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commodog

VA Admits in service treatment but denies connection?

Question

Hey guys. Thanks in advance for reading this!

So this is what I received today for my sleep apnea claim (See Attached)

So they acknowledge I had sleep apnea in service.
Then deny my current sleep apnea is associated with me having sleep apnea in the past?
For the record, the words "sleep apnea" were never used with me while in-service.
They just told me I must not be getting sufficient sleep.

It wasn't even clear to me until my current doctor submitted me for a sleep study that that is what they were talking about back in 2004-2005.

So like, two totally different sleep apneas?

The VA is weird as hell sometimes...

Going to go ahead and NOD this, but what do you guys think needs to be included to succeed?
How is it that they can admit I had sleep apnea treatment in service, but then deny sleep apnea because I tried to "warrior my way back into society"?

Also, for your consideration, I am...:

...70% PTSD
...10% TBI (Vehicular fall down a friggin cliff during the invasion)
...10% Tinnitus

Thanks!
 

13500005_1207792649231821_1799970713_o (1).jpg

Edited by commodog
Inclusion of pertinent information

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Three factors needed for direct SC:

1. Event/diagnosis while in the service
2. Current diagnosis
3. Doctor's opinion connection #1 and #2

Looks like the VA admits you have #1 and #2, but the C&P doctor denied #3 per the explanation:

"We did not find a link between your medical condition and military service"

"Per your VA exam, the examiner opined that your current sleep apnea is less likely than not...

 

Get your C&P exam results and confirm that this is actually what the doctor opined. It is not unusual for the VARO to fail to properly read a C&P exam. It has happened to me more than once.

It is also worth it to find out the title of the C&P examiner. If they are a nurse practitioner, request another exam or get your own doc to provide their opinion (see below).

The best way to overcome a "less likely than not" is to get your treating physician to opine "as likely as not", "more likely than not", or "is due to".

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Hey, thanks Vync!

I will do just that.
The doctor, in the C&P, told me, and I quote, "I am putting it down that you first showed these symptoms in 2003."
Then he showed me a field on the computer screen that said something, and he put "2003" into it.

I am really weirded out by the response I got.

I will petition for my C&P exam results.

Thanks!

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23 hours ago, commodog said:

Hey, thanks Vync!

I will do just that.
The doctor, in the C&P, told me, and I quote, "I am putting it down that you first showed these symptoms in 2003."
Then he showed me a field on the computer screen that said something, and he put "2003" into it.

I am really weirded out by the response I got.

I will petition for my C&P exam results.

Thanks!

I hope you are able to find something positive from your results.

Good luck!

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I agree.  Get an IME/IMO from a specialist or your current doctor connecting past, present and future.

Then do a FOIA request for the C&P examiner's curriculum vitae to use if he/she is a nurse practitioner or physcian's assistant, when comparing to your MD in a NOD and/or BVA appeal.

Good luck!

Mark

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On 6/20/2016 at 11:07 AM, commodog said:


...70% PTSD
...10% TBI (Vehicular fall down a friggin cliff during the invasion)
...10% Tinnitus

Thanks!
 

13500005_1207792649231821_1799970713_o (1).jpg

You several options.... You only need to show connected consistent symptomology to the current sleep apnea.  Not treatment.  The BVA has ruled many times that "the Veteran is capable" of and relaying his or her own symptoms.  You can simply put a statement with your appeal.

Also consider secondary service connection "caused or aggravated" for TBI, PTSD, and Tinnitus.

I would recommend Dr. Anaise or Dr. Ellis for IME/IMO... Dr. Anaise has a record of connecting PTSD to Sleep Apnea.

Here is a case of an IMO connection Sleep APnea to PTSD (from Dr. Anaise's website):

The usefulness of IMO Letters to establish rating for sleep apnea secondary to PTSD 

In a recent decision by the BVA (FEB 2 8 2014 DOCKET NO. 11-09 193) the board reiterated the importance of IMO Letters supported by medical literature in establishing service-connected disability for sleep apnea secondary to PTSD the board held: “The Veteran had a VA examination in October 2009. The Veteran reported sleep apnea with an onset two to three months earlier. The VA examiner opined that, per medical literature review, sleep apnea is not caused by or aggravated by the Veteran’s PTSD. The VA examiner stated that the basis of the opinion was the review of medical literature. The literature was not specified. At the Board hearing in March 2012, the Veteran testified that his therapist has told him that PTSD aggravates sleep apnea because he has nightmares and dreams in his sleep. The Veteran testified that he has anxiety attacks in his sleep that keep him from catching his breath. The Veteran testified that he has used a CPAP machine for about four years. In this case, there is positive medical evidence which links the Veteran’s current sleep apnea to service-connected PTSD via aggravation. The most probative opinion is that of Dr. T which not only provided a link between the Veteran’s PTSD and sleep apnea (by aggravation) but also was supported by submitted medical literature. Despite the negative VA opinion, in light of the positive medical opinions from the private psychologist, the Board finds the evidence is at least in equipoise regarding whether the Veteran’s sleep apnea is aggravated by service- connected PTSD. Accordingly, resolving all reasonable doubt in the Veteran’s favor, service connection for sleep apnea is warranted. – Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C.A. § 5107(b). ORDER Secondary servi

 

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