Hardtyme Posted November 10, 2017 Share Posted November 10, 2017 I am trying to obtain S/C for Sleep Apnea and would like for one or more (hopefully this is in the correct area for this) to review the atch letter and advise me if anything else needs to be added for an IMO.Sleep Apnea Letter.rtf Link to comment
0 Moderator broncovet Posted November 10, 2017 Moderator Share Posted November 10, 2017 This letter appears to be a strong IME/IMO in support of your claim. You have at least 2 of 3 required Caluza elements: Current diagnosis, and nexus. Now, only you can answer if you have an "in service event" or aggravation documented. Link to comment
0 Hardtyme Posted November 10, 2017 Author Share Posted November 10, 2017 All I have is the diagnosis of hypertension and subsequent treatment, the inattentiveness and inappropriate responses at medical meetings which could be identified as hypersomnolence and, after being on a CPAP for several years the hypertension vanished. Meanwhile with the incorrect and erroneous diagnosis by a Physician Assistant, I have left ventricular hypertrophy, cardiomegaly, coronary artery disease, Chronic kidney disease, stage 2 and impotence.Additionally, major studies have shown that 1/2 of those diagnosed with hypertension (HTN) have OSA and one hale fo those with OSA have HTN. Moreover, studies have shown that with successful treatment of OSA the HTN is eradicated. I believe that the studies comment is certainly warranted and carries a significant burden of proof in my favor since in applies to my condition. And thank you for your honest reply! Link to comment
0 Gastone Posted November 11, 2017 Share Posted November 11, 2017 Any chance you could post redacted copies of your SMR's that your Sleep Specialist refers to? If not, was your BMI over 29%, was your neck in excess of 17 in? Who corroborated your Sleep issues back in 1983 thru 84? I think you're going to have a tough sell for Direct SC of SA. What was the date of your 1st Overnight Sleep Study which resulted in a definitive SA DX? Oklahoma VMC, correct? As to the "Incorrect Erroneous" PA's DX of Hypertension, appears that your BP was checked on at least (3) separate occasions over a one month span, 12/83 - 1/9/84 and 1/30/84. That's meets the Medical requirement for a Hypertension DX . What were your highest and lowest readings on the respective days? What was the documented reason for the 12/83 Sick Bay call? I take it that upon discharge from active duty, you were still taking BP Meds, did you get a VA SC for BP? What was the date of your CAD DX? Link to comment
0 Hardtyme Posted November 11, 2017 Author Share Posted November 11, 2017 Here are the Progress Notes and Consult. As for the visit that prompted the blood pressure f/u, I am certain it was a periodic PE. Link to comment
0 Gastone Posted November 12, 2017 Share Posted November 12, 2017 Generally speaking, in otherwise healthy individuals, Hypertension goes unnoticed until it's picked up at a regular yearly physical or impromptu medical screening. You indicate above that you are certain that the referenced Active Duty PA Exam was a "Yearly PE," as opposed to you seeking medical intervention for specific symptoms. I don't see any clinician notes pertaining to you claiming Sleep or memory issues, are there pages missing? You were 40 and 176 lbs in fatigues and boots, so unless you were 4ft tall, your BMI was good and you didn't have a 17+ in neck. Have you ever heard of "White Coat Hypertension?" As I mentioned previously, to the best of my knowledge Medical requirements for making a Hypertension DX have not changed in the past 30 yrs. A patients BP must be observed over a minimum of 3 days with multiple readings from both arms before the actual HPTN DX can be made. What treatment plan was put into effect? The 01/25/85 ENT exam doesn't reference any Night Breathing, Choking or snoring issues, strictly Hearing. Other than a Mild noise induced Hearing loss DX, Hearings Aids were not Rx'd, however Hearing protection was advised. In 2007 your what, 62 and DX'd with CAD, right? When was the actual VA or Private Overnight Sleep Study and resultant test results based MD/DO DX? Link to comment
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Hardtyme
I am trying to obtain S/C for Sleep Apnea and would like for one or more (hopefully this is in the correct area for this) to review the atch letter and advise me if anything else needs to be added for an IMO.Sleep Apnea Letter.rtf
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