Sleep Apnea claim with only a diagnosis from active duty?

[afvetwife2000]

I'm new here so I hope I am doing this right. I am actually the wife of the vet that is filing a claim. In April of 2011, 2 weeks before being placed on TDRL for a heart condition, my husband had a sleep study done at a VA sleep center. The result was sleep apnea and recommendation was a CPAP machine. Because he was on TDRL he did not pursue VA benefits. He also did not receive (didn't ask either) for a CPAP machine. We didn't realize that was recommended until recently when we requested the diagnostic paperwork. My husband has been completely separated from the Air Force since October of 2015 (no longer on TDRL).  In Nov 2016 he filed a claim that included sleep apnea. The sleep apnea was denied in May of 2016 as it said it was not service connected. That's when we called the sleep center and requested the diagnosis to be printed. We assumed the VA would have access to this because they said they did not need him to send any medical records, they could filter through them on their own. Once we got it printed from the sleep center he "reopened" the case (didn't know he should have just appealed) and included the diagnoses paper. As far as any other history related to sleep problems while he was enlisted.. it is documented a couple of times that he visited the military hospital post deployment for sleep issues and was told to take Benadryl.  He never thought of going to the doctor because he snores a lot.. we always assumed he had sleep apnea but honestly didn't realize how dangerous it could be so he never went to the doctor about it while active duty. He just went for the study before being put on TDRL because like I said, we knew by his symptoms he had it and he wanted it documented. We are in the process of waiting to see if he will get denied again. I'm including the diagnosis information we have. Based on what you guys usually see.. do you think he has a chance of getting benefits? He was rated at 0% for his heart so no benefits currently

*Overall sleep architecture was consistent with sleep disordered breathing. The patient demonstrated a severe degree of sleep fragmentation (arousal index 82.6/hr). The majority of these arousals were secondary to sleep disordered breathing(SDB). The patient slept 114.4 of 282.0 minutes in the supine position. The lowest oxygen saturation was 86%. The patient had a periodic limb movement of sleep (PLMS) index of 0.9/hr and a PLMS arousal index of 2.77/hr. The EKG revealed no abnormalities. EEG no abnormalities.

IMPRESSION: Obstructive Sleep Apnea

RECOMMEDATIONS:

1. Discuss with patient treatment options considering CPAP or surgical evaluation

the rest is just about if patient was CPAP what to do.

 

 

[afvetwife2000]

Just clarifying when my husband got out of the military. His last day of active duty was back in 2011. When you go on TDRL and then separate, the day before you went on TDRL is considered your last day of active duty since TDRL is counted just like being retired. His first sleep study was done 5 days before going on TDRL.  So technically it's been 5 years since he was diagnosed while still active duty and his current diagnosis.... not within one year.

[gs106]

OK, Sorry, I was looking at the "completely separated from the Air Force since October 2015"  as being out for less than a year. 

[john999]

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[john999]

I had an operation for my OSA.  The Inspire device was implanted in my chest and throat.  I turn it on via hand control and it sends electric stimulation to my throat  and tongue to open throat and move

tongue forward so it does not block you airway.  It cost $100,000 but insurance paid all.   Before I had this and oxygen at night my oxygen saturation levels fell into 70% level.   My pulmonologist said I was

going to die.   I could not tolerate the CPAP.  I was the first person in Florida to get this operation on commercial basis.   I still wake up feeling pretty awful and must take Provigil to stay awake.   I did not

have OSA before I got DMII due to AO.  VA says I also have a heart condition  60%.     I want to file a claim for OSA .  My OSA was described as "profound".  The guy at Veterans law blog says he knows

how to connect the OSA.   Is he full of it or not?  How many RVN vets have OSA?  I mean the 1/3 that are not dead already.

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[afvetwife2000]

Update: My husband was ordered a new sleep study with the VA sleep lab.. Not for diagnostic reasons but to prescribe him a Bipap machine. They wanted to do the study and adjust the machine to see what he needed.  He picked up his bipap machine yesterday and today the ebenifits site shows his claim was completed and in disabilities he is rated at 50% on the site. We are a little confused as to why the effective date is for Aug. 29 when he reopened his claim on June 06, 2016. Does anyone have any idea why they would have done that? He tried calling but the man he spoke with said he couldn't tell him anything and he'd have to wait to get his paperwork in the mail. Also.. he is set up for direct deposit... what's the time on that looking like these days? Thanks!

[afvetwife2000]

So far, no back pay has come in. We downloaded his benefits form and this is what it states: 

Gross Benefit Amount:  836.13

Net amount paid:  0.00

Effective date: Sept. 01, 2016

Combined Evaluation:  50 percent

His case closed on 9/22/2016. We are a little confused on the effective date. He submitted his claim some time in June, 2016.  That included a form from his sleep study done with the VA while active duty that stated he had severe sleep apnea. So he already had a diagnosis on file from active duty. He was not issued a machine at that time though. About a month ago he was asked to do another sleep study so they could adjust settings on cpap/bipap machine to issue it to him. He did that and picked up his Bipap machine about 2 weeks ago.  Would that have anything to do with his effective date being later than when he filed? He did already have a service related rating of 0% related to heart problems that he will be appealing later on ( one thing at a time right now).  So the sleep apnea was the only open case.  Can anyone let me know when he should be expecting his pay to start and also, because of the effective date.. would he be getting backpay? Thank you!