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Tomio

Sleep apnea secondary to diabetes

Question

I am brand new to this group and was surprised not to find any posts about claiming sleep apnea as secondary to diabetes type 2.  Perhaps I'm just not looking hard enough.  My claim for diabetes was approved as presumptive  due to agent orange exposure

 My sleep apnea was disapproved as not being service connected.  I submitted an NOD claiming my sleep apnea as secondary to my service connected disability.  I did a lot of research in this area and found several articles which clearly stated that diabetes can cause sleep apnea. I submitted excerpts from these articles acknowledging that these articles address the general population and not my particular case.  I also submitted a statement from my physician who has been my treating physician for over 20 years.  In his statement he said that I was diagnosed with diabetes while under his care and subsequently diagnosed with severe sleep apnea requiring the wear of a CPAP machine.  He clearly stated that he's in the best position to comment on my medical history and current situation.   He concluded that based on well known studies and based on his personal knowledge if my medical situation, he can eliminate possible causes of sleep apnea such as obesity, neck and throat characteristics, smoking, and alcohol consumption and conclude that is more likely than not that there is a causal relationship between my service connected diabetes and my subsequent diagnosis of sleep apnea.

I did a search on BVA decisions on this subject and was surprised to see so few and was even more surprised about the win loss ratio.  Of 6 cases, only one was approved and that one was based on the veteran claiming that because he was diabetic, he was prescribed medication that caused him to become obese and because of his obesity, he developed sleep apnea.  He also submitted doctors statements from several doctors supporting his contention. I believe two cases were remanded and all the remaining cases were quite weak on my opinion. 

The reason I'm posting this is because I'm trying to find that glimmer of hope while I await the decision of the DRO. Anyone out there have any advice or encouraging words for this guy.

 

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Does the VA have that Opinion?

Did they have it when they made their decision?

Did it follow the IMO/IME criteria here at hadit under "Read First if Getting an IMO"...

actually it seems it did but

Did they list it as Evidence in the decision?

If they had it and didn't use it, that is a violation of 38 CFR 4.6 (CUE)

If they did have it and listed it as evidence as then opined on why they did not accept it under BOD (Relative Equipoise) we sure need to read the decision to help more.

Can you scan and attach their denial here (cover C file, name, address etc prior to scanning it)?

  "He concluded that based on well known studies and based on his personal knowledge if my medical situation, he can eliminate possible causes of sleep apnea such as obesity, neck and throat characteristics, smoking, and alcohol consumption and conclude that is more likely than not that there is a causal relationship between my service connected diabetes and my subsequent diagnosis of sleep apnea. "

Did he enhance that statement  as to the casual relationship with a full medical rationale? As well as some good medical citations?

Did he give them a complete Curriculam Vitae or at least a rundown of his expertise in the field of diabetes?

 

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When you researched OSA, generally all medical articles have a list of about 12+- contributing factors, age, Weight, Male, Family History, Neck size, Wide Tongue, Alcohol use/abuse, medications, just to name a few. Then there are the actual DX'd medical conditions that may be associated as actual causative factors. All must be an established DX, prior to SA symptoms or actual SA DX.

As to getting SA SC'd for Diabettes II or PTSD, very very dificult. Can't say I've seen any success stories here on Hadit.

I think it all comes down to a "Preponderance of Medical Evidence," and a Sleep Specialist's DBQ or Clinician Notes, indicating very clearly, (More Likely than not) that your SA is directly related to your Diabetes II.

Other than your DB II, how do you stack up against the list of usual suspects?

A redacted copy of your C & P SA DBQ and copy of Denial letter would be helpful.

Semper Fi

 

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Have you been able to google the C & P doc whose exam denied the claim?

They might have been a gynecologist. or a nurse. or at least someone with no expertise at all in Endocrinology.

A VA Endo went against my AO DMII death claim twice.

I had 3 IM0s for, ( 2 from NeuroRadiologist- Dr Bash and a freeby from a former VA Neurologist) so BVA wanted one more against but I proved the remand called for a cardiologist and I got a PA's opinion instead. I know more about cardiology than he did. I pointed out medically , how speculative his statements were, to the BVA and they agreed and didn't consider that opinion at all  and awarded.

When they try to knock down our IM0s we MUST know down their quacks...ooops I mean C & P "docs".

 

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Gastone and Berta.  Thanks for your posts.  I am a 68 yr old Asian male who weighs 138 pounds with a BMI of around 23 and I have a scrawny 14 and a half inch neck.  I have never smoked and  have not drank alcohol in over 20 years.  There is no family history od sleep apnea and I have no abnormalities in my oral and throat area.  I can't understand why there has been so little success in this area

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