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Comp & Pen Sleep Apnea & Hypersomnia
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Question
Alex Googe
I was wondering if anyone can let me know what my most recent comp & pen results mean.
=========================================================================
Date/Time: 12 Jan 2017 @ 1430
Note Title: C&P EXAM
Location: VA CONNECTICUT HEALTH CARE SYS
Date/Time Signed: 13 Jan 2017 @ 1308
-------------------------------------------------------------------------
LOCAL TITLE: C&P EXAM
STANDARD TITLE: C & P EXAMINATION NOTE
DATE OF NOTE: JAN 12, 2017@14:30 ENTRY DATE: JAN 13, 2017@13:08:24
URGENCY: STATUS: COMPLETED
Sleep Apnea
Disability Benefits Questionnaire
Is this DBQ being completed in conjunction with a VA 21-2507, C&P
Examination
Request?
[X] Yes [ ] No
ACE and Evidence Review
-----------------------
Indicate method used to obtain medical information to complete this
document:
[X] Review of available records (without in-person or video telehealth
examination) using the Acceptable Clinical Evidence (ACE) process
because
the existing medical evidence provided sufficient information on which
to
prepare the DBQ and such an examination will likely provide no
additional
relevant evidence.
Evidence Review
---------------
Evidence reviewed (check all that apply):
[X] VA e-folder (VBMS or Virtual VA)
[X] CPRS
1. Diagnosis
------------
Does the Veteran have or has he/she ever had sleep apnea?
[X] Yes [ ] No
[X] Obstructive
ICD code: g47.33 Date of diagnosis: 2012
2. Medical history
------------------
a. Describe the history (including onset and course) of the Veteran's sleep
disorder condition (brief summary):
Veteran served 7/82-5/86.
VBMS does not document the diagnosis of sleep apnea during service, and
the diagnosis of OSA occurred years post-discharge. Given that there is
no objective documentation for the diagnosis of, or treatment for, OSA
in service or within 1 year of discharge, this examiner does not find
evidence of OSA directly due to service.
Obstructive sleep apnea (OSA) is the result of obstruction of the upper
airway,with symptoms including unexplained daytime fatigue, loud
snoring, and periods of apneas ("pauses" in breathing). Risk factors
include male sex, increasing age,obesity, and large neck circumference.
OSA is associated with anatomical upper airways changes, including
decreased muscle tone, increased soft tissue around the airway, and
structural features that give rise to a narrowed airway.
Depression is not an established risk factor for the development of
OSA.
As such his current OSA is less likely as not (50 percent or greater
probability) proximately due to or the result of major depression
b. Is continuous medication required for control of a sleep disorder
condition?
[ ] Yes [X] No
c. Does the Veteran require the use of a breathing assistance device?
[ ] Yes [X] No
d. Does the Veteran require the use of a continuous positive airway pressure
(CPAP) machine?
[X] Yes [ ] No
3. Findings, signs and symptoms
-------------------------------
Does the Veteran currently have any findings, signs or symptoms attributable
to sleep apnea?
[ ] Yes [X] No
4. Other pertinent physical findings, complications, conditions, signs,
symptoms and scars
-----------------------------------------------------------------------
a. Does the Veteran have any other pertinent physical findings,
complications, conditions, signs or symptoms related to any conditions
listed in the Diagnosis Section above?
[ ] Yes [X] No
b. Does the Veteran have any scars (surgical or otherwise) related to any
conditions or to the treatment of any conditions listed in the Diagnosis
Section above?
[ ] Yes [X] No
c. Comments, if any:
No response provided.
5. Diagnostic testing
---------------------
a. Has a sleep study been performed?
[X] Yes [ ] No
If yes, does the Veteran have documented sleep disorder breathing?
[X] Yes [ ] No
Date of sleep study: 12/2012
Facility where sleep study performed, if known: Gaylord
Results:
severe OSA with AHI 122
b. Are there any other significant diagnostic test findings and/or results?
[ ] Yes [X] No
6. Functional impact
--------------------
Does the Veteran's sleep apnea impact his or her ability to work?
[ ] Yes [X] No
.
7. Remarks, if any:
-------------------
No remarks provided.
LOCAL TITLE: C&P MENTAL DISORDERS
STANDARD TITLE: MENTAL HEALTH C & P EXAMINATION CONSULT
DATE OF NOTE: JAN 19, 2017@11:07:56 ENTRY DATE: JAN 19, 2017@11:07:56
AUTHOR: EXP COSIGNER:
URGENCY: STATUS: COMPLETED
COMPENSATION AND PENSION EXAMINATION REPORT (FREE TEXT)
=======================================================
MEDICAL OPINION REQUEST
TYPE OF MEDICAL OPINION REQUESTED: Secondary Service connection.
OPINION REQUESTED: Secondary Service Connection.
The Veteran is claiming service-connection for hypersomnia as secondary to his service-connected major depression associated with left ankle, residuals of left medial malleolus fracture. The Veteran's current treatment records now show he has hypersomnia.
There is a recent mental exam conducted on 10-27-16 in file, however, if another examination is warranted, please pursue exam for diagnosis and to
assess current severity.
Is the Veteran's hypersomnia at least as likely as not (50 percent or greater probability) proximately due to or the result of his service-connected major depression associated with left ankle, residuals of left medial malleolus fracture?
Rationale must be provided in the appropriate section.
POTENTIALLY RELEVANT EVIDENCE:
TAB A: DBQ Mental Disorders exam dated 10-27-16
Tab B: VAMC treatment records showing Veteran has hypersomnia
RESPONSE:
Veteran's hypersomnia is at least as likely as not (50 percent or greater probability) proximately due to or the result of his service-connected major depression associated with left ankle, residuals of left medial malleolus fracture. It appears that as his depressive symptoms increased,in part related to the incident at work described in his most recent C&P exam.There is evidence based on the timing of the change in sleep and ADLs, as well As the known symptoms of major depression, that provide evidence for this secondary
service connection.
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Gastone
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Here is an article... Not sure if it helps, but Association of Psychiatric Disorders and Sleep Apnea in a Large Cohort. Here is the link: http://www.journalsleep.org/Articles/281111.pdf
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Hello all, I am new to this site and I pretty much have the same story. I retired in 2005 and rated 60%. for Panic Attacks, back surgery, left shoulder surgery (collar) surgery and scars. I was ne
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