Looking to get some advice on my current situation and the outcome of my C&P exam. I was seeking to do this claim by myself for sleep apnea as secondary to ptsd but it appears I will most likely fall short. Finding individuals who are well versed on the inner workings of the VA and claim process has been relatively hard for me. Im not sure where to go or what to do so I will give yall a brief rundown to help clarify my situtation.
I was medically discharged on June 6 2014 for Chronic PTSD with depressed mood and sleep impairment as well as TBI. I was put on TDRL until 02/23/2016 when I was approved for PDRL. In addition to PDRL I was approved and appointed a caregiver through the VA's program. The VA rated me at 50% for PTSD and 40% for TBI along with 20% for back and 10% for degenerative joint disease. Prior to discharge I was put through the ringer with therapists, psych doctors, two ptsd rehab programs. One rehab program lasted a couple months and the other was a couple weeks. Everytime I would bring up any sleep issues I had they were quick to associate it with PTSD and throw more pills at me. Since discharge my nightmares have increased coupled with waking up choking nad gasping for air. According to my caregiver there has been numerous occassions where I will wake up screaming ripping shit off the walks and trying to low crawl out the door as im gasping. I usually have no recollection of the events until she informs me the next day but I do remember the nightmares. My memory seems to be getting worse and worse each day and I always brought it up to the VA as well as the social workers that call. I'm assuming this may be associated with sleep apnea since i stop breathing 15 times an hour. Finally after a meeting with the caregivers nurses and my assigned caregiver they determined that I most likely suffer from sleep apnea and put me in for a referall. Dec 2016 I was put in for a sleep study and by january the study was done stating I had moderate sleep apnea and needed a cpap machine.
Moving forward I put my claim in after reading several articles, reports and forums posts from various other vets regarding sleep apnea as secondary to PTSD. At the time of my discharge I was not given any medical records and everything seemed to happen super quick. Ive since requested my medical records using the freedom of information act but it appears that takes 6-12 months to get anything back from.I attched my DBQ from the MEB process, sleep apnea findings and report, letter from my caregiver whom I knew prior to exiting the service and would witness the episodes as well as other documents supporting the sleep impaiment claim. The C&P reviewer kept harping on the fact that there was nothing in my file the stated I snored etc so it couldnt be service connected. She agreed after I mentioned there are various reputable reports done stating the link between the two and that one can aggravate the other. She agreed stating she had read some as well but then proceeded to state that PTSD does not cause sleep apnea. Seems like she was missing the whole point of my argument. As of May 28th I noticed my claim went to Pending Decision Approval with a completion date of 6/1-6/6. Im assuming this is expedited because of an incoming denial letter. Attached below is the DBQ pulled from my Blue Button. Your advice and input would be greatly appreciated even if its harsh criticism. Thank you!
Sleep Apnea Disability Benefits Questionnaire Name of patient/Veteran: XXXXXXXXXXXX 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] In-person examination 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: 2017 2. Medical history ------------------ a. Describe the history (including onset and course) of the Veteran's sleep disorder condition (brief summary): Veteran was diagnosed with obstructive sleep apnea in 2017. His sleep study on 1/12/2017 showed mild obstructive sleep apnea with AHI of 14.4 events per hour. He now has CPAP machine. He has some difficulty keeping the mask on all night. He reports that he has restorative sleep when the mask stays on. 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: 1/12/2017 Facility where sleep study performed, if known: Northport VAMC Results: mild obstructive sleep apnea with AHI of 14.4 events per hour 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? [X] Yes [ ] No If yes, describe impact of the Veteran's sleep apnea, providing one or more examples: he is tired during the day 7. Remarks, if any: ------------------- MEDICAL OPINION REQUESTED: Direct service connection Does the Veteran have a diagnosis of (a) SLEEP APNEA that is at least as likely as not (50 percent or greater probability) incurred in or caused by (the) SC PTSD during service? It is less likely than not that the veteran's obstructive sleep apnea is proximately due to PTSD. Obstructive sleep apnea is characterized by recurrent collapse of the upper airway during sleep resulting in substantially reduced flow of air into the lungs despite ongoing breathing efforts. In this veteran's case, this is occurring an average of 14.4 times per hour. There is not sufficient medical evidence to show that PTSD can cause collapse of the upper airway.
Question
thedeuce222
Looking to get some advice on my current situation and the outcome of my C&P exam. I was seeking to do this claim by myself for sleep apnea as secondary to ptsd but it appears I will most likely fall short. Finding individuals who are well versed on the inner workings of the VA and claim process has been relatively hard for me. Im not sure where to go or what to do so I will give yall a brief rundown to help clarify my situtation.
I was medically discharged on June 6 2014 for Chronic PTSD with depressed mood and sleep impairment as well as TBI. I was put on TDRL until 02/23/2016 when I was approved for PDRL. In addition to PDRL I was approved and appointed a caregiver through the VA's program. The VA rated me at 50% for PTSD and 40% for TBI along with 20% for back and 10% for degenerative joint disease. Prior to discharge I was put through the ringer with therapists, psych doctors, two ptsd rehab programs. One rehab program lasted a couple months and the other was a couple weeks. Everytime I would bring up any sleep issues I had they were quick to associate it with PTSD and throw more pills at me. Since discharge my nightmares have increased coupled with waking up choking nad gasping for air. According to my caregiver there has been numerous occassions where I will wake up screaming ripping shit off the walks and trying to low crawl out the door as im gasping. I usually have no recollection of the events until she informs me the next day but I do remember the nightmares. My memory seems to be getting worse and worse each day and I always brought it up to the VA as well as the social workers that call. I'm assuming this may be associated with sleep apnea since i stop breathing 15 times an hour. Finally after a meeting with the caregivers nurses and my assigned caregiver they determined that I most likely suffer from sleep apnea and put me in for a referall. Dec 2016 I was put in for a sleep study and by january the study was done stating I had moderate sleep apnea and needed a cpap machine.
Moving forward I put my claim in after reading several articles, reports and forums posts from various other vets regarding sleep apnea as secondary to PTSD. At the time of my discharge I was not given any medical records and everything seemed to happen super quick. Ive since requested my medical records using the freedom of information act but it appears that takes 6-12 months to get anything back from.I attched my DBQ from the MEB process, sleep apnea findings and report, letter from my caregiver whom I knew prior to exiting the service and would witness the episodes as well as other documents supporting the sleep impaiment claim. The C&P reviewer kept harping on the fact that there was nothing in my file the stated I snored etc so it couldnt be service connected. She agreed after I mentioned there are various reputable reports done stating the link between the two and that one can aggravate the other. She agreed stating she had read some as well but then proceeded to state that PTSD does not cause sleep apnea. Seems like she was missing the whole point of my argument. As of May 28th I noticed my claim went to Pending Decision Approval with a completion date of 6/1-6/6. Im assuming this is expedited because of an incoming denial letter. Attached below is the DBQ pulled from my Blue Button. Your advice and input would be greatly appreciated even if its harsh criticism. Thank you!
Sleep Apnea
Disability Benefits Questionnaire
Name of patient/Veteran: XXXXXXXXXXXX
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] In-person examination
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: 2017
2. Medical history
------------------
a. Describe the history (including onset and course) of the Veteran's
sleep
disorder condition (brief summary):
Veteran was diagnosed with obstructive sleep apnea in 2017. His sleep
study on 1/12/2017 showed mild obstructive sleep apnea with AHI of 14.4
events per hour.
He now has CPAP machine. He has some difficulty keeping the mask on
all
night. He reports that he has restorative sleep when the mask stays
on.
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: 1/12/2017
Facility where sleep study performed, if known: Northport VAMC
Results:
mild obstructive sleep apnea
with AHI of 14.4 events per hour
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?
[X] Yes [ ] No
If yes, describe impact of the Veteran's sleep apnea, providing one
or
more examples:
he is tired during the day
7. Remarks, if any:
-------------------
MEDICAL OPINION REQUESTED: Direct service connection
Does the Veteran have a diagnosis of (a) SLEEP APNEA that is at least as
likely as not (50 percent or greater probability) incurred in or caused by
(the) SC PTSD during service?
It is less likely than not that the veteran's obstructive sleep apnea is
proximately due to PTSD. Obstructive sleep apnea is characterized by
recurrent
collapse of the upper airway during sleep resulting in substantially reduced
flow of air into the lungs despite ongoing breathing efforts. In this
veteran's
case, this is occurring an average of 14.4 times per hour. There is not
sufficient medical evidence to show that PTSD can cause collapse of the upper
airway.
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thedeuce222
Just got home and read your replies. Firstly, I want to thank you all for your responses especially @broncovet and @Gastone for reaching out to me personally. I appreciate you taking the timeout of yo
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