Sleep Apena Denied. Next Steps?

[Wigwagflag]

Hey all,

I recently received my rating decision for Sleep Apnea claim. 

The Rating Decision states the following, "Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. While your service treatment records reflect complains, treatment or a diagnosis similar to that claim, the medical evidence supports the conclusion that a persistent disability was not present in service. Although, there is evidence of a sleep complaint in service, there is no diagnosis of sleep apena in service, nor was there a diagnosis of any other sleep disorder in service. Service connect for sleep apena is denied since this condition neither occurred in nor was caused by service." 

I complained about and received medication specifically for sleep problems hyper-somnolence etc for about two years. At my particular post getting an MRI was an uphill battle, I did not complete a sleep study on active duty but I did receive one from my local VAMC.  I have my complete STRs. Do I have any recourse?  Would a IMO or nexus letter be helpful? Any guidance you guys could provide would be helpful as my VSO is lost in the sauce. 

[Tbird]

@WigwagflagWe've had a lot of posts about Sleep Apnea here's a list of search results on the site 

[Gastone]

Time to get on the NOD Train, don't wait for the 11th hour of the 11th month. You're not the "Lone Ranger" as far as SA initial Denials goes.

Who didn't have some sort of sleep issue while on active duty?

How long after discharge did you have your VMC Overnight Sleep Study? Which type of SA (OSA, CSA or MSA) were you diagnosed with? I take it you're on CPAP.  Is your BMI North of 28%, Neck 17+, large+ Tongue?

Just having a  Sleep Issue complaint and receiving sleep aid meds (RX or OTC?) while on active duty doesn't necessarily support a Direct SA SC. Did anybody ever refuse to sleep in a fighting hole with you because you snore? Any Buddy Letters submitted as supporting evidence?

[broncovet]

You posted, 

Quote

Although, there is evidence of a sleep complaint in service, there is no diagnosis of sleep apena in service, nor was there a diagnosis of any other sleep disorder in service. Service connect for sleep apena is denied since this condition neither occurred in nor was caused by service." 

This is a bogus denial.  Caluza vs Brown has defined the criteria for service connection, and it does not require a diagnosis in service.  See more here:

https://asknod.org/2014/09/23/bva-caluza-v-brown-20-years-later/

Instead, these are the "Caluza Triangle" for service connection:

1.  CURRENT diagnosis.  A diagnosis in service is not required.

2.  In service event or aggravation. 

3.  Nexus, or doctors opinion linking the current diagnosis to the in service event.  

My advice is to file a NOD, you should win if you have all 3 Caluza elements.  

Edited March 28, 2018 by broncovet
add more.

[Buck52]

Some Veterans have  S.C. Sleep Apnea or a type of OSA to PTSD Medications that have not had S.A while in military or any documentation for it.

if you been S.C. For a condition that can cause or be related to S.A. it can be service connected...once they says yes this is cause/Related to from his S.C Condition then it becomes S.C. And Rated.

Main thing is you will need  Qualified Dr to nexus this for you and this is not an easy task  but it can be done.

Gastone mention weight and tongue size can factor in to S.A. 

If I understood his posting about that?

[Wigwagflag]

7 hours ago, Gastone said:

 

How long after discharge did you have your VMC Overnight Sleep Study? Which type of SA (OSA, CSA or MSA) were you diagnosed with? I take it you're on CPAP.  Is your BMI North of 28%, Neck 17+, large+ Tongue?

Just having a  Sleep Issue complaint and receiving sleep aid meds (RX or OTC?) while on active duty doesn't necessarily support a Direct SA SC. Did anybody ever refuse to sleep in a fighting hole with you because you snore? Any Buddy Letters submitted as supporting evidence?

I got my VMAC sleep study 3 year after my discharge. At the initial VAMC I was being treated, it took months to get a PCP appointment. Specialty appointments were mythical unicorns. I was diagnosed with OSA. I am on the CPAP. My BMI is 22% and my neck size is 16' 1/4. I was prescribed Ambien, Amitriptyline, and Trazadone at various times on AD for sleep. I do have a buddy statement from my section chief stating that I frequently dozed off during duty hours and he also noted that when he had to wake me up for comsec change over I snored loudly and would sometimes stop breathing. The things that I am  SC for that could be related are to my sleep issues are "Trauma related Anxiety," TBI, Sinusitis, and Allergic Rhinitis.  I've been in talks with Dr Anaise and I think I should go get that IMO done.  

[Gastone]

Then again, you might want to consider spending $150 to $250 to see a non-VA Sleep Specialist, Preferably a Board Certified Neurologist that is a well-seasoned Adult/Pediatric Sleep Specialists.

Any chance you could post a redacted copy of your VA Sleep Study and the subsequent formal Diagnosis? Both should be in your MHV Clinician Treatment Notes.