How often is medical evaluation needed?

[Navyguy2013]

How often is medical evaluation needed?

I have a pending disability claim (4.5 years old) for Sleep Apnea requiring the use of a CPAP. I have not needed to see my doctor for my sleep apnea over the past 3 years for this. I use me CPAP every night. My CPAP supplier and insurance provider require a valid prescription for my CPAP supplies. I send in a copy of my CPAP supplies invoice to the VA intake center every time I get my CPAP supplies. How often do I need to be medically evaluated, or have a follow up with my CPAP doctor for my claim to stay valid?  

[Gastone]

Are you currently SC'd for any condition and receiving any Cpap equipment from your VMC?

Do you get yearly Downloads off your Cpap machine and forward them to your SA Specialist for review?

At every VMC, there is an SA Nurse that mans an SA equipment Walkin Clinic 1 day a week. You can take your Cpap in to have your settings per your DX verified and have the Download Card reviewed and printed out. A copy of the Download results will be placed in your VMC MHV File.

As to your "How often" do you need to see a SA Dr, that should be up to your treating SA Specialist. I was DX'd in 2010 and have seen my non-VA Clinician once every year to review my BiPap Download. At my last visit (10/16) he advised me that it was unnecessary for me to have yearly visits but he would like a yrly download to be forwarded to him for review.

Why don't you receive your Cpap equipment and supplies from your VMC. If you're not 30?% SC there's a co-pay, is that the problem?

Semper Fi

 

[broncovet]

Your CPAP probably has a "chip" in it so they know when/if you are using it or not.  If you have a pending claim for sleep apnea for 4 to 5 years, then you need to figure out what is going on.  

Was it denied by the RO?  Did you appeal?   Did you get a SOC and then not respond?  If you did not respond to a SOC, then you dont have an appeal anymore..after about 60 days your claim will be deemed "abandoned".  Some Vets make the mistake of filing a nod, then ignoring any other letters from VA.  You must file an I9 to "perfect" your appeal to the board within 60 days of receipt of the SOC.  

Not going to the sleep doc for 3 years is not a good sign.  First, cpap supplies (mask, hose, etc) go bad after about a year, so it would appear you are not using it, since the docs order for cpap supplies expires, too, unless you see the doc, or at least make and appointment with sleep clinic.  

If you have been using your cpap all along, you should see the sleep doc.  If you have not been using the cpap, then you should see the sleep doc and maybe he can help you tweak the reasons why:  maybe its too noisey, maybe your mask does not fit right, you may need the humidifier, etc, etc.  

[broncovet]

If you discontine treatment, especially after getting benefits, then the VA assumes it has improved, and you can expect VA to take a hard look at a reduction.  

[Vync]

Medical evaluation of conditions appears to vary In my opinion. The VA does seem to pay more attention to some conditions over others. Respiratory conditions like asthma and sleep apnea tend to draw more scrutiny from the VA than other conditions like tinnitus or 'roids. I speculate it may be because those conditions have ratings that surpass 10%, plus failure to treat them may result in significant problems for the veteran. If you get treatment from outside the VA for them, just be aware that the VA may need copied of the records as proof. Also, non-VA providers are not required to keep records permanently.

[Navyguy2013]

Thank you all for your replies

I am waiting on a NOD for my Sleep apnea. I replace my CPAP equipment every 30 days. I use my private insurance for my CPAP and doctor because I am waiting on my NOD. I have sent all of my sleep apnea test results to the VA, I also send all of my CPAP supply invoices to the VA intake center.  I receive replacement parts for my CPAP every 30 days. I use my private insurance for this. I use John Hopkins for my CPAP supplies, they require a valid prescription for my CPAP supplies.  My C&P exam from JAN2017 for my sleep apnea show a service connection, a Nexus, a chronic condition with the medical requirement for a CPAP machine.

[Buck52]

They call me up once a year for me to come to the Sleep Clinic (VMC) and they check my C-PAP and the ''chip'' There are two chips in my C-Pap

They can tell me how many hours I've used it and count my apnea's that occur during the night.

Yep  the VA Prescribe C-PAP will sure tattle on ya  if your not using it.

And I don't have a Sleep Apnea Claim...guess they think I might file one?