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Sleep Apnea question about CPAP prescription

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Wayne TX

Question

I will have been on a CPAP come a year Dec. 1st.  As I understand I have to turn my CPAP into my local VAMC, which I assume is to show the actual usage in order to get prescribed for another year of usage. My question is what is VA looking for inside the CPAP besides obviously the conisitent usage, and what actual data is there for them to see and evaluate?  I read somewhere that they can see if your apneas have increased or decreased......is this true?  Has anyone ever actually gone from moderate or severe OSA to no apneas ? If this is true..........I do not understand how it can go lower in apneas when other conditions are still involved like allergies, sinus, deviated septum, etc.?  Just curious what is involved and what is the data  extracted from CPAP.  I do have a claim in for SA as a NOD.  Thanks for any help on this subject.

Edited by Wayne TX
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Thanks for the feedback guys.......yes OEF21B......I am enrolled at Dallas VAMC and had two sleep studies done there.  I was written as moderate OSA but I  have not been rated for OSA as yet by VA...........I claimed for it based on a 2006 diagnosis but I was never issued a CPAP nor did i push so it ended up as a NOD now.......my fault......learning curve.

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That 06 Mild OSA DX, still Active Duty? What SC's make up your Combined SC 40%?

Semper Fi

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I have also been told to bring my CPAP in every sleep visit I have. Yes they do use it to monitor your breathing issues and if you don't use it they do hold that against you to evaluate your condition getting worse. You have to understand that not using your CPAP will decrease your chances of a good nights rest but what about insomnia. Yes you do feel rested for the first hour or two but that only means if you are active. If not active and work at a desk then I'll give your rested feeling around 30 minutes top. My opinion is if your goal is to get good sleep use the CPAP, if your goal is not to feel sleepy throughout the day seek out a neurologist  for further diagnoses.   You know one of the presumptive issues is insomnia.

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Gastone........it is 30% sc allergy, 10% sc sinus......also had deviated septum surgery (1970) while on active duty and another again at Dallas VAMC in 2007.   The 10% on sinus is also on NOD claim for increase to 30%.. I had mild OSA in 2006 and blew it off as told I was overweight and told to lose weight before they would do anything else first........I did just that and elected to have lap band surgery and it dropped my weight by 50 pounds by 2007, and nothing else happened with Neurology so I figured all was good then and let the OSA slide...........but then wife noted that my non-breathing episodes were now increasing and longer in duration in 2015, so she convinced me to go have another sleep study done last November and this one it came up as moderate OSA, and I had not gained any weight back at all.  I have been on CPAP since December 2.  Since I am on CPAP now, I have filed a NOD for OSA based on sc aggravation due to allergies, sinus, and having deviated septum surgery. I was rejected on my first try because I was not on CPAP when I filed.  

Edited by Wayne TX
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Wayne, did the initial Denial specifically state you were Denied SC for Lack of an in Service DX, or because of the not being on Cpap?

The Cpap RX basis for a SA Denial, very strange. I haven't looked at the 38 CFR 4 for SA since I requested an Increase of my SC 50% to 100% back in 14. I do believe there are (2) lesser SC 10 & 30, (3) if you include a 0%. I'll have to do a review. Even if you had extremely Mild OSA and it could be Directly or Indirectly Secondarily SC'd, you should have received a SA SC 0%.

Your Denied SA Claim, were you trying for a Direct SA SC or a Secondary to a current SC condition?

You've NOD'd that Denial, right? What did you choose, DRO Review (12 - 16 months), DRO Hearing ( 3 - 4 yrs) or BVA Hearing (4+ yrs).  If you chose the DRO route, could you share your redacted compelling "New & Material Evidence," that was not available to the original rater, and is mandated by VA Reg for a DRO Review/Hearing?

Any chance you could post redacted copies of you SA DX and your VA Denial Letter?

Semper Fi

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Gastone......yes I NOD in May 2016....I applied immediately for DRO Hearing in Waco. I agree I should have at least got a 0 rating. I was shocked as my secondary applied was 30% allergy which was sc. I was not on a CPAP when I filed and that is what I've been told by others here and other places the reason they did not  rate me. I had a IMO Doctor state I was "more likely than not service connected" for sleep apnea and Waco said there was not enough rationale to his opinion....whatever that means.  I knew I was not eligible for 50% not being on a CPAP - but not even rating a O blew my mind.  My C & P exam was scheduled 7 days before my second sleep study so all that jazz sent into Waco was all  based on 2006 sleep study data........why they did not wait until my second sleep study is another blunder on their end  and I have called them out. Could this be a legit Cue Error...... I have been wondering about that?

 The VA Doctor said I was not in his opinion sc due to sleep apnea and it was all based on 2006 sleep study that he saw in my file -  not 2015 sleep study

I was  diagnosed and documented in  2006 with mild OSA and also was sc for allergies in 2009.......did not even file  until June 2015.  I went on CPAP in Dec. 2015 after I got re-tested and had  advanced to moderate OSA.

 All they have done, as I see it, is run up a heavy amount of retro pay to be coming my way whenever this is finally addressed as now I have CPAP documention + sc aggravation from both allergies and sinus, plus two deviated septum surgeries - one during active and one VAMC.  No way this will end up as a 0 again.  This whole mess just pisses me off that not even a 0 was warranted.

 

Edited by Wayne TX
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