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.

[Buck52]

Does Anyone know how they conduct a SLEEP Apena C&P?

I may be asking a silly question here  but  if were sleep  how can we let them know  we have Apnea's occuring at night and stop breathing  boo-coo times during the night?....the C-pap  /bipap machines has a pin card in it that they (Sleep Clinic Doc's) take out and it gives them all this information....so don't the C&P EXAMINER need to rely on this information?  as we can't answer their questions as were a sleep.

I Do seem to sleep better with my C-Pap  but sitll have nightmares (from my PTSD) and I knock my mask off and wake up all sweating...I  get up use the restroom and put my mask back on and go on back to sleep  but at times this happens 2 or 4 times during the night.

I mention this to my VA Physistrist and even ask her if the meds I take for PTSD could cause this or aggravate my Sleep Apnea ?  she said No?

How do you dispute a Phyistrist? 

she said all veterans with PTSD have night mares  your not the only one..I thought Duh.

I been thinking bout not filing...whats the use if you keep getting denied...I cant afford to keep get IMO/IME.  just to be denied.

jmo

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

 

 

nj

So back to round one with me.

[ArNG11]

6 hours ago, Buck52 said:

Does Anyone know how they conduct a SLEEP Apena C&P?

I may be asking a silly question here  but  if were sleep  how can we let them know  we have Apnea's occuring at night and stop breathing  boo-coo times during the night?....the C-pap  /bipap machines has a pin card in it that they (Sleep Clinic Doc's) take out and it gives them all this information....so don't the C&P EXAMINER need to rely on this information?  as we can't answer their questions as were a sleep.

I Do seem to sleep better with my C-Pap  but sitll have nightmares (from my PTSD) and I knock my mask off and wake up all sweating...I  get up use the restroom and put my mask back on and go on back to sleep  but at times this happens 2 or 4 times during the night.

I mention this to my VA Physistrist and even ask her if the meds I take for PTSD could cause this or aggravate my Sleep Apnea ?  she said No?

How do you dispute a Phyistrist? 

she said all veterans with PTSD have night mares  your not the only one..I thought Duh.

I been thinking bout not filing...whats the use if you keep getting denied...I cant afford to keep get IMO/IME.  just to be denied.

jmo

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

 

 

nj

So back to round one with me.

Yes this is a fact.  I wish we, as patients, could have easy access to this information, either before going to a sleep center or taking the machine to the vendor.  I would most definitely make a copy of the data or transfer the data to another source as well.  That way you still have the saved measurements.  You know, in case the technician accidentally erases the data.  

 The SD card records all that information, how many full respirations, how long they are, how many apnea related events per hour, for how many seconds, and how often a minute.  They use this information to either lower or increase the pressure in order to try to decrease the apneatic events.  Along with other data depending on what brand of machine and what features it has.  A machine like a bi-pap will have more complex information and specifics.  

In my mind, damaged as it is, I would take an educated guess that this data would be relevant to a Sleep Apnea C&P.  More so for the technician and sleep doctor to use the data to make adjustments on your machine to reduce the sleep problems.  But I'm not an expert, I just read about the information packets about the machine and medical information relating to this.  

[jamesat40]

I have a question and need some advice. I put in a claim for OSA in 2014 and per the award letter received in April 2015 I was denied. After the denial for OSA, I initiated a NOD to keep the claim open. On 18 August 2016, I looked in ebenefits and noticed they had given me a non-service connected (NSC) (pension) rating of 50% for OSA as a secondary to my service connected (SC) Sarcoidosis and Asthma. This rating didn’t appear until 18 August. Check ebenefits weekly.

I called the regional office (RO) in Montgomery Alabama on the next day and I was informed that I had received the award in April 2015. The RO then explained that the VA says in their notes that they agree that I have OSA, but not due to my SC disability of Sarcoidosis and Asthma. I am SC for 3 disabilities, Sarcoidosis with Asthma, PTSD, and GERD. I have conducted research in the Board of Veteran Appeals (BVA) and found appeals g showing that other veterans had been granted SC for OSA for each of the disabilities that I have. In my opinion VA has acknowledged that I have OSA by giving it a rating of 50%. My goal now is to have it changed from NSC to SC. Is there anyone with experience in do so? If so, please lend me some advice.

[john999]

I would like to get that doctor to opine on my DMII and Sleep Apnea.  I had the SC   DMII before the OSA.  I did not have the OSA until I gained some weight which may be cause and effect of my DMII.