Hi All! New And Need Help - Sleep Apnea And Bulging Vertebrae.

[freeda]

Hi everyone. Big thanks to the Patriot Guard member who pointed me in this direction.

My husband just retired with 20 years active duty MC in October. So far he's been diagnosed with sleep apnea and been given a CPAP. It is my understanding that the SA is an automatic 30%?

He also has, but needs further followup on bulging vertabrae due to degenerative disk disease, and some problems with both feet and a shoulder. Oh, and a skin condition that only came up after his last trip to Iraq. And some hearing loss... stuff like that. Oh, and hypothyroid.

Part of me wonders if it's worth bothering with, as concurrent receipt doesn't kick in until you hit 50%, so it's dollar for dollar reduction for anything up to that. Plus he's working fulltime, so taking the time to go to the doctor (plus paying the 20% after Standard) kind of eats into our time and budget.

Any advice would be very much appreciated.

Edited December 27, 2006 by freeda

[RockyA1911]

Welcome Aboard!!!!

SA requiring use of CPAP is 50% compensation. From the CFR 38 part 4

6847 Sleep Apnea Syndromes (Obstructive, Central, Mixed):

Chronic respiratory failure with carbon dioxide retention or cor

pulmonale, or; requires tracheostomy.................................................................. 100

Requires use of breathing assistance device such as continuous airway pressure (CPAP)

machine.........................................................................

......................................50

Persistent day-time hypersomnolence ................................................................... 30

Asymptomatic but with documented sleep disorder breathing.................................... 0

Semper Fi!!!!!

RockyA1911

[freeda]

Oh!! Sounds like that CFR thing is going to become my best friend, huh? B)

So it will be worth following up on his other issues, then?

[Objee]

Hi everyone. Big thanks to the Patriot Guard member who pointed me in this direction.

My husband just retired with 20 years active duty MC in October. So far he's been diagnosed with sleep apnea and been given a CPAP. It is my understanding that the SA is an automatic 30%?

He also has, but needs further followup on bulging vertabrae due to degenerative disk disease, and some problems with both feet and a shoulder. Oh, and a skin condition that only came up after his last trip to Iraq. And some hearing loss... stuff like that. Oh, and hypothyroid.

Part of me wonders if it's worth bothering with, as concurrent receipt doesn't kick in until you hit 50%, so it's dollar for dollar reduction for anything up to that. Plus he's working fulltime, so taking the time to go to the doctor (plus paying the 20% after Standard) kind of eats into our time and budget.

Any advice would be very much appreciated.

Freeda,

First, WELCOME to Hadit!!

You've got a lot of clerical work to do. You'll need copies of your husband's service medical records (SMRs), his personnel records, etc.

You have 3 basic things to accomplish for each disability:

1. Prove (with MEDICAL records) that each disease/wound/injury happened on active duty.

2. Prove (with MEDICAL records) that he has effects of the on-duty problems right now AND they affect his employability - that they're either listed as a recognized problem or you can medically prove they should be.

3. Prove (with MEDICAL evidence) that #2 is directly connected to #1.

When you can tie this all together, you've got 50% for the CPAP/apnea and 10% minimum for hypothyroidism if he takes the pills. You're over the 50% cutoff right there.

Good luck and rely on the others on Hadit that are the experienced generals in the VA wars. Ask and ye shall receive!

Ralph

[jbasser]

Freeda, It appears to mne the rating can be A lot higher depending on the Level of the DJD / DDD.

Degenertative Disk Disease is rated under IVDS. Invertrabal disk syndrome and the ratings are based on your husbands limitation of motion. If there are any nerves involved, then the VA rates the Nerves separately.

With the Cpap use is 50 percent. Concurrent recipt should be OK.

The Sooner filed the better.

[Vike17]

Freeda,

Was your husband diagnosed with Sleep Apnea while on acyive duty, or was he just recently (after retirement) diagnosed?

Also, you said;

He also has, but needs further followup on bulging vertabrae due to degenerative disk disease, and some problems with both feet and a shoulder. Oh, and a skin condition that only came up after his last trip to Iraq. And some hearing loss... stuff like that. Oh, and hypothyroid

Was he seen for his back, bi-lateral feet, shoulder, and hypothyroidism while he was in the service, meaning are these noted in his SMR's? If they are noted in his SMR's, were these disabilities considered "chronic?" For example, if your husband was only seen twice over a twenty year period for back pain, the VA will have to deny the claim because it wasn't a chronic disability. Or do you mean he was just seen after his retirement for these conditions? If so, just because he was diagnosed within one year of leaving service doesn't mean that they warrent service-connection under the presumptive rule. The only presumptive condition that jumps out at me that you mentioned would be possibly the Degenerative Disc Disease (which is actually arthritis).

Since your husband is within one year from his retirement from active duty, he should file his claims ASAP to protect the effective date. If his claims are granted, the effective date will be the day after his retirement.

Hope this helps!

Vike 17

Edited December 27, 2006 by Vike17

[carlie]

Freeda,

Hi there and welcome to hadit. I'm sure you will find some very helpful information

here concerning your husbands veterans benefits. You are right in already knowing

that claims will take time, but when your husband reaches 50 % service connected disability,

there won't be anymore co-payments. Also, at 30 % SC he will get additional compensation

for dependants.

For the answers to many question you will probably have, you could start here:

hadit homepage: http://www.hadit.com/

be sure to check out the MORE FAQS LINK on the bottom left of our homepage.

38 CFR (Code of Federal Regulations): http://ecfr.gpoaccess.gov/cgi/t/text/text-.../38cfrv1_02.tpl

You will MAINLY be concerned with Parts 3 & 4. The CFR's are the regulations VA is

SUPPOSED to go by.

M21-1MR :

http://www.warms.vba.va.gov/M21_1MR.html

These are only some starting points for you.

Important things I suggest.

Keep a file of your copies in chronological order - never provide originals to give someone.

Get a complete copy of your husbands C-file, (Claims file).

Have him always sign a ROI

(release of information) form, to get copies of doc appointments, etc... mailed to him.

Always send any correspondance to the VARO (Veterans Administration Regional Office)

certified or return receipt requested mail.

If your close to the VARO, take it in person, ask them to make you a copy of the top page

and ask them to date stamp it, so you have some proof it was submitted.

Always submit information on time.

When your hubby goes to doctor (or whatever) appointments, if he feels the reason he is

there might be related to service, or secondary to a service injury, just ask the provider

for an opinion as to if they feel in their medical opinion it might likely be connected to

an event or injury incurred during military service. If he has a copy of the service records

that shows this could relate to active duty problem, take that to show the doc also.

Hope this helps you some, and again welcome !

carlie