ptsd Sleep Apnea Filing secondary to a SC Disability!

[Buck52]

This maybe helpful to some of you  wanting to File a secondary claim from a SC DISABILITY THAT YOU MAY HAVE  FOR A SLEEP APNEA CLAIM.

Even though this case is an old one   some of you may want to read up on this case that are thinking about filing a Claim of Sleep Apnea secondary to a SC disability that you may have.

you can get pull up these CFR'S That you need to read up on and do what you need to do for your claim..and submit your evidence accordingly.

 

Please read this   it sure could help you with your claim.

 

Citation Nr: 0102100 Decision Date: 01/25/01 Archive Date: 01/31/01 DOCKET NO. 99-22 315 ) DATE On appeal from the Department of Veterans Affairs Regional Office in St. Louis, Missouri THE ISSUE Entitlement to service connection for sleep apnea as secondary to service-connected post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Richard A. Cohn, Associate Counsel INTRODUCTION The veteran served on active duty from April 1970 to December 1971. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 1999 rating decision of the Department of Veterans Affairs (VA) Regional Office in St. Louis, Missouri (RO) which denied service connection for sleep apnea as secondary to service-connected PTSD. FINDINGS OF FACT 1. The record includes all evidence necessary for the equitable disposition of this appeal. 2. There is competent medical evidence linking current sleep apnea to the veteran's service-connected PTSD. CONCLUSION OF LAW The veteran's sleep apnea was aggravated by his service- connected PTSD. Veterans Claims Assistance Act of 2000, Pub. L. No. 106-475, 114 Stat. 2096 (2000); 38 U.S.C.A. § 5107, 38 C.F.R. § 3.310(a) (2000). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran attributes sleep apnea to his service-connected PTSD. The veteran does not contend that he incurred or aggravated sleep apnea during service and there is no evidence of sleep apnea or other sleep disorder in the veteran's service medical records SMRs. Procedurally, this appeal is developed fully and ready for Board adjudication. The RO has verified the veteran's period of service; there is no issue as to the substantial completeness of the veteran's application for VA benefits; the veteran has undergone VA examination pursuant to the application; the RO has requested and associated with the claims file all available service and postservice medical records pertinent to this appeal; VA is unaware of other unrequested records pertinent to this appeal, and; the evidence is sufficient to permit the Board to proceed with appellate review. See Veterans Claims Assistance Act of 2000, Pub. L. No. 106-475, 114 Stat. 2096, (2000). A veteran may be entitled to service connection for a disability under either a direct or secondary analysis. Direct service connection is warranted for disability resulting from disease or injury incurred or aggravated in service. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. § 3.303 (2000). Secondary service connection is warranted both for a disability caused by a service-connected disorder and for a disability aggravated by a service-connected disorder. 38 C.F.R. § 3.310(a) (2000). In the latter case, compensation is limited to the extent to which the service- connected disorder increased the severity of the secondary disorder. Allen v. Brown, 7 Vet. App. 439, 448 (1995); Jones (Wayne) v. Brown, 7 Vet. App. 134, 136-37 (1994). A service- connected secondary disorder becomes part of the original disorder. 38 C.F.R. § 3.310(a). The veteran is a decorated former Army combat soldier whose PTSD has been service-connected since July 1995. SMRs include no evidence of a sleep disorder in service and the veteran claims none. VA medical records confirm that the veteran underwent sleep studies in February and October 1998 from which he was diagnosed with sleep apnea. A VA psychiatric progress note from February 1999 briefly reviewed the studies' findings and applicable research and concluded that PTSD and its treatment "in all probability has aggravated the obstructive sleep apnea." The note further states that "it is certainly as likely as not that this veteran's sleep apnea is directly related to his PTSD." The VA physician who examined the veteran in July 1999 identified two likely causes of his sleep apnea: enlarged tonsillar tissue and obesity. The physician found no etiological connection between PTSD and enlarged tonsillar tissue. However, he acknowledged that "an argument could be made" linking the veteran's obesity with PTSD although the veteran's medical records did not include another medical opinion to that effect. In the Board's judgment the record presents adequate evidence upon which to base a finding that the veteran's PTSD aggravated his sleep apnea. The opinion expressed in the February 1999 progress note is neither ambiguous nor equivocal on that point. The July 1999 examination report is more tentative -- finding only a medical possibility of attenuated causality under a different rationale. Nevertheless, the July 1999 opinion does not refute the February 1999 opinion, and it is well established that VA itself may not refute expert medical conclusions in the record with its own unsubstantiated medical conclusions. Colvin v. Derwinski, 1 Vet. App. 171, 175. (1991). Therefore, absent medical evidence actually denying a causal linkage between PTSD and sleep apnea in this case, the Board reads the two opinions together as providing, at minimum, evidentiary equipoise which must be resolved in the veteran's favor. See 38 U.S.C.A. § 5107(b). Accordingly, the Board is constrained to find that service connection for sleep apnea is warranted here under a secondary analysis. See 38 C.F.R. § 3.310. ORDER Service connection for sleep apnea is granted secondary to service-connected PTSD.   WARREN W. RICE, JR.

[syne7]

I believe you can request a doctor change with a form.

[syne7]

Apparently sleep apnea can be secondary to MDD.

http://www.va.gov/vetapp09/files2/0911508.txt

You need to consider getting opinions, nexuses, and IMO's/IMEs

[syne7]

Here is another

http://www.va.gov/vetapp14/Files4/1427494.txt

 

[Buck52]

yes thats what I was thinking  but were not Dr's

you need to see a quailfied Dr  that knows MMD may not be the cause of your sleep anea  but it surely agervated it,,,,be hard for them to deny then!

 Dr Quote'> Ralfh Johnson''' In my professinol opinion of 20/25/30 years in practice with & my credentials  my State Liscense Dr PHD, ect,,ect,, ..I have reviewed Mr Veteran medical Records and came to the conclusion It is likey as not that Joe Veteran OSA problem are indeed agervated & arise from his SC MDD

''Agervated'' being the key word.

Some Dr's will not say  sleep apnea is cause from a certain secondary  but they can say it is aggrevated by it.

Andyman  MDD is one of those conditions that agervates Sleep Apnea!

The Dr's can word it where the VA can't dispute it...if the VA Drs agree or meets the other Dr half way 50/50  then its in eqiupoise and that always goes to the veteran!

jmo

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

Edited May 17, 2016 by Buck52

[OEF 21B]

1 hour ago, Buck52 said:

''Aggravated'' being the key word.

Some Dr's will not say  sleep apnea is cause from a certain secondary  but they can say it is aggrevated by it.

 

Here is what I put on my VA FORM 21-4138 when I filed my Sleep Apnea claim on 27 JUL 2015:

I am claiming Sleep Apnea as a service connected condition secondary to my service connected PTSD (30 AUG 2010, 50% Rating).

I submit for considerations three studies conducted at Brook Army Medical Center, Walter Reed Medical Center, and a report from the American Academy of Sleep Medicine that all not increased rates of Sleep Apnea in veterans with PTSD.

VA Training letter 10-01 clearly states that SLEEP DISTURBANCES are included in Signs and Symptoms as Qualifying Chronic Disabilities for claims based on service in the Gulf War and Southwest Asia.

My civilian physician, Dr. David H. Plump, examined me on 17 JUL 2015 and concluded that my OSA is at least as likely as not AGGRAVATED by my service connected PTSD and that it is at least as likely as not that my service connected PTSD is AGGRAVATED by my diagnosed OSA.

 

Time-Line:

Initial Claim: 27 Jul 2015

C&P by VES: 25 Aug 2015

Decision: 15 Jan 2016

Here is what my decision letter stated:

- Service connection for sleep apnea has been established as related to the service-connected disability of posttraumatic stress disorder.

- A higher evaluation of 100 is not warranted for sleep apnea syndromes unless the evidence shows: Carbon dioxide retention; or Chronic respiratory failure; or, Corpulmonale;,, or Tracheostomy required.

- We have assigned a 50 percent evaluation for your sleep apnea based on: *Requires use of breathing assistance device such as a continuous airway pressure (CPAP) machine.

I think that by claiming AGGRAVATION and not CAUSED BY PTSD, MDD, Chronic Pain, etc.,  is easier to get a non-VA doctor to write a nexus.

Semper Fi -

Edited May 17, 2016 by OEF 21B

[Andyman73]

That only works if you already are SCd for MDD or PTSD. While I have MDD DXd by VA MH dr, and SA DXd by private Dr., neither are SCd for me, yet. 

All I have are my SCDs for physical issues...painful ROM and such....