Am I interpreting this VA letter correctly? (sleep apnea)

[100Bound]

First bullet says, "We have assigned a 50% evaluation for your sleep apnea..."

But here's where it's interesting. The second bullet says, "A higher evaluation of 100 percent is not warranted for sleep apnea syndromes unless the evidence shows:Carbon dioxide retention; or Chronic respiratory failure; or Corpulmondale; or, Tracheostomy required." (underlining is mine)

I thought it had to be chronic respiratory failure AND carbon dioxide retention? So, if I'm reading this correctly, according to this letter, all I would have to prove is carbon dioxide retention and I'd be rated at 100%?

[Gastone]

 EODCMC:  SA symptoms can go undiagnosed, even by MD's. My (20yr) family Dr had me on weekly B-12 shots for almost 2 yrs, attempting to address my recent extreme fatigue and daytime drowsiness.. It wasn't until I had to change Drs due to Insurance acceptance in 09, that the New Dr sent me for a Sleep Study. She picked up the SA symptoms on the 1st get acquainted office call, 2 weeks later, I was DX'd and on Bipap, week later on supplemental 02 at night.

The SA had been kicking my Axx and doing heart damage, for at least 2+ yrs before I got on the Bipap & 02  machines.

Semper Fi

[broncovet]

Yes.  Based on what you posted the operator "or" means "either criteria".  If it said "and", then both criteria would be required.  

VA makes regulations confusing, often, so VA raters can interpret it as "and", when you parse it out, the operator is or.

 

Example:

  I was denied SMC L because "I was not confined to my bed".   BS.  

Consider this regulation:  (highlights mine) § 3.352 Criteria for determining need for aid and attendance and “permanently bedridden.”

(a) Basic criteria for regular aid and attendance and permanently bedridden. The following will be accorded consideration in determining the need for regular aid and attendance (§ 3.351(c)(3): inability of claimant to dress or undress himself (herself), or to keep himself (herself) ordinarily clean and presentable; frequent need of adjustment of any special prosthetic or orthopedic appliances which by reason of the particular disability cannot be done without aid (this will not include the adjustment of appliances which normal persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); inability of claimant to feed himself (herself) through loss of coordination of upper extremities or through extreme weakness; inability to attend to the wants of nature; or incapacity, physical or mental, which requires care or assistance on a regular basis to protect the claimant from hazards or dangers incident to his or her daily environment. “Bedridden” will be a proper basis for the determination. For the purpose of this paragraph “bedridden” will be that condition which, through its essential character, actually requires that the claimant remain in bed. The fact that claimant has voluntarily taken to bed or that a physician has prescribed rest in bed for the greater or lesser part of the day to promote convalescence or cure will not suffice. It is not required that all of the disabling conditions enumerated in this paragraph be found to exist before a favorable rating may be made. 

 

    end regulation quote.  

Did you see what is happening here?  "Bedridden is NOT required, but it will suffice to meet the criteria only if the doc requires it.    The last paragraph explains that you dont have to meet all these things, that any of them will suffice.  So, the VA interprets this in their favor, "bedridden will be a proper basis for the determination", and since I dont have a doc's note requiring me to stay in bed, that means denied in the VA raters eyes.  Its bogus.  It does not say I have to be bedridden at all, it says I can meet ANY of the criteria above and qualify.  

Some VA rater comes along, reads the sentence:

Bedridden” will be a proper basis for the determination.

and says, nope, no docs note for bedridden denied.