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EODCMC

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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.

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  • HadIt.com Elder

I agree with Andyman

you need to take it back and let them adjust it accordingly 

AS for as getting C-FILE...If you are a Vietnam area veteran  those C-files have gathered dust over the last 30 or so years for me the last 45 years and They don't won't to look for them...the Newer Gulf war Veterans seem to get their C-FILE a lot faster...so I'm thinking us Vietnam vets are not thought about to much and our C-File is just sitting on the back burner gathering up dust.

jmo

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

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EODCMC,

As for use and adjusting, it's been 2+ years for me, and I still am not comfortable with it. However I keep plugging away, every night, and so on. I haven't found it off my head yet, so I guess it's okay, as far as that goes.

Sometimes my wife wakes me because the seal is broken and the rushing wind noise wakes her.

Long in the tooth, eh?  They wanted to deploy my Dad for GWI, but by then he was medically grounded, and quite glad for it, too.  At that point he was already over 20yrs AD since the fall of '68, and wasn't interested, much, in another "field trip".

Your C-file was started on the first day of your first VA activity, at least claims related, as far as I understand how the C-file works.  It's only completed when your life is completed, unless you have survivors getting benefits.

Someone once told me the only dumb question is the one you don't ask.  But my experience has been...what if you don't know what you don't know, and therefor, never ask?

Semper Fi

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In regards to CPAP and associated equipment. Various machines, but they basically do the same thing. Doc/technicians adjust "pressure."  Distilled water- can't stress that enough and keeping it clean

The associated equipment includes the mask- full face, nasal, half face.  Key is 1) finding what you're comfortable with and 2) getting them replaced probably every six months.  

I have tried all types and settled on a nasal type that the VA replaces every six months as the "rubber" gets hard and loses the seal-  Kit also comes with new hose.   Hope that makes sense and answers some questions

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  • HadIt.com Elder

I found out the Res-Meds C-PAP Machines  have  ''two '' pin card'' not sure what they call them?  its the little devise that plugs in your machine an records everything while you sleep....anyway after the first 30 days of use your suppose to take it or the whole C-pap machine back to the VA Sleep Clinic  and let them have it, then you take your machine back for a year and you should get a letter letting you know.

However the machine has another PIN Card built into the machine  (hidden)

I am trying to figured out how to hook my computer (Laptop) up to where the old Pin card was   and see if it will display the information that way.

They do this to see if the machine has been in use..if they find out its not  they will probably send a proposal to reduce....if your S.C. rated at a %?

I been using mine every night  but take it off about 5:00am every morning..I use mine about 6 or 7 hours a night.

As for as keeping them clean  I soak mine in hot water mixed with my shampoo Hour or so rinse with hot water 2 or three time  then hang up let dry, harsh soaps can dry out the rubber and get brittle. and the hose I put a cap full of my minted mouth wash in it and shake the hose back and forth several times and rinse out with hot water 2 to three times &  hang up and let dry...this gives me a aroma that  helps  me fall to sleep,a better  clean air soothing type feeling.

Clean out the water reservoir  at least once a week and change the air filter every two weeks.

AS for as getting a SC Rating for S.A. or O.S.A.  IF you don't have medical documentations and buddy statements for snoring while in service   you will most likely be denied 70% of vets are denied for this reason...but if you have another disability Muscular Chronic Pain  or a disability that can Aggravate the S.A.  Then that what you need to file it to & also be careful how you use the word Sleep Apnea or OSA...it would be better to use OSA  b/c that covers most of the symptoms from Sleep Apnea.  although they basically mean the same  its just the way the VA looks at it.

btw ,Did I read someone say you can order your C-FILE from St Louis???

jmo

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

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VA is reluctant to award Sleep apnea claims.  There are 2 keys, as I see it, to winning sleep apnea claims.

1.  Make sure you have all of the big 3.   Check your records, dont rely upon your memory of what happened, as doctors may have written down something different than what you think or may have not written anything at all, or your records could be missing, or shredded.  Big 3:  Current diagnosis of sleep apnea,  in service event or aggravation, and nexus or link between the previous 2.  

2.  Be ready to appeal and persist until you win, with the applicable evidence.  This may mean you have to get an IME/IMO if your VA doc wont give you a statement connecting it to service.  It also probably means a long fight. 

     In my experience, VA will provide a CPAP machine even if your disorder is not service connected.  I got my CPAP at VA, and I have not yet gotten VA to concede that my apnea was secondary to depression, even tho my sleep doc said it was.  That is, I have a nexus, and a bogus denial.  Persistence wins when other stuff does not.  

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Thank you both for your responses to my query. Yes, my application is an FDC. I supplied scans from my service record that fully documents my sleep study, results and the need for a corrective action; CPAP and elongated palate/ubula surgery. Additionally, I sent the current scans from my Tricare Doctor and sleep study verifying a worsening state. I am now trying to adjust to this damn machine. My initial desire was for the VA to pay the difference for what Tricare will not. Now I'm stuck in the system. 

Silver, if I'm right...someone took my file and placed a reminder in their calendar to act on it in Aug. Aug-Nov is the timeframe they guesstimated this process to take. Right? 

Thanks again.

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