Denial of Sleep Apnea without C&P Exam

[Galen Rogers]

Howdy All,

I originally file a claim for Sleep Apnea (OSA) in 2008 after I was diagnosed in late 2007. That was after I retired from the Navy so the diagnosis was never in my military health record. I filed it on my own because my AMvets rep said it would not get approved and he would not mess with it. The VA sent me a request to allow them to contact my doctor directly that I signed and sent back. I knew nothing about a NEXUS letter or lay letters or even the connection with Reflux, Rhinitis, and Sinusitis. A short while later after they contacted my doctor I received the denial letter stating "Not service connected".  Because of my ignorance I accepted that until a few fellow retirees with OSA said they did the same thing but then provided lay letters from shipmates and their wives and their claims were approved. Since then I have read all I could find and have reached out to others for assistance. So my real question is " Would the fact that I was not provided a C&P exam be a basis for a CUE?" The denial came from the Regional VA office.

[Gastone]

I didn't see anything relating specifically to SA Appeals, did you? This was from 2014, is there an update specifically addressing successful OSA appeals?

[Galen Rogers]

It does not go into specifics on what types of claims, initial or appeals. It is somewhat out dated but then not sure how much time he has to update stats. I believe there are alot of folks on here that know of Dr Bash and his assistance to vets. There are other doctors I have read about also but none with first hand experience with. 

[Berta]

"My NEXUS ties the facts that I had Reflux, Rhinitis, and Sinusitis in service. OSA is directly associated with those problems. Medical studies and literature at that time stated those connections and the VA Rater should have known that."

VA raters cannot connect medical dots-

It is certainly possible that your SC disabilities might be the cause of the SA.

Have you formally re-opened the sleep apnea claim with the IMO/IME from Dr. Bash?

Dr. Bash knows his stuff- I based the IMO/IME criteria here in the IMO forum on 2 IMOs he did for me.

The IMos were for undiagnosed, untreated DMII ( from AO exposure) contributing to my husband's death.

At first I wondered if a  Neuroradiologist could opine well on diabetes.

But he was able with that background to opine on the MRI findings and the autopsy, etc etc, even adding that the VA Endocrinlogist ,whose rhetoric  had denied the claim, was wrong based on his experiences with assessing medical records  of "thousands" of diabetics.

There could be a CUE potential but that is dependent on the re opened claim.