ptsd How should I claim sleep apnea??

[armyvet89]

I want to claim sleep apnea. I deployed and returned in 2010 to Iraq. I was NG. I hurt my knee over there and am submitting a claim for that as well as my diagnosed ptsd. The doctor (not a va doc) that did my surgeries on my knee said that I need to get seen for sleep apnea because I showed several signs/symptoms. During that time I was still in the NG but not active duty. Would a statement like this be enough to consider it a nexus? If not I assume that I can submit it second to ptsd after I am awarded for ptsd correct? Thanks for the help!

[Andyman73]

Do you have medical record entries showing the Dr. recommending you seek treatment for SA?  That would be worth it's weight in gold.  If you are already DX'd for PTSD, put in a claim for that ASAP.  The SA would most likely be secondary to that.  Others will chime in with better info than I have for you.

[broncovet]

Several things.  

1.  When did the doc say (you exhibited) sleep apnea symptoms?  Do you understand that you dont get compensated for sleep apnea UNLESS you use a CPAP?   YOu need 3 things for service connection:

a.  current diagnosis   (sleep apnea, PTSD, etc).  b.  In service event or aggravation

c.  nexus, or doc statement which says your sleep apnea is at least as likely as not due to ? in military service.  

EXception to the 3 above, is secondary service connection.  Then, you need only a diagnosis and nexus between your sleep apnea and primary service connection.  

2.  You wont be service connected for PTSD until/unless A VA doc diagnoses PTSD.  VA wont accept private practioner PTSD diagnosis.  VA thinks only VA docs can diagnose and treat PTSD.  Its in the VA rules somewhere, but it may be ripe for a legal challenge if you are up to it. 

3.  No a statement like that wont suffice as a nexus.  A rater will look through a couple exams looking for "the VEts sleep apnea is at least as likely as not due to xx event in military service".  No "at least as likely as not" no service connection.  

[armyvet89]

I do have paperwork saying the doctor recommends I get tested for SA but he was just an orthopedic surgeon. Would that hold any weight? I have the dx for ptsd but haven't submitted the claim yet because I'm waiting on medical papers to submit with the claim. If I do end up claiming SA second to ptsd do I have to put it on a separate claim?

[broncovet]

No.  The VA requires "medical competency".  Medical competency means you have had medical training or medical experience in that field.    Otherwise Vets could find a friend who got a PHd in basketweaving opine,

"The Veterans sleep apena is at least as likely as not due to military service".  

The VA gets away with incompetent examiners every day, but dont YOU try that or they will howl like a stuck pig.   YOu see, when VA calls you for a medical exam that doc is "presumed competent" UNLESS the Veteran challenges the competency of the examiner.  This means that if the doc went to play golf, and the janitor says your sleep apnea is unrelated to your PTSD, he will be presumed competent unless YOU dispute it.  

 However, VA will challenge the compentcy of your IMO if he fails any of the issues below.    For an IMO/IME on sleep apnea to be valid, the doc would need:

a.  Show competency in sleep medicine, such as "board certified" sleep med MD.  

b.  View your medical records, and document same.

c.  Make a precise stament similar to: Vets sleep apnea is at least as likely as not secondary to (service connected) PTSD.

d.  The doc MUST give a "medical rationale" as to why he so stated.  Such as:  "According to (medical journal) published by Harvard Universtity, "64% of sleep apnea patients were known to be due to Post tramatic Stress disorder".  

Without medical competency, documenting your records were reviewed, a valid nexus statement, and a medical rationale, Va will reject your physicians statement.  

Edited March 29, 2016 by broncovet

[Andyman73]

21 hours ago, armyvet89 said:

I do have paperwork saying the doctor recommends I get tested for SA but he was just an orthopedic surgeon. Would that hold any weight? I have the dx for ptsd but haven't submitted the claim yet because I'm waiting on medical papers to submit with the claim. If I do end up claiming SA second to ptsd do I have to put it on a separate claim?

Send that sucker off!!! Since you already have the DX for the PTSD, send in that claim.  File on Ebennies for instant EED starting point.  Then send in copies of the medical records once you get them.

Yep, SA secondary to PTSD will be it's own claim.  But like Bronco said, gotta have a sleep specialist make the link to PTSD.