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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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Buck52

Sleep Apnea Secondary to PTSD?

Question

I have a SC 70%PTSD Rating  Just got this in Feb 6th 2016...

This is my story and a normal one with Veterans.

During my DSM5  PTSD Diagnose by the VA   The psychiatrist sent me to sleep clinic for a sleep study,(I mention to her I had problems sleeping not only from nightmares) they couldn't get me in with in 60 days  so they called ( private outside sleep clinic) and contracted out the sleep study to a private sleep clinic...I did the sleep study(split sleep study)  digitally and visionally watch by sleep tech & montiered the first 4 hours   then woke up and a cpap was hook up to me... and the results were I did have Sleep Apnea and required the use of (Continuous positive airway presure )*c-pap machine

Currently seeking  treatment  with VA Phyistrist and counseling /therapist with VA

 As for as having sleep apnea  I never mention this while in military...I never knew I had it?  other than buddys stating ''I sure snored loud''  but never the less no records will be found while in military about sleep apnea or OSA  btw Sleep Apnea was not known back then...late 60s

I had this and sleep disturbance for a long time just never knew it and could never afford a sleep study out of pocket..until the VA had me to do one...I was diagnosed with Sleep Apnea  or OSA... My question is should I file a secondary claim for Sleep Apnea  due to my 70% PTSD?

On my last claim for SC PTSD 70% .

before the 70%PTSD I was TDIU P&T  so VA rated me the SMC S-1 H.B.....I met the criteria for the SMC-S 1 H.B.

However I am happy with the rating...but nothing was said about my Sleep Apnea...on my PTSD Claim....I did file  a ITF in January 2016 just right before they adjudicated my PTSD Claim.

If I file  a FDC Sleep Apnea Claim secondary to my PTSD    would this get me another statutory rating under SMC? 

Also would this be considered pyermiding?

I realize I need an IMO to help with this claim.

 

..........Thank you in Advance

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

 

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

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Anybody know if this would be   pyermiding?

and what all would I need for evidence?

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Buck 

       Join the SLEEP APNEA boat!!!  Apparently there's plenty of room on it from all the post about SA.  So you do have a SA DX?  Did the VA DX you even though you had an Outside agency Dx you?  Did you receive your C-PAP machine from the VA?  If yes to these questions than a Nexis would be the next hurdle to overcome and this seems to be the one that is hardest to make over!!!!  Andyman and myself are paddling upstream in the same boat as you with the Nexis port nowhere in sight as of now.  You should probably start with your MH PCP and see if he/she will tie this in with your already DXed PTSD!!  They go hand in hand and everybody seems to see this except the VA.  We just need to keep each other informed about the different paddles that we use and compare note and work on a plan of attack!!!  

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yes I have a VA Sleep Apnea Diagnose and they gave me a C-PAP to use with three different Mask..and an exta longer hose.

I may call Dr Ellis  from Oklahoma City  he does IMO'S for secondary or Agervated  by...ect,,ect,, & opinions and I understand he is real good  and a Veteran himself.

If I call him or email him I'll let you guys know what he said.

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I am not sure I'll get any comp?

I am happy with my comp/rating

its 100% plus 70% with SMC-S 1 H.B.

 I just want to get it service connected for DIC Reasons for spouse.

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On 5/12/2016 at 10:17 AM, Buck52 said:

Anybody know if this would be   pyermiding?

and what all would I need for evidence?

No, it would not be pyramiding. It would be a 'secondary' disorder, which is a “…disability which is proximately due to or the result of a service-connected disease or injury…” (38 C.F.R § 3.310).

In terms of evidence, I would definitely talk with a Veterans Service Officer about it. There are a couple of options:

  1. You could file a claim for OSA (Obstructive Sleep Apnea) secondary to PTSD, and then go to the C&P exam and see what happens. --> If this is not successful, you could then try the next option and ask for a reconsideration.
  2. You could pay for an Independent Medical Examination (IME) and then file the claim. --> Downside here is that you might be successful with the first option, and you would not have needed to spend the money on an IME.
  3. You could ask your sleep medicine doctor and/or psychiatrist for a 'nexus letter'. --> Unless the doctor knows what's involved and how to write it (which takes a lot of time, btw), this is not likely to succeed.

I know that many veterans have received SC for sleep apnea secondary to PTSD. However, there is not any scientific evidence at this time that shows a causal link (nexus) between PTSD and OSA. Vets usually get SC because the C&P examiner does not read the scientific literature and they simply give an opinion. The VBA must accept such opinions as valid unless there is some obvious error. 

If you do file a claim, be sure to request not only SC based on OSA being "proximately due to or the result of" PTSD, but also SC based on OSA being aggravated by PTSD. I wrote about this point in a blog post regarding secondary mental disorder claims, although the same principle applies to a PTSD-->OSA claim. There is not yet any definitive research regarding PTSD exacerbating OSA, but it seems to be a more plausible connection than direct causation. 

All the Best,

Mark

P.S. Central Sleep Apnea is a different animal--I am referring only to OSA. I would never give an opinion regarding PTSD-->CSA secondary claim because there is so little known about the possible relationship, but some physicians, e.g., neurologists, psychiatrists, and others, are more comfortable with such claims because they have more knowledge about possible physiological processes that could theoretically lead a person with PTSD to develop CSA (or PTSD aggravating CSA). Thus, the couple of times I was scheduled for a C&P exam regarding a PTSD-->CSA claim, I would have the exam transferred to an MD.

P.P.S. I highly recommend working with a Veterans Service Officer for a PTSD-->OSA claim.

Edited by Mark D Worthen PsyD
improved formatting; added another P.S.; fixed grammatical error
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