cue Help with reopening claim or CUE?

[Darc_wolf]

Hello,

I am seeking help on reopening or CUE-ing  a denied claim from 2015. I gave up fighting for a while and just recently had a claimed competed. I am seeking one of the toughest claims to get connected for (sleep apnea) and just wanted to see what you all thought of the denial reasoning and DBQ? I had a chance to look at some of my STR's and they stated a few times untreated hypertension which I wasn't aware at the time was resulting from OSA which I was diagnosed with four years after leaving the military. I am still waiting on a c-file that I put in for as of June. I have also gotten together two buddy letters and was wondering if you all think I should go ahead and spend the money for an IMO. I am currently using a CPAP after being diagnosed on 2005. Please forgive me if I am all over the place this is my first post though I've been lurking for a while. :)

 

[Darc_wolf]

1 hour ago, Tomahawk said:

The major problem with your "little gem" is that you still have to have a doctor backing your statement.

" 15. A determination of proximate cause is basically one of fact, for determination by adjudication personnel. VAOPGCPREC 6-2003 and 19-1997. With regard to the hypothetical presented in the previous paragraph, adjudicators would have to resolve the following issues: (1) whether the service-connected back disability caused the veteran to become obese; (2) if so, whether the obesity as a result of the serviceconnected disability was a substantial factor in causing hypertension; and (3) whether the hypertension would not have occurred but for obesity caused by the service- 10. Executive in Charge, Board of Veterans' Appeals (01) connected back disability. If these questions are answered in the affirmative, the hypertension may be service connected on a secondary basis."

You will have to have a doctor state that your SC disability caused the obesity.  Which will be much more difficult than you'd expect.  Yes lack of exercise due to your SC disability may have been a contributing factor, however your eating habits are more than likely the primary cause in most doctors "professional opinions"

Thanks for responding Tomahawk. If the adjudicators have to resolve the issue of whether or not the disability attributed to obesity then according to their own rules it should myself appellant? Since I had prior history of compliance with PRT and the failures didn't start until after my asthma worsen any rational person would see the causal relationship between the asthma and weight gain. As to eating habits I am not sure a rational adjudicator would opine that my eating increased as the asthma worsened, but I could be wrong? I am curious to know why would a doctor have to connect what is already in my service records?

Thanks again for chiming in.

[Berta]

You mentioned Buddy statements but there is only one in the pdf. from your wife.Spouse statements can help if they are backed up by actual inservice Buddy statements.

Have you attempted to get a buddy statement from someone who served with you- and who bunked  with you, same time, same place of service?

Does your military personnel file reveal any instances where you over slept for duty or were too tired to function in your MOS?

I agree that claims like this need strong Independent Medical Opinions.

But an IMO cannot perform a miracle. It is always the best bet for a veteran to thoroughly review their SMRs carefully, to see if they feel there is enough there to warrant service connection and that would also warrant  the expense of an IMO.

Poorly controlled DMII can certainly cause weight gain but I went over the blood chem report in the pdf and that does not reveal a poorly controlled DMII scenario.

 

[Tomahawk]

The way I read the statement is that someone has to form a medical opinion that your obesity was "caused" by the service connected disability.

With that said, I had my SA claim denied based on obesity.  Ill look for it when I get home.  But it said something along the lines of "while medications taken for SC disability have contributed to weight gain, that alone is not the cause of the obesity as adjusting caloric intake would make up for the reduced activity levels"

 

Basically the doctor stated that I had sleep apnea because I was overweight, and that I was overweight because I ate too much, not because of the 800 medications I have taken that weight gain is a side effect of.

[Darc_wolf]

4 hours ago, Berta said:

You mentioned Buddy statements but there is only one in the pdf. from your wife.Spouse statements can help if they are backed up by actual inservice Buddy statements.

Have you attempted to get a buddy statement from someone who served with you- and who bunked  with you, same time, same place of service?

Does your military personnel file reveal any instances where you over slept for duty or were too tired to function in your MOS?

I agree that claims like this need strong Independent Medical Opinions.

But an IMO cannot perform a miracle. It is always the best bet for a veteran to thoroughly review their SMRs carefully, to see if they feel there is enough there to warrant service connection and that would also warrant  the expense of an IMO.

Poorly controlled DMII can certainly cause weight gain but I went over the blood chem report in the pdf and that does not reveal a poorly controlled DMII scenario.

 

The other statement is the "Scanned at Library" pdf. I definitely overslept for a few musters, but none are recorded in any adverse action. I will look into a medical opinion after I review my claim file. I actually have glucose readings in the 90's prior to exiting AD, but I am unsure what constituted high levels at the time.

Thank you for your review.

[Darc_wolf]

3 hours ago, Tomahawk said:

The way I read the statement is that someone has to form a medical opinion that your obesity was "caused" by the service connected disability.

With that said, I had my SA claim denied based on obesity.  Ill look for it when I get home.  But it said something along the lines of "while medications taken for SC disability have contributed to weight gain, that alone is not the cause of the obesity as adjusting caloric intake would make up for the reduced activity levels"

 

Basically the doctor stated that I had sleep apnea because I was overweight, and that I was overweight because I ate too much, not because of the 800 medications I have taken that weight gain is a side effect of.

Thanks Tomahawk, I read you on that.