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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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How to go about requesting an disability increase due to sleep apnea

Question

Hi - I'm currently sitting at 90% SC disability with 50% for sleep apnea. My Apnea Hypopnea Index (AHI) score was 25 events/hour when I was awarded the 50% SC for sleep apnea (about 4 years ago) - I've been on a CPAP machine ever since.

I haven't been able to sleep consistently for the past 6-7 months so I went in for a 5 year follow up sleep study that showed my Apnea Hypopnea Index (AHI) score had increased to 62.3 events/hour - even while using the prescribed CPAP machine. I'm going back in this weekend to get the air level modified/increased by the sleep center that conducted the sleep study.

Question: Is the AHI increase sufficient enough to put in for an increase SC disability rating for sleep apnea?

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Have you researched the SA 100% Rating "ORs?" If not, do that 1st, there is no Award between 50 or 100%.

You referenced your SA problems regarding awakenings, I didn't see any mention regarding P02 levels. Is there any indication in any of your SA treatment Notes or actual SA DX of you P02 falling below 90%?

Sleep P02 recordings below 90, will usually require the use of supplemental 02 while on Cpap or Bipap. That DX, would be New & Material Evidence supporting a chronic respiratory Failure SA Increase to 100%. Worked for me, this past 12/15.

Semper Fi

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Gastone - I haven't gotten the full report from the sleep study I just had, will be getting those late next week - I imagine - as I go in this weekend for the titration tweaking. 

From my sleep study in 2011, the AHI was 25/hour, Respiratory Event-Relate Arousal (RERA) index was 37.7/hour yielding Respiratory Disturbance Index (RDI) of 62.6/hour. Supine RDI was 98.5/hour & right side RDI was 1.2/hour. The lowest oxygen saturation during this portion of the study was 87% & I spent 0.3 minutes with an oxygen saturation below 89%.

Not sure if any other those numbers answer your question.

Thanks for your help on this!

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Only the (1) P02 Desat event, could be an anomaly. Be sure to discuss it with your SA treating Clinician.

You didn't get an RX for an 02 Concentrator, to use at night while on Cpap? Request an over-nite P02 study from your Sleep specialist.

VA Dr will write the referral, 02 VA contract Supplier will bring out the over-nite P02 recorder. Usually only 1 night's readings are required, sometimes 2, if Dr wants data from both on & off cpap. Normal Sleep P02's are in the above 92% range.

Untreated SA, mild to severe can be a killer, combined with low P02's your looking at a Double Wammy. Better to be safe, than sorry.

Semper Fi

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I drifted, did you research the100% SA Rating Requirements? do you have any of those conditions?

If not, your SA is locked at 50% if DX'd Cpap or Bipap, regardless if you use it. If at some point you are DX'd with Pulmonary Hypertension, immediately file an FDC Secondary to your SC'd SA. VA recognizes the Nexus from SA to PH DX as SC.

Semper Fi

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Gastone,

You're chock full of helpful advise, especially in this particular arena.  Is Pulmonary Hypertension same/same as high blood pressure?  If you have SA secondary already, can you get the PH secondary to the secondary SA? Thanks.

Semper Fi

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