Sleep Apnea Secondary to Bronchiecstasis Denied

[sandiegonavyvet]

Hi all,

Just wanted to try to get some guidance.

I was recently awarded an increase in benefits, from 60% to 90%. I am very thankful for that.

I previously was at 60% for Bronchiecstasis, Asthma, Lung Infiltrates SC, then I submitted claim for Anxiety and was awarded 70%, which puts me at a combined rating of 90%.

My issue is that I also submitted for Sleep Apnea, but did it as a new claim, not as secondary. From what I have been learning, I should have submitted the Sleep Apnea as secondary to my lung conditions. My primary doc tells me that I have CPAP and Obstructive Sleep Apnea because of all my lung issues.  I plan on re-submitting with the help of DAV and trying to let them know that this is secondary due to all my lung diagnoses.

Also when they re evaluated me, they left my asthma, lung infiltrates, and bronchiecstasis the same rating at 60%, but  my condition changed from when I had submitted it. I actually am now on Bactrim, prophylactic meds (antibiotic) , and 40mg Prednisone (Steroids)for the last year. I was not on prednisone when I initially filed for VA benefits.  I was also Rx'ed Xolair infusions which I have to admit myself to hospital every 14 days. I don't think they saw this, even though I provided all records, and they left me at 60% asthma and lung condition with no increase on that. I think that made a big difference because that increase in lung diagnosis would have put me at 100% instead of 90%.

Any suggestions? I was looking online to try to get a lawyer, but I don't knw if I should just go with DAV which are the VBO who helped me before.

Thank you all in advance.

[broncovet]

A few things:

1.  Did you order a copy of your cfile, and did you have a medical exam where a doc said your cpap "was at least as likely as not" related to (secondary) to your service connected condition(s).  That is what you need for secondary service connection.  

2. VA awards "increases" when your symptoms increase, not when a doc changes your medication(s).  Its about symptoms, not treatment, as treatments can vary.  

[Buck52]

Good Advise from broncovet  he is right on!!!

[Gastone]

How about posting a copy of the SA DBQ & Denial Letter?

No in-service SA DX, symptoms or being treated within the (1) year window after discharge rules out the Direct SC, must be a Secondary issue.

If this is a recent Denial, you could make an Official Request for a CUE Review, citing VA Medical "Evidence of Record" that proves a Nexus of your SA Secondary to your existing SC'd Lung conditions.   Keep in mind, this filing doesn't stop your NOD Filing Clock.

Meanwhile, it would serve you well to find a Sleep Specialist, say an MD Board Certified Neurologist that specializes in Sleep Medicine. His written medical opinion would be a Deal Maker for a DRO.