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JDF

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Retired in 2013 with 40% rating.  20-cervical strain, 10-knee injury, 10-degenerative arthritis.

couple of questions,

I am considering a sleep study for osa.  I snore a lot and it disturbs my sleep. If I am diagnosed with osa, how difficult is it to connect to service. Is it worth my time to try.

also, I suffer from lower back pain, loss of work, and some physical therapy.  I've already been rated at 20 percent. How would I go about increasing my %, and is it worth my time. What's the success rate with the va after 4 years of retirement  

 

Thanks in advance for any help. 

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First start some treatments for your problems, OSA is getting harder to prove

these days but if you had this in service while active it shouldn't be that hard to prove.

Medical records and a copy  of c-file would help you to prove your case. Most all back conditions

is rated as "ROM" range of motion how far you can bend forward ,backward, & sideways. 

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Please be careful adopting words the VA has provided to narrow conditions.

Sleep apnea has, effectively, two* sub-diagnosis:

1.Obstructive

and

2. Centralized

The VA loves for you to use obstructive- It's easy to deny vis a vis gulf war disabilities. Centralized doesn't fit the check boxes on their denial form, so to speak.

Please don't get the idea that I have any medical knowledge, I just don't want anyone to put themselves on the denial path before they even begin.

Interestingly, two DBQ's for Sleep Apnea:

Central Nervous System and Neuromuscular Diseases (except TBI, ALS, PD, MS, Headaches, TMJ, Epilepsy, Narcolepsy, Peripheral Nerves, Sleep Apnea, Cranial Nerves, Fibromyalgia, and CFS)

And

SLEEP APNEA DISABILITY BENEFITS QUESTIONNAIRE

* (there's a third listed, a mix of the two)

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JDF

 for S.C. of Sleep Apnea

You will need military medical records to show you were treated for OSA or any type of sleep disturbance , snoring can be used as evidence but you need to prove it  , medical records are the best, if you don't have medical documentation then you can use buddy statements   that witness your sleep disorders   like snoring, waking up  stop breathing and jerk coughing  ect,,ect,,,

Notrized statements from people that knows you before military and after.

A good lay statment from your spouse will be considered.

you can ask your Dr if any of your S.C. Conditions can be ''Related to'' Sleep Apnea  or OSA and if he says yes  then file a secondary claim to the S.A. 

I believe ''pain'' can be related to S.A.  but you need a Quialfied Dr's Pro Opinion.

Request a sleep study from your MH Doc's or your PCP  you will need a diagnose for S.A. before you file your claim for that.

My Advise ,claim or no claim If your Diagnose with Sleep Apnea you will be prescribe a C-PAP Machine, I suggest you use it  it could very well save your life.

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I understand the "new" VA requirement for 50 percent rating is that the doctor must document your  CPAP is "medically necessary".  

This looks a lot like the VA is trying to deny as many OSA claims as possible.   I mean, gee whiz, when does the doc tell you to do this because its "medically necessary".  Dont you assume the doc is doing his job and prescribes stuff for you that is medically necessary, or is the doctor prescribing stuff so he can get kickbacks from the drug company's or the companies who make CPAP supplies?  

I think doctors should be upset about this "medially necessary" clause..it insults them.  I mean, gee what is the doc gonna say:

"

Quote

Naw, I did not prescibe this CPAP because it was medically necessary, I prescribed it because I needed a new BMW, and a larger boat, and because I have stock in the company that makes CPAP supplies."  

 

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