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Is it safe to say if I had no prior dx of sleep apnea and now my first ever study showed mild sleep apnea since my sTBI it could be claimed as secondary? I'm awaiting my local Va opinion but if it is secondary to my TBI at which point is pyramid a problem. I already have blackout spills claimed as dizziness and lightness, scars from the feeding and tracheotomy tube, and migraines claimed as headaches. Lumped in with it is PTSD and soon to be Chronic AD for a combined 70% . If i now file for Sleep apnea which now I'm being fit tested for a CPAP machine if found to be a secondary claim could that be lumped in with my TBI and I'm not going to bother asking about ratings.

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No, its not "safe to say if I had no prior dx of sleep apnea and now my first ever stududy showed mild speep apneay it could be claimed as secondary".  

To get sleep apnea as a secondary condition, you need:

1.  Current diagnosis of sleep apnea (and you are using a cpap if you want to go for a 50 percent rating).

2.  A doctors statement which says your sleep apnea is at least as likely as not secondary to (TBI or PTSD).  

Unless you have this "secondary nexus" documented in your file, you wont be getting any additional compensation for sleep apnea as a secondary condition.  

However, since you are 100 percent, a secondary service connection for sleep apnea may or may not raise your disability compensation level.  To be eligible for statuatory SMCS

housebound, you need a single 100 percent plus an additional 60 percent seperate and distint ratings.  If your sleep apnea is secondary to your tbi or ptsd, Im not sure if you would qualify as "seperate and distint".  Someone else may chime in, but its hard to say something is seperate and distint when its secondary.  

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Any DX, SC'd as "Secondary" is a separate SC Issue, even if Rated at 0%. 

If in fact, you were to obtain a Sleep Specialists confirmed Nexus of your DX'd SA being linked to the SC'd TBI, an RX for CPap or BiPap would result in an SA 50% Award. 

There isn't a Pyramiding issue with a Brain & SA (Respiratory- 2 different systems) SC, however, I do see a problem with the PTSD & "soon to be Chronic AD." Do you think the AD will result in a separate SC or an increase to an existing PTSD Rating?

Any mention in your SA DX of an RX for a 02 Concentrator to be used in conjunction with the CPap? That would be evidence of "Chronic Respiratory Failure" and could lead to an eventual SA 100% Award at some later date.

Semper Fi

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Ok I was just checking my Neurologist chimed in yesterday at my TBI exam said the same thing and to file it she knows I'm already 100 p and t with SMC S. She said I should get everything that I'm dx with filed for SC so later down the road. Right now I have 9 issues SC and two in an appeal that should be granted just a matter of time. This was dx at the Va hospital so hopefully speeds up an FDC claim.

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