Sleep Apnea and Me

[Willy P]

Hello Everyone,

I'm in the middle of a claims process with the VA for sleep apnea, and I just wanted to share my story and maybe get some feedback.  Since I started this process, I have spent some time surfing these forums and finding my information on Google.  Mostly I have found claims for sleep apnea as secondary to other things or advertisements for E-books on how to get approved.

I separated from the Navy in August last year after 9 years of service. I never sought treatment for apnea while I was in, but I did go to my civilian doctor (Tricare Prime Remote) in 2011 for trouble sleeping/falling asleep and snoring.  He prescribed some mucinex for congestion and recommended a neti pot to help my breathing (he is a very natural-approach doctor which normally I appreciate).  I never saw any improvement, and since he didn't think it was a serious concern, I never bothered to ask for a referral to someone else.

I deployed right up until getting out of the Navy, and after I got back (June of 16) my wife starting waking me up in the night worried that I had stopped breathing.  She also started consistently sleeping in the other room because of my snoring, which had never been quite as bad.

I got a sleep study done and diagnosed with moderate central and obstructive apnea in February this year (6 months after discharge), and started the claims process in March.

The local VSO was pretty rude and didn't seem interested in helping me, so I waited for the ebenefits site to start working again, and filed the claim online.  I submitted all of my recent records and sleep study results, as well as the record of my doctor visit in 2011 with sleep complaints.

I went to a scheduled C&P exam two weeks ago, and here are a few of the notes:

Evidence reviewed (check all that apply):

[X] VA e-folder (VBMS or Virtual VA)

[X] CPRS

1. Diagnosis

------------

Does the Veteran have or has he/she ever had sleep apnea?

[X] Yes [ ] No

[X] Obstructive

ICD code: G47.33 Date of diagnosis: 2/2016

[X] Central

ICD code: G47.31 Date of diagnosis: 2/2016

2. Medical history

------------------

a. Describe the history (including onset and course) of the Veteran's

sleep

disorder condition (brief summary):

veteran states did not seek treatment for sleep issues in service

however did have difficulties and wife confirms starting around 2010.

The veteran was diagnosed with sleep apnea within the year of

discharge.

He currently wears cpap

 

5. Diagnostic testing

---------------------

a. Has a sleep study been performed?

[X] Yes [ ] No

If yes, does the Veteran have documented sleep disorder breathing?

[X] Yes [ ] No

Date of sleep study: 2/2016

Results:

AHI 24.8 with 84% oxygen nadir

 

TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE

CONNECTION ]

a. The condition claimed was at least as likely as not (50% or greater

probability) incurred in or caused by the claimed in-service injury, event

or

illness.

c. Rationale: The veteran has recently been discharged from active duty

8/2015 and within the first year diagnosed with obstructive and central

sleep

apnea. It is as likely as not that the veteran experienced sleep apnea in

the

service. The veteran and veteran's wife notes he particularly noticed

sleep

issues around 2010 while in service.

The following week, my claim status in eBenefits went to "Preparation for Decision", and that is the latest as of now.

Should I bother with obtaining my C-File at this point?  I haven't heard of it until the past couple of days.  It appears that all of my records have been reviewed.

What do you think are the chances of being awarded service connection for this?  I really have no idea what to expect.

At any rate, I just wanted to get my story out there.  If anything, it may help someone like me who is trying to figure out the chances and what to expect.  But mostly, I think posting this will help with the stress of this whole process.

Thank you for reading!

Willy P

 

 

 

 

[toddt]

"The condition claimed was at least as likely as not (50% or greater

probability) incurred in or caused by the claimed in-service injury, event

or illness."

 

That almost certainly certifies your claim

[Willy P]

Todd,

Thank you for the feedback. Honestly I didn't know if I had a leg to stand on with no in-service diagnosis and no other medical problems in service to point to. I think the main thing going for me is that I'm recently separated. 

 

The VSO I spoke with flat out told me it would get denied, but "I guess I could try to help anyway". No thanks, buddy. 

[silverdollar22]

Willy P your good to go IMHO!!!  Glad to see someone get what they deserve as far as sleep apnea is concerned.  This goes to show how important claiming your problems within 360 days from service completion is.  I think this one will be a no brainer.  I also think a early Congratulations is in order!!!

[Willy P]

Silverdollar,

Thank you for the encouraging words.  Maybe I just had no faith, because I wasn't even going to file this claim at first.  I'm glad to hear that people think I have a shot.

One of the concerns I had was that I have read about sleep apnea not being a "presumptive condition" and being diagnosed within a year didn't automatically mean service connection.  Even though I have read it, the C&P examiner mentioned several times in person and a couple times in the notes that I'm within a year, so apparently it does hold some kind of wait.

Maybe the "presumptive condition" jargon I found only applies to back pay from date of discharge?  I guess I'll find out.  This whole process has been a mystery.

Thanks again

[Willy P]

Well, I'm not sure if this means anything or not, but on Monday my claim completion date estimate was "07/01/16-07/30/16", and now this morning it says "07/01/16-07/14/16", and a little alert symbol that says my claim is past it's completion date.  It says to go through IRIS or call the 800 number.  Does that mean somebody may be looking at it, or is eBennies playing head games?

[cooter]

Unless someone has a crystal ball it'll be impossible to answer that. If it were me I would go ahead and call the 800#. I'm only guessing but maybe they're still working on the EED for your backpay. Again, I'm only guessing!!!

 

   <Coot>