ptsd Independent Medical Exam for sleep apnea.

[Rocket1949]

Hello Hadit followers.

I have an appointment with a civilian sleep doctor coming up.  I'm looking for help to ensure that I get this right. 

I was diagnosed with ( OSA ) obstructive sleep apnea after two different VA doctors put in a request for a sleep study. Both doctors had stated that my symptoms and the fact that I had PTSD could be a indicator of sleep apnea. 

After getting lost in anachronism hell , ( IME,IMO,DBQ  and some I can't remember ) ,I've narrowed it down to getting an Independent Medical Exam to show a link between my Sleep Apnea and PTSD. I could not get my VA doctors to write me a letter. I have found a doctor whom  at least acknowledges that there is a link between SA and PTSD. I've seen other doctors and they didn't think there was a link. From what I have researched  there is a body of evidence that states there is.

If after this new doctor exams me and agrees that there is a link I'm going to ask him to write an letter in support of my claim.

I need help on what information needs to be in an IME . Does the doctor need to review my C file and medical records? I assume that he does.

Does anyone have an example of a IME letter that they could share ? I'm claiming that my sleep apnea is secondary to my PTSD and that it is aggravated by my PTSD. 

If anyone has anything to share it would be greatly appreciated. 

Thanks for taking the time to read my rather lengthy post.

[Buck52]

Even if you get a diagnoses for S.A. and get on a C-Pap machine.

It's hard to get it Service Connected if you don't have any prior Military Service Records to support it.  the S.A. or OSA.

It's anyone guess if they will secondary your S.A. to PTSD or OSA  The cause for your S.A.??

A Qualified Dr would need say it is likely as not aggravated by your S.C. PTSD...I never found a Dr that would state that.

[broncovet]

Your doctor's report needs to be worded correctly or your claim will be denied.  Here is what your report needs to say:

1.  Diagnosis.  Sleep Apnea, and a prescription for a CPAP.  If you already have said diagnosis, your examiner should/needs to state that it was diagnosed in xxxx (year/month/day) by Dr. _____.  

2.  Your doctor needs to state that he examined you and READ YOUR ENTIRE MEDICAL RECORDS.    If he does not read your file AND SO STATE, the whole exam could be thrown out.  

3.  Your IMO doc should supply his ciriculum Vitae, that is, he got his MD at ____ college, and he is board certified in sleep medicine.  Or, he needs to state his medical competency, such as, "I have been treating sleep disorders for 13 years"

4. He should supply a nexus with medical rationale, and it should be in THIS format:

"The VEteran suffers from Obstructive Sleep Apnea, and has been prescribed a CPAP since June, 1999, at xx pound pressure.  HIs sleep study done 11/19/2004 confirms this with 8 apnea events per hour.   In my professional opinion, his sleep apnea is at least as likely as not related the the PTSD that he suffered from in the military.  (Rationale):

Harvard Medical School, in a 2003 study,  explains that 95% of PTSD victims have sleep apnea or other sleep disorders.  My findings are consistent with those of my peers, that this Veterans OSA is at least as likely as not related to PTSD.  

 

[lotzaspotz]

Although Board cases don't set a precedent, you may find it helpful to Google "Board of veterans appeals sleep apnea secondary to PTSD" and read the rationale the Board used to grant service connection.  Here's one: 

http://www.va.gov/vetapp13/Files2/1316035.txt

Also replace the word "grant" with "denying" to see why the Board denied service connection.  

You can do the same type of search at the Court of Appeals for Veterans Claims site, www.uscourts.cavc.gov, under decisions and opinions.  Look for remanded (since the CAVC hardly ever grants anything outright).

[MikeT]

On 9/19/2016 at 0:53 PM, Rocket1949 said:

Hello Hadit followers.

I have an appointment with a civilian sleep doctor coming up.  I'm looking for help to ensure that I get this right. 

I was diagnosed with ( OSA ) obstructive sleep apnea after two different VA doctors put in a request for a sleep study. Both doctors had stated that my symptoms and the fact that I had PTSD could be a indicator of sleep apnea. 

After getting lost in anachronism hell , ( IME,IMO,DBQ  and some I can't remember ) ,I've narrowed it down to getting an Independent Medical Exam to show a link between my Sleep Apnea and PTSD. I could not get my VA doctors to write me a letter. I have found a doctor whom  at least acknowledges that there is a link between SA and PTSD. I've seen other doctors and they didn't think there was a link. From what I have researched  there is a body of evidence that states there is.

If after this new doctor exams me and agrees that there is a link I'm going to ask him to write an letter in support of my claim.

I need help on what information needs to be in an IME . Does the doctor need to review my C file and medical records? I assume that he does.

Does anyone have an example of a IME letter that they could share ? I'm claiming that my sleep apnea is secondary to my PTSD and that it is aggravated by my PTSD. 

If anyone has anything to share it would be greatly appreciated. 

Thanks for taking the time to read my rather lengthy post.

Rocket. I'm in the same situation.  I have a letter from my doctor of 20 years.  You'll want your doctor to state their experience and that they have reviewed your C-file.  The doctor has to use the words "as likely as not" to describe a link between the sleep apnea being related to the PTSD.  The doctor also has to explain why they believe that.  They can mention training, cite medical journals, and scientific papers, etc.  I'm about to send my disability papers in and I'm not sure if I should send in my doctor's letter at the beginning or wait for the appeal.

[Buck52]

Thats an older docket#   the VA has recently getting tight with a fine tooth comb on S.A. Claims   making it harder for the vet  to get it  even secondary to another condition, this Docket don't show what the evidence the rater used?..but agreed with this veterans Dr's that it could be granted secondary to his S.C. PTSD  But that's been a few years ago.

so what was the evidence used to prove this?

Unless you have a great'' Specialist'' Sleep  Dr willing to say what it takes to get S.C. secondary to another S.C.  Condition  or you have medical records in prior service of S.A./OSA... You will be denied 90% of the time.

I believe S.A. claims are subject to C&P the first 5 years  they will try to reduce. but then again all our claims are subject to C&P ,

S.A. being the most popular....b/c of the IT Card or Sims Data Card  built in the C-Pap Machines.

[Gastone]

What's your "Preponderance of Medical Evidence," supporting a PTSD SA Secondary look like? Could you post redacted Clinician Statements or Treatment notes?

Take the PTSD DX (what's the Date of DX) off the table for a moment. How do you measure up with the 10 or 12 SA Usual Suspects linked as an etiology to SA, listed in most SA medical Articles? How long were any of the a fore mentioned problems listed in any of your Medical Records prior to the PTSD DX?

SA Secondary to PTSD is definitely not a Slam Dunk. A few Hadit members have noted that the VA has recently made SA Claims, as a Secondary issue, more difficult to prosecute. Your about to find out.

Semper Fi