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.

[Andyman73]

syne7,

1, yes, been DXd with SA, and RXd with Cpap.

2. Yes. when I had my MH C&P exam, the "person" put chronic sleep disturbances in his remarks.  So my SA claim is tied together with my MH claim.  Not sure if I can separate without a Nexus clearly stating SC is at least, or more likely connected to my service.

3. Not sure if I can make claim with out nexus. So...no sleep C&P exam.

Now, I do have a referral in at my VAMC for appointment with the sleep dept. there.  And I do have a sleep study scheduled with my private provider.  Also, waiting for report from recent neuro eval.  The neuro docs know I have SA, and have a copy of my complete sleep study.  And a SMR entry where it shows I had LOC from when I fell down the stairs. I'm really praying that the neuro docs will be able to connect the dots between those and the neuro exam, and my memory loss, and MDD.

Semper Fi

[syne7]

Thanks for the clarification.  In some cases sleep apnea has been liked to MDD.  So it sounds like one route would be to get a Nexus/IME/IMO supporting sleep apnea secondary to MDD. 

Also it will be interesting to see what your neuro finds.

[Andyman73]

Even tho the VA tries to turn a blind eye to the whole SA phenomenon, general medicine is already linking depression/PTSD with SA, each feeding and strengthening the other.

I know I had problems sleeping, while on AD.  I took OTC sleep aids, and alcohol to help sleep. Don't know how to get that together for the SA and MDD.  I even have an Article 15 for public intox, and spent 21 days at an outpatient rehab program as a result of it.  I have that and the evaluation paperwork in my SMR.

I'm quite sure that plays a big part in my MDD and SA as well.

Yes, I'm quite anxious to get a peek at that report.

Semper Fi

[ArNG11]

Andy I don't see how the VA raters can go against medical correlations. 

Also I don't see how a DRO can associate certain symptoms with specific service connected illnesses. They have no medical training yet local regional office believes this is going to fly. 

Im in a similar boat but my nexus was attributed with GERD and sleep apnea. I have the evidence to prove the correlations both with GERD and MDD/PTSD. 

I'm very interested in finding out whether the apnea will be denied at BVA level with those factors in to play. 

Also with my recent DRO decision service connecting sleep disturbances with the MDD, I'm very curious on how the VA comp is gonna try to counter the GERD correlation and the MDD correlation to Apnea.  

I will post either which way it goes when I have my turn in the hot seat at BVA.

[Andyman73]

ArNG11,

It's easy, examiner chose not to talk about it during the exam, kept going away from the whole reason of being there.  Then the RO chose to do what was best for the VA, not the Veteran.

As long as the head shed keeps downward pressure on the ROs to deny, and to the examiners to opine against the Vets, this will continue. 

It's just too funny how scandal after scandal comes to light, and the only real changes are the changes made to shuffle the whole thing around.  Which makes it look, to the outside world, that the VA is doing things to fix it, when in fact that's all they are doing, rearranging the furniture, not replacing it.

[silverdollar22]

Good analogy andyman!!  Keep shuffling the problems around and then it will look like were doing something about it!!!