Sleep Apnea - Secondary Claim?

[Detonator]

Hi everyone,

I wanted to get some thoughts and advice on filing a claim for Sleep Apnea as secondary to my service connected issues. SC for Degenerative Disc Disease Lower Spine (20%), R Knee (20%), L Knee (10%), Bilateral Sciatica (10% each side), Insomnia including Major Depressive Disorder & Anxiety (50%) - Yes, all three are combined. I am a long time sufferer of major insomnia related to my lower back problems. I take several sleep medications to include Quetiapine, Ambien, Trazadone, Prazosin, and other meds to include Gabapentin, Sertraline, Bupropion, Hydrocodone. 

I've had lower back surgery at the VA several years ago and my lower back has worsened. This last year I've had 3 levels of nerves burned in my lower back and multiple injections. I gained up to 25 lbs and lost some of it. Recent MRI showed bottom disc levels are worsening. The VA now shows me as overweight / obese but the weight does go up & down based on my mobility. During the last 2 years my sleep has gotten much worse with nightly awakenings and night sweats. No joke, it's horrible.

In 2007 I had a sleep study done and it showed no sleep apnea only very mild upper airway resistance syndrome. I recently had another VA sleep study which now shows moderate sleep apnea (OSA). My pulmonologist who has treated me for many years wrote in his notes that "it is likely that weight gain has increased severity of airway obstruction. Weight gain may be due to reduced activity from chronic back pain and also medication side effects." They have me on a CPAP (I meet the VA requirements) now although its difficult to use because of my anxiety and insomnia.

Questions:

I would like to file a claim for Sleep Apnea as secondary to weight gain from my lower back issues, depression and medications. Do you think what my pulmonologist wrote in his note is enough?

I just received the sleep study report (today) and it said to avoid sedatives...This sounds like a stupid question but aren't sleeping medication sedatives?

Should I file a claim for obesity? I'm not sure if there is even such a claim.

Thanks for any help you can provide.

Detonator

[Buck52]

These are questions you need to ask your Dr's

You actually need an in-service sleep disorder  To Service Connect the sleep Apnea.

I'd say file a claim for sleep disturbance secondary & aggravated by your Pain...but you could file for Sleep Apena too...but S.A. is a hard one to win....check with member Andyman73   he has filed for sleep Apnea secondary to pain...and was denied

if you get denied  you can always NOD the decision and request  DRO Hearing at your R.O. To make a decision.  get an IMO From a sleep specialist to Nexus your pain to sleep apnea.

 

[lotzaspotz]

Instead of "weight gain may be due to...."  it would be much better to phrase it, "weight gain is as likely as not (or more likely than not) due to...."  As likely as not means a 50/50 chance, in which case the benefit of the doubt goes to you.  More likely means the majority of the evidence is in your favor.  My husband was awarded OSA due to weight gain from secondary effects of medication prescribed for a service connected adrenal disorder.  He medically retired in 1993 with over 20 years served, and OSA back then wasn't a recognized disorder, so no one would have been testing for or diagnosing it.  He filed the claim in October 2007, and it was granted with that effective date.  So, as much as an in-service diagnosis would certainly improve the chances of the claim's approval, it's not absolutely necessary.

[Gastone]

And your Neck Size is? Take a look at the SA list of usual suspects, about 10 or 12 as I last recall. How do you stack up?

Just the moderate "porking up," which can also come with regular aging, might not be quite enough to get you over the SA SC Rating Hump.

The 07 "Mild upper airway DX," was any etiology addressed by a Board Certified MD/DO ENT Specialist?

Taking any type of Sleep RX could be a Major Health Risk (Like Death) when you have OSA, CSA or MSA.  Just for info purposes, what are your P02 (Pulse Oxygen Level) readings, on and off Cpap? Any P02 level below 90%. should be of concern and needs to be addressed. Usually supplemental 02 is the RX when P02's drop to low/mid 80's, with or without SA DX requiring Cpap or Bipap.

As to filing your claim, you've started the FDC establishing your File Date for Retro, right?

If not, do it now on E-Ben. Attach Pdf copies of all your Non-VA SA Medical Evidence, set back and let the Rater figure it out. Non-Direct SC SA secondary claims are tough, expect and plan for a Denial & NOD. You won't know, until you know, you know.

Semper Fi