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Continue usage of CPAP after VA rating for Sleep apnea

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VetDO

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Hello, 

First time user here. I posted earlier, but I don't know what happend to my post. So the bottom line is that, I received mild obstructive sleep apnea diagnosis right before I discharged from the Army few months ago. After the discharged, I received a CPAP machine from the VA hospital and moved to different state. I was told that I would need to setup an new CPAP machine at the new location. Just today, I found out that I've received 70% rating for my sleep and some other stuffs. My question is, do I have to use CPAP for rest of my life to receive my 50% for sleep apnea? I haven't used my CPAP because I get worse sleep. Will the VA reduce my rating if I don't get issued a new CPAP and continue with "treatment"? Thank you for your help. 

 

-vetDO.

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The VA Respiratory dept has never asked me for the SD card from my CPAP machine in the 5 yrs that I have had it. Theyve allowed me to change out tubing and headgear a few times, but as far as compliance, who knows? 

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Yes.  If you discontinue use, expect the VA to reduce you.  As was pointed out, they know if you are using it or not.  

Your sleep should not be worse with the CPAP.  I suspect there is a problem, such as the wrong mask, its not fitting properly, the wrong pressure, etc.  You may also need to try humidified air (fill the machine with distilled water), or, if you are using humidified air, try it dry.  There is also a heat setting which you can tweak to your liking.  

I suggest you go to the sleep doc, and tell him your issues.  Its more than just your rating..its about your health. 

When you have apnea events, you stop breathing and can die, or, it can/will damage your heart.  (Too low of oxygen will damage your heart).  

If you were incorrectly diagnosed, then stop the CPAP, but I dont recommend trying to deceive VA.  These things tend to catch up to you.  You could owe the VA a bunch of money..for compensation for a cpap that you are not using.  Just be honest with them and you should be ok.

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To add to what broncovet said, keep this in mind as well...most of us with SA and Cpap have struggled, or are still fighting with the VA to get SC for SA. 

And one more thing, if DXd and RXd Cpap, please use it. A fellow Vet and coworker of mine's father died, at age 53. He thought he could spend a weekend prepping his hunting camp for deer season, without his Cpap. Fell asleep in a lawn chair in front of the fireplace, after the first day of hard work.  They found him there several days later, still in the lawn chair.  My friend is taking it pretty well, but his step-mom and kid sister are devastated.  Autopsy results showed asphyxiation due to position of head and neck,slumped over, his body couldn't even choke/gasp itself awake.

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If you have been prescribed one and don't use it you are more than likely harming yourself.  That may be why VA just changed the regulation to say that you don't have to use it.  If you die they don't have to pay you any longer and have more money for bonuses.

To answer your question...no, you don't have to use it.  The last bullet in the change states that.

Evaluate sleep apnea using the criteria in 38 CFR 4.97, DC 6847 (sleep apnea syndromes (obstructive, central, mixed). 

 

When determining whether the 50-percent criteria are met, the key consideration is whether use of a qualifying breathing assistance device is required by the severity of the sleep apnea.  

 

There are two related considerations

 

·   what devices qualify, and

·   whether use of a qualifying device is necessary. 

 

On the question of what qualifies as a breathing assistance device, the DC lists a continuous positive airway pressure (CPAP) machine as an example.

 

Other qualifying breathing assistance devices include:

·   other positive airway pressure machines (automatic positive airway pressure device (APAP); bilevel positive airway pressure device (BiPAP)).

·   nasopharyngeal appliances (nasal dilators; nasopharyngeal stents)

·   oral appliances (mandibular advancement devices (MAD); tongue-retaining mouthpieces), and

·   implanted genioglossal nerve stimulation devices.

 

Note:  Positive airway pressure machines may also be called non-invasive positive pressure ventilation (NIPPV) or non-invasive ventilation (NIV).

 

On the question of whether sleep apnea requires use of a breathing device, there are two important and related points

 

·   Use absent a medical determination that the device is necessary does not qualify.  The regulation requires that the device be necessary and this is a medical question. 

·   If the competent medical evidence of record shows that use of a qualifying breathing assistance device is medically required, the fact that the claimant is not actually using it as prescribed is not relevant. 

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Oh good grief, it has nothing to do with the VA wanting to kill us off. Mostly they can't regulate that you use a medical assistive device legally because it would be forcing it upon your person, only rate on whether or not the disorder or disability is severe enough to warrant its use.  /rant on I get really tired of constant doom and gloom about how the VA  wants us all to die, or the prevailing opinion from some that seem to think the VA has a personal bone to pick with them. Its gets exhausting to filter out and does not one any useful good /rant off

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get rid of sleep VA doc and see outside pulmonary specialist if you can...if data download from smart card shows you are getting worse with continuing compliance with CPAP you are hurting yourself..

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