for example, I don't know if you'll have a strong case. Ive not seen one approved based on that yet, and my doctor even tried to equate the two prior to my finding service records. VA shot it down saying that while obesity was a symptom it could not be directly correlated just to military service. I went in heavy and then dropped in service, and then got heavy again- I have a pre disposition for it. *shrug* I appealed and then used that time to continue building my case. It was then returned later as being 20%- a compromise, I guess, between sleep disturbance caused by pain and sleep disturbance caused by not breathing. Later it was increased when I was rated 100% and P&T to the normal 50% that many see. This took about 4 years total. 

If you have central apnea you probably have a good shot, and Ive seen other SA ratings tied to PTSD in some form or another so you are probably in better shape for a rating than I was, just make sure  your records and  your doctor both support you, and be prepared for a possible appeal. (I already said that, didnt I? :-)  )   

 

Good luck! :-)

 

CAS

[Vync]

In addition to the excellent advice above by Andy and Broken, it is not uncommon for SA patients to have a bit of extra weight. The VA will likely be quick to point this out if it applies in your case and try to blame SA as being secondary to anything other than what it could be, in your case PTSD. However, I was diagnosed with SA a couple of years ago, but I was only about 5' 11" and 170 lbs at the time. I was relatively lean. The doctor was kind of blown away because of it. I just wanted to pass along this advice because I would not put it past the VA to make this a challenging claim.

[Gastone]

A 50% SA SC would get you to 90%, so file the claim, yesterday. With that said, SA claims as Secondary to PTSD are very difficult to prosecute, expect and plan on a Denial.

Look over the 12 or so listed usual suspects, likely to cause SA. What type of SA have you been DX'd with, OSA, CSA or MSA? Do you have anything in the way of a Sleep Specialists clinician notes or actual DBQ opining as to the etiology of your SA? Not unusual for SA to be UN-diagnosed for years prior to getting the official DX.

There's no 80% Rating for PTSD and you mentioned a bump of 10% got you to 80% SC. Have you actually received a New 80% Rating? Correct me but it appears to me, you were PTSD say 50%, with another issue/s that got you to 70, right? From a 70% rating, a new 10% (what got bumped) gets you to 73% rounded down to 70. Even if that's the case, a New 50% SA SC would get you rounded to 90%.

Semper Fi

[broncovet]

I have some experience in this.  Im also seeking OSA secondary to depression.  There is medical evidence linking OSA to depression/PTSD.  But you have to have YOUR doc say its so for YOU, not just generally.  

My sleep doc opined i had OSA "as a result of" depression.  

Then, I spoke with a private sleep doc and asked him if sleep apnea was related to depression.  He said they are, and they even have many of the same symptoms.  (OSA and depression).  Remember, not sleeping well is often a red flag for depression.  

My claim is in appeals now.  In my case the board certified sleep doc gave me a nexus, but the VA ordered a c and P exam with a doc with no knowledge or experience in sleep apnea.  She opined it was not related to depression, and VA ran with that and denied.  

I have challenged the exam because:

1.  Doc is not compentent to opine on sleep apnea without education or training on same.

2.  A c and p exam was "developing to deny" because there was already a favorable nexus in the file.  

[ArNG11]

this is all good advise.  I will tell you just like others though, the VA avoids Sleep Apnea claims like the plague.  Just get your ducks in a row and get a favorable nexus.

The VA supplies my, rather, used to supply my filters and spare parts yet I according to VA doctors I  have no sleep apnea problem.  

I had/have a multiple symptom claim for thyroid, gerd and sleep apnea.  Long story short in the very same exam and c&P notes.  The OB GYN opined that I don't have sleep apnea and don't use a CPAP.  In the very same set of exams, the OB GYN doc opined that I don't suffer from fatigue for thyroid  because I wake up refreshed and alert because I use a CPAP.  I kid you not this is how it will go. This was done at the OKC VAMC.

Make sure you get a hold or your records and find references to symptoms of you having issues.  Find relative studies of the correlation between PTSD and Sleep Apnea.  Actually most studies indicate the correlation with MDD not just PTSD and apnea.

Fight it, and get your studies and favorable nexus written and turned in along with that all important NOD. Make absolutely sure that they reference the symptoms in service and after service or you will have great difficulty in getting an apnea claim successfully processed in your favor. Oh and have them reference that they have reviewed your military records as well.  JMO, JME.

BroncoVet I agree with you as well.