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mikeusaf1980

Heart Attack caused by Sleep Apnea MI by OSA

Question

Hello all,

I separated in 2007 and was awarded 80% for a number of things (listed below) after awards I have never made another claim.  Since I got out I've used the VA for some care for my eyes and CPAP gear but not for everything as I have private insurance.  Last month on Dec 21st I had a heart attack at 37 years old (turned 37 2 weeks before on Dec 11th) with 1 each 100% blockage requiring a stent.  I was not on cholesterol or BP meds and I receive no disability for any cardio related issue.  I had an electrocardiogram and my heart looks great with 100% function and my non VA cardiologist said I have to take plavix for a year and likely statins and BP meds for life but other than that no restrictions and no other damage.  I read that OSA causes issues including heart attack but I have had high normal cholesterol  since I was active duty (ldl 150ish, tri - 100+, hdl 40s, total 210+) and  normal BP always.

 

My questions are:

1 - Can I tie the MI event to OSA?  And if so can it cause the MI even if my BP and Cholesterol are not really considered high?

2 - If I have 100% function and no damage is it worth the effort?

 

disabilities 

Disability

Rating

left knee strain

0%

left ankle strain status post talar break

10%

right ankle strain

10%

multi-level degenerative disc disease, thoracolumbar spine (claimed as lumbar and thoracic back conditions)

10%

bilateral keratoconus

30%

tinea versicolor

10%

allergic rhinitis (also claimed as sinusitis), status post septo-rhinoplasty

10%

tinnitus

                                                                     10%

 

central sleep apnea

50%

 

 

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Yes..there is a risk.  The VA has implemented a plan to reduce all Vets who apply for an increase in order to stop Veterans from seeking an increase, thus reducing their workload and backlog, as well as saving money to fund the "next pork barrel" hospital.  Just kidding, tho suprisingly we see this myth propogated by VSO's, VA employees, and even some Vets advocates.  

However, knowledge is power, and you are gonna get that right now!  

The VA has "specific criteria" when they can reduce you, and, if you have been rated over 5 years or are P and T, then they can not reduce you UNLESS you not only Actually improved, but did so while working.  

The VA can not reduce you for applying for an increase, this is NOT a criteria for reduction!  Of course, if you did "actually improve under ordinary condtions of life", then you probably wont be applying for an increase, now would you?  Gee, you get better so to get even with VA you apply for more benefits?  How often is that gonna happen.  

It IS true that VA looks at your whole file when you seek an increase, however, the VA does that anyway, always on the lookout to save money by cutting benefits, especially by Vets who have improved and no longer need benefits, such as they are able to go against all odds, cure incurable diseases and go back to work full time!  

Incredibly, some rather famous Vets did just that, but were still not reduced!   John Mc Cain, Max Cleland are both senators collecting 100 percent and working as a US Senator.  Tammy Duckworth, a 100 percent disbled Vet, not only worked for VA while collecting her 100 percent, but is a big, big shot.  I hear she got out of VA and joined the 2 above, who are 100 percent and are into politics.  

The facts are that VA can/does reduce Vets who improve, but that happens independently of whether or not they apply for an increase.  

While its true, when you seek additional benefits, many eyes will be on your claim, the fact remains that VA has laws, and these prevent reducing Veterans who dont meet the applicable "improvement" criteria as follows:

(Note the 5 year protections only apply to P and T Vets, or those who have been rated 5 years or more):

3.344 Stabilization of disability evaluations.

(a)Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b)Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, § 3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c)Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

[ 26 FR 1586, Feb. 24, 1961; 58 FR 53660, Oct. 18, 1993]
 

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Yes, you can tie it to OSA, provided that a doctor writes in your records that your heart attack was "at least as likely as not" due to OSA (which is service connected).  

You need that or a similar nexus.  

As far as whether or not its worth it, the stakes "may be" more than money.  

You see, if you die from a "service connected" disoder, you widow (wife) can get DIC, which would be a very very big deal to her, worth about 1200 to 1500 per month for the rest of her life.  If you dont die from a service connected disorder she wont get DIC, UNLESS you have been 100 percent for 10 full years, then it does not matter your cause of death, your wife will still get DIC.  

I will presume you are unlikely to pass from OSA, but a heart problem can be very bad.  Also, even tho maybe you dont have problems with your heart now, you will be eligible for an increase if it gets worse.  

 

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Broncovet,

Thank you for your response, I am starting to do more research as your points on the spouse benefit are significant to me regardless if I get much of a rating now. 

One concern I have is I don’t want to lose the rating I have, is there a risk to that?  I had not been using the CPAP nightly until 2 years ago when I started putting it on every night but normally rip it off.  8 months ago VA replaced my CPAP (which was also the first time I went to them regarding my sleep apnea) and this one tracks how many hours I use it and I don’t reach the 20 days in a 30 day period with at least 4 hours use needed to be considered effective treatment but this is improving.

None of my disability items have improved and in fact my back, my eyes and my allergies (moved to San Antonio and the ceder is death around here) are all worse...

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Did your Cardiologist opine as to a possible etiology of the MI? What's the Date of your CSA DX? Are you on BiPAP with supplemental 02?

Back in 2010, my non VA Sleep Neurologist put the "More Likely than Not, MSA was linked to my 2006 CAD B-Pass surgery in his Treatment Notes. 2 months later I got the Secondary 50% Award.

2016 VA heart Echo indicated low end Pulmonary Hypertension had developed. Filed an FDC SA Secondary right away, within 2 months got a PH SC 0%, but  my SA got bumped from 50 to 100% with an SMC S (1) award about 6 months later.

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