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Need advice to denied Sleep Apnea claim

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Wayne TX

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Would like some opinions.......I have sleep apnea and restless legs....two sleep studies done at VAMC.......been on a CPAP since early December.......I am already SC for both allergic rhinitis w/Polyps and Sinus......would either of these or both be strong enough secondaries to get Sleep Apnea SC approved?  I have nothing in my service records for sleep disorder or sleep complaints.  I was told I was a loud snorer but I didn't think much of that.  I do have a history of allergies and sinus surgery all during my military service and a lot in VA File.  I got denied on Sleep Apnea claim in January 2016.  I got an IMO done in May 2015. but Dr. went with Obesity opinion (which I qualified as well, 40 pound weight gain) instead...........he did not use allergy and sinus SC as secondaries. He could of gone with the rhinitis but didn't...........sinus did not get approved until January 2016. Also, I was not on a CPAP yet when I filed the initial claim....all I could supply was two sleep studies results showing I had moderate apnea.  I was not issued a CPAP until December of 2015, and got my denial in January 2016.  I need to file a NOD now so looking for some advice in going this route. Thanks

 

Edited by Wayne TX
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  • HadIt.com Elder

 It's Quite hard to get  SC for  OSA/S.A.

 you need a document from prior military service of some type of OSA or S.A., However it can be proved why you have OSA today from other prior military S.C.disabilities.

Do you have a SC Rating with VA For PTSD??

If so it can be connected to OSA from taking medications for PTSD  this would be a secondary to filing a claim for OSA.

 you need a VA OSA Diagnose and on cpap machine.& a nexus from the Dr that order your SA Study and reason.

Here is a link from VA Watchdog about OSA. & Getting it S.C.

https://www.vawatchdog.org/obstructive-sleep-apnea-osa.html

Maybe this will be of some help

Edited by Buck52
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  • HadIt.com Elder

I would not let Obesity get in the way...to many normal weight people have S.A.  

So when a Dr tells you to lose weight and you won't have S.A ask him can he guarantee that?

sure we all would love to have our dream weight but hey we live our lives like we see fit   right!

jmo

....................Buck

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to add to what Buck said-   current weight gain of 40 lbs since when?

Assuming you were within weight standards when active duty, can you ID a cause for the weight gain-  injury (that is SC)causing no PT, causing weight gain?  if so I'd say the SA would be secondary to injury which caused the weight gain and is the cause for the SA.

Just a thought.

 

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  • Moderator

It is tough, but treat sleep apnea like most other claims, but don't overlook secondaries.  

I keep saying this, but you need 3 things to service connect most anything (except secondaries):

1.  Current diagnosis

2.  In service event or aggravation.

3. Nexus or link between the two (doc's stmt that says your sleep apnea is at least as likely as not due to xx event in military service.

With a secondary, you dont need an in service event, you already have that with the primary.  You just need a current diagnosis and a strong IMO/IME to a service connected condition.

My advice is to get your C file, go over it.  YOu may be suprised you already have a nexus to secondary conditions (I was).  The VA did not like that, and ordered a C and P exam anyway, from one of their denial puppets who had no experience in sleep medicine.  

You can go to Chris Attigs website who has great information on sleep apnea.  

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Broncovet,

Yes, plug that Attig SA info!  Good info there.  I really ought to heed your advice on that one myself. 

Andy

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