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Sleep Apnea/Asthma claim

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chgofire

Question

I'm currently at 90% rating current ratings are 50% TBI, 70% PTSD, 0% foot fungus, 10% Left wrist fracture.  8 months ago the VA diagnosed me with sleep apnea after a sleep study and I was issued a CPAP machine.  Back in the sandbox we were exposed to a huge burn pit 24/7 ever since leaving the service I developed some form of asthma, breathing problems requiring me to carry an inhaler.  Also, I have developed ED but when I filed a claim for ED I was not granted any ratings because they link it to my PTSD, etc. which I think it's bs!  

I should of filed an appealed for ED but I never did since the claims process is so damn complicated and frustrating, not sure why the VA makes this so incredibly hard for injured Veterans especially Veterans who have been seriously hurt by IED's and other combat related trauma.  I have to admit that trying to get 100% rating has been not only difficult but painful experience.  

I’ve been given medication for a continuous foot fungus issue that has never let up but I was only granted 0% for it.  So now Im considering asthma, sleep apnea, ED, and foot fungus.  Thoughts, recommendation or advice? 

 

Thank you~ 

 

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  • Content Curator/HadIt.com Elder

If you have an IMO for each condition, that should be very helpful.

Asthma and SA sound plausible due to your exposure to the burn pits. For asthma, the ratings are based on the type of medication treatment or FEV1%.
  Just keep in mind that they are both respiratory ratings. For purposes of your combined rating %, they will use the higher % of the two.

An ED claim secondary to PTSD makes sense. The psychotropic medications given to treat PTSD have a known side effect of ED. If they denied an ED claim, it might be worth it to get an IMO (if it is not listed in your records already). Keep in mind, a successful ED claim typically results in an SMK-K award (a bit over $100/month) and is not added to your combined rating.

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On 5/22/2018 at 11:19 AM, Vync said:


  Just keep in mind that they are both respiratory ratings. For purposes of your combined rating %, they will use the higher % of the two.

 

Yes this is what the VA claims, but factually  sleep apnea is not a respiratory disease. BVA has awarded a few claims with separate ratings already. I have a pending appeal for separate ratings that if necessary I  will take it all the way through the court system. VA has screwed to many veterans with this reasoning for too long and they will continue to get away with is as long as veterans let them.

I mean how is it that they can even deny separate ratings  (Using 4.96  Rating coexisting respiratory conditions. Ratings under diagnostic codes 6600 through 6817 and 6822 through 6847 will not be combined with each other. Where there is lung or pleural involvement, ratings under diagnostic codes 6819 and 6820 will not be combined with each other or with diagnostic codes 6600 through 6817 or 6822 through 6847. A single rating will be assigned under the diagnostic code which reflects the predominant disability with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. However, in cases protected by the provisions of Pub. L. 90-493, the graduated ratings of 50 and 30 percent for inactive tuberculosis will not be elevated.)

since sleep apnea is not a respiratory disease they should not be able to claim 4.96 as a reason to deny.

 

And in my case to make it worse  I have Asthma/COPD and sleep apnea. I use oxygen so am rated 100%. I don't think the rating system is fair, because I only get the one rating. Others who only have COPD and use oxygen get a 100% rating.. Its doesn't seem right that someone with three diseases gets the same rating as someone with one disease... 

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  • Content Curator/HadIt.com Elder

@Richard1954

I really agree with your assessment and I hope you win your appeal.

Sleep apnea causes your airway to close. But why does the VA send me to their neurology/sleep clinic instead of the pulmonary clinic? I assume it's because SA is caused by a neurological issue.

I also have asthma (60%), but am not on oxygen yet. When I found out that pyramiding applied between it and SA, I didn't even bother to file an SA claim.

Here's an idea. File a claim for COPD w/ oxygen as secondary to your asthma. Makes me wonder if you get a 100% rating then they would take the higher of the two ratings... :ph34r:

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5 hours ago, Vync said:

@Richard1954

Here's an idea. File a claim for COPD w/ oxygen as secondary to your asthma. Makes me wonder if you get a 100% rating then they would take the higher of the two ratings... :ph34r:

Actually,  I really am rated for asthma w/copd secondary, and sleep apnea. But in reality all three stand alone as service connected  , the asthma and COPD were diagnosed on active duty, and the sleep apnea was service connected based on the history and IMO.   COPD - 100% ,  asthma-60% and sleep apnea 50% even thou they do not count all three ratings when combined.. they still have to rate them separately before they give a combine rating, and they have to consider the separate rating for other things like SMC's.  As I was saying  it doesn't seem right that a person could have 3 diseases and only get the one rating.. but it is what it is....

Edited by Richard1954
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Are you doing this DIY or are you using a POA-VSO? Sounds like you could use a well seasoned VSO-Rep. What type of SA have you been DX with, OSA, CSA or mixed MSA?                Has any Sleep Specialist opined as to a possible Etiology of your SA? Is your BMI 27%++, neck 17 in++, Large Tongue, Large Abdomen?               Are you using a POA_VSO or doing your Claims as a DIY project? Sounds like you could use the assistance of a Well Seasoned VSO-Rep, could help you get untwisted.

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5 hours ago, Gastone said:

Are you doing this DIY or are you using a POA-VSO? Sounds like you could use a well seasoned VSO-Rep. What type of SA have you been DX with, OSA, CSA or mixed MSA?                Has any Sleep Specialist opined as to a possible Etiology of your SA? Is your BMI 27%++, neck 17 in++, Large Tongue, Large Abdomen?               Are you using a POA_VSO or doing your Claims as a DIY project? Sounds like you could use the assistance of a Well Seasoned VSO-Rep, could help you get untwisted.

I recently found out the VSO will not longer be working at the VFW, I filed for upper respiratory issues due to burn pit exposure, asthma, sleep apnea and lost of vision due to a TBI injury.  So I visited the VA and filed the claims with the assistance of my local VA hospital.  So let's see what happens.  The VA makes things extremely hard for Veterans I'm not sure if this is done on purpose or what not but it's very frustrating to say the least..  Currently I am at 90% and I have a massive medical file on record and tons of other references.  

I'm keeping my fingers cross~  

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