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Claiming sleep apnea as a secondary to restrictive lung disease

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navyguy357

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I have a service connected disability with zero rating for restrictive lung disease. How can I claim my recent VA diagnosis for sleep apnea as a secondary? How can I find a doctor who will write me a nexus letter? How can I request an increase for restrictive lung disease? Any help would be greatly appreciated.

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2 minutes ago, broncovet said:

If you are using a CPAP, simply ask your sleep doc if he thinks its related to your restrictive lung disease.  

If he says yes, then ask him to document same, that is, make a note in your records.  

If he says No, then ask him why not, and carefully listen to his answer (write it down if necessary).  

Then, if you like post his answer, and this can be researched to see if his reasoning is valid, or is he covering the VA's Zass.  

Understood. I have an appt. with the VA doctor that diagnosed me with sleep apnea and I will ask. If he answers yes and makes notes in my record, does his notes have to be the same as what VA expects in a nexus letter?

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If you haven't already done so, when you get the time, review the BVA Decisions for the past few years regarding Claims for SA Secondary to your respective Respiratory DX.

What type of SA have you been DX'd with, OSA (obstructive SA), Central (CSA) or Mixed (Combination of OSA & CSA)?  OSA is definitely the most common DX claimed as either Direct or Secondary Service Connected. Without a Board Certified MD/DO Sleep Specialist's confirming NEXUS medical opinion, your Secondary Claim is probably doomed.

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6 minutes ago, Gastone said:

If you haven't already done so, when you get the time, review the BVA Decisions for the past few years regarding Claims for SA Secondary to your respective Respiratory DX.

What type of SA have you been DX'd with, OSA (obstructive SA), Central (CSA) or Mixed (Combination of OSA & CSA)?  OSA is definitely the most common DX claimed as either Direct or Secondary Service Connected. Without a Board Certified MD/DO Sleep Specialist's confirming NEXUS medical opinion, your Secondary Claim is probably doomed.

I was diagnosed with obstructive sleep apnea. How do I find a MD/DO sleep specialist?

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Finding a SA Specialist shouldn't be too much of a problem. Generally speaking, all major hospitals should have a Pediatric/Adult Sleep Dept.

You should be able to get an appointment for follow-up care, preferably with a Board Certified Sleep Neurologist. I see mine once a year to review my BiPaP Download, costs about $200.00 if paying cash. Each time I leave his office I have a copy of his Clinician Treatment Notes, at no additional cost.

More important right now, what is your precise Restrictive Lung Disease DX and how long has it been Rated at SC 0%?

After a cursory review of relationship of RLD & SA (see attachment) there could be a Nexus depending on severity of RLD (SC 0% ain't severe). When was your last VA LFT, no worsening of results?

Case Report 4 Sleep Apnea and Restrictive Lung Disease - Team 3 P451 Spring 2012.html

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If you want a local doc, then you can look it up in the yellow pages, or do a google search for 

"sleep specialists" or "sleep clinics" or sleep doctors in my area.  Then, call their office and ask them if they can/will do and IME for Veterans benefits.  I suggest you explain exactly what you need for VA.  What you need is a doctor to opine, "The patients OSA is at least as likely as not related to the "sleep disorder" diagnosed in military service".  The doc will have had to "reviewed your records, and so state, and he will need to give a rationale as to why he made this statment.  

If the doc you call can not/ will not do this, then you need to move on to a sleep doc who can and will.  If this doc thinks your sleep apnea is unrelated to your sleep disorder diagnosed in service, then you need to move on.  

This is not "doctor shopping" but you need a sleep doc who is familiar with what VA requires for service connection.  His statement needs to be in a language VA can understand, and that is "The Veterans sleep apnea is at least as likely as not related to his sleep diagnosis in service".  

It wont work if he says, "The Veterans sleep apnea "MAY" be related to service, and it also wont work that it "could" be related to service.  

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If you want a local doc, then you can look it up in the yellow pages, or do a google search for 

"sleep specialists" or "sleep clinics" or sleep doctors in my area.  Then, call their office and ask them if they can/will do and IME for Veterans benefits.  I suggest you explain exactly what you need for VA.  What you need is a doctor to opine, "The patients OSA is at least as likely as not related to the "sleep disorder" diagnosed in military service".  The doc will have had to "reviewed your records, and so state, and he will need to give a rationale as to why he made this statment.  

If the doc you call can not/ will not do this, then you need to move on to a sleep doc who can and will.  If this doc thinks your sleep apnea is unrelated to your sleep disorder diagnosed in service, then you need to move on.  

This is not "doctor shopping" but you need a sleep doc who is familiar with what VA requires for service connection.  His statement needs to be in a language VA can understand, and that is "The Veterans sleep apnea is at least as likely as not related to his sleep diagnosis in service".  

It wont work if he says, "The Veterans sleep apnea "MAY" be related to service, and it also wont work that it "could" be related to service.  

Do your homework and READ Berta's take on this:

 

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