Sleep Apnea Claim

[EODCMC]

Hi, I am a 30 year retired vet. I retired 13 years ago. I as recently diagnosed with "very severe" obstructive sleep apnea. The machine they gave me is preset on the highest output flow. My episode exceed 35 times an hour with some lasting more than 30 seconds. 

I was diagnosed with sleep apnea a couple of years prior to retirement and the study and diagnosis is documented in my record. In fact, they wanted to operate on my uvula. There lies the rub. The operation could have ended my career so I didn't persue. Additionally, while on active duty I developed severe chronic sinusitis and allergic rhinitis and this also is documented in my service health record. I have been living with this and chalking it down to getting old.

Fast forward...I recently got a machine that they say I have to wear for the remainder of my life. I just learned that Tricare Prime does not pay for it all. So, I researched online and submitted a claim the E-benefits and it has been received and was under review until today when they changed this to "gathering of evidence" Development Letter Sent.

Does anyone know what this means? What do I have to look forward to concerning the process. I watch the news. It doesn't look good, right?

thanks in advance.

[EODCMC]

Andyman, yea that would be a dead end. Plenty of training and volunteering, but I missed the action. I would have thought my active duty sleep study and DX would have been enough.

My VSO thinks they may balk because of the 12 years between the studies that I didn't seek help. I guess it's the price one pays for avoiding medical help and chalking things up to old age. However, I went from mild OSA and CPAP DX to extremely severe OSA and I just couldn't refrain from seeking help.

Combat Sleep Apnea is a new one...ha.

[afvetwife2000]

On ‎8‎/‎5‎/‎2016 at 3:11 PM, EODCMC said:

Andyman, yea that would be a dead end. Plenty of training and volunteering, but I missed the action. I would have thought my active duty sleep study and DX would have been enough.

My VSO thinks they may balk because of the 12 years between the studies that I didn't seek help. I guess it's the price one pays for avoiding medical help and chalking things up to old age. However, I went from mild OSA and CPAP DX to extremely severe OSA and I just couldn't refrain from seeking help.

Combat Sleep Apnea is a new one...ha.

I just joined this site and made a post similar to yours. My husband had a sleep study done a few weeks before he went on TDRL. I was positive for severe obstructive sleep apnea. That was five years ago and between then and now he hasn't sought medical help for it. We are hoping they don't deny his claim.

[EODCMC]

First of all, welcome to the site!

Yea, I'm only slightly concerned. There is a clear nexus to service connectivity. But, you can always bolster your husband's claim. My VSO asked me if my Tricare PCM would write a short paragraph in my file stating that my current condition is more than likely a continuation of the active duty DX. It doesn't hurt to try. I suggest you do the same. 

There are some terrific folks here that will chime in with real help. You will learn very fast who to listen to...Berta cough Berta cough Berta.

[EODCMC]

Update:

I went on E-benefits today to download a Form 21-4138, Statement in Support of Claim that my Dr. filled out supporting my claim. She provided a clear nexus of exacerbated medical condition that started with my active duty sleep study and DX of OSA to my current one, seperated by 14 years. I will print a redacted copy when I get home to my computer.

Additionally, to my delight, I found my Estimated Date moved up 3 months to 8/21/16-10/17/16.

Comments anyone?

Edited August 18, 2016 by EODCMC
Typo

[EODCMC]

For anyone following this thread, I received a phone call today to setup  my C&P exams for a week from Tuesday. Interestingly, they called and they are following up with an e-mail and USPS notification.

[Buck52]

probably QTC C&P Exam?

Some Vets don't like QTC?   (Lockheed-Martin)    My PTSD  C&P was from QTC...I had no problems.

Anyway  be sure and take extra copies of your evidence  in- case  the Examiner don't cover everything or have all your Evidence .

The RO sends them your records /evidence  to look at on the puter  and some times  they don't send everything...so just have your records /evidence with you  just in case!

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