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allansc2005

Secondary Conditions: How to file?

Question

Got a veteran who just won SC for Obstructive Sleep Apnea(OSA), vet also has other conditions commonly known to be caused by, or associated with OSA, namely, heart condition, obesity, gum disease, high blood pressure, et al.

In filing for these secondary conditions, does the veteran need to seek out, and get a medical opinion/DBQ for each condition, or can say the veteran's own MD give the professional opinions needed for the veteran to file the cases?

 

Veteran is now SC at 50% for OSA and tinnitus.

 

Thanks,

Allan

2-2-0 HUAH!

 

 

 

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To obtain SC for a secondary condition requires:
1. Current SC condition (their OSA would qualify)
2. Current diagnosis
3. Medical opinion/nexus

The veteran can go ahead and get the medical opinion/DBQ for each proposed secondary condition, with adequate medical rationale and appropriate jargon ("as likely as not", "more likely than not", or "due to/caused by").

Once all 3 requirements are met, they could go ahead and file a fully developed claim. If the medical evidence/opinion happens to be from a non-VA provider, I highly recommend they also provide the VA with necessary Release of Medical Information forms. If they don't do that, then the VA will have to ask the veteran to fill them out, which could make their claim take longer.

 

 

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He needs "Expert evidence".  Expert evidence for VA means that the medical professional has expertise in this area, that is, he has medical training or experience in treatment of OSA.  

It does not mean he has a Phd in Sociology.  It means he regurarly treats patients with OSA, and, probably has medial training in sleep medicine.  

Yes, you need an expert in each claimed condition.  ONE MD may have expertise in more than one medical speciality, tho.  So a doctor could be an expert in sleep medicine and also in arthritis, if he has treated both types of patients.  

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