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AFVet04

Sleep Apnea Claim Being Reveiwed By VA Only 1 Week After Service Connection Granted

Question

I was just recently granted service connection for sleep apnea last week.  Today, I was looking at Ebenefits and noticed my claim was being 'reviewed' by the VA.  I contacted them and they told me that is was like a 'random' review that could result in a reduction, or an increase, or no change to my benefits.  Anyone heard of this happening only 1 week after receiving your decision letter awarding service connection?  What should I do?

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Welcome to Hadit!

First, don't panic. Keep in mind ebenefits is known for not having the most accurate statuses. Mine said in progress for two weeks after my rating decision arrived in the mail. Consider waiting a week and then rechecking the status.

If your SA rating was based on use of a breathing device, like a CPAP, and you are compliant, then you should be ok.

Sometimes the VA proposes reduction in a rating. The VA must send you the exact reasons they propose to reduce it. After that, you are given a period of time to respond and contest it.

Also, please keep in mind that the VA can go back and review ratings. In my case, after winning an increased rating, he decision letter said I would be brought back in a year for re-eval because my "condition was expected to improve."

 

Here is some very brief information about the varying levels of protection. For additional details and legal-ese, please refer to the corresponding regulation:

5 years is governed by 38 CFR 3.327
Once the effective date reaches 5 years or more at the same level, it is considered stabilized.

10 years is governed by 38 CFR 3.957
It protects the SC status from being severed.

20 years is governed by 38 CFR 3.951(b)
It protects the rating level (percentage) for a disability.

If the VA deems fraud was involved, none of the above apply.

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listen up, there is a computer in the CPAP machine, they can call you in to "calibrate" the machine in a month or 2. they put a card in and pull the data. Ive heard of vets going to the VA and swearing they use the machine every night, and the VA pulls the data and sees that the CPAP machine was never even used. Dont get caught short. use it . They pulled the data on mine and could tell ALOT. how long I apnea, how many times, how long I slept, ECT .

You can bet your lucky marble though, if they pull data and you arent using it, they are going to put it in your file. Sleep apnea is a claim the VA would love to see go away. I believe somebody made ALOT of money selling the VA  all of the machines.

 

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@63SIERRA is correct! I have appointment where I have to bring in my card for them to review data, provide new supplies, make adjustments, etc...

The machine I received had cellular capability so they could download the data at will, but the lady at the VAMC sleep clinic said it was not enabled at that time.

If you are having any issues with the mask not fitting correctly or taking it off in the middle of the night, be sure to contact the sleep clinic as soon as you can. They tried a number of masks until I got one that works for me.

Below is the sleep apnea rating criteria. I heard a commercial on the radio about an implantable device called Aspire (or something) to help keep the airway open while sleeping. Makes me wonder if that would be considered as a "breathing assistance device"...

 
Quote

 

6847   Sleep Apnea Syndromes (Obstructive, Central, Mixed):  
Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy 100
Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine 50
Persistent day-time hypersomnolence 30
Asymptomatic but with documented sleep disorder breathing 0

 

 

 

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Thanks for your replies.......I do use my BiPAP ........I have severe health issues when I don't use it...... I just thought it was very odd to have the VA already reviewing my sleep apnea rating only 1 week after they granted service connection for it......I dunno, I guess I'll find out what is going on sooner or later.

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Use it Regardless of a claim,  it could save your life.

And everyone is Right  these new OSA machines have that'' tattle tale card'' in them.

Although I don't agree with what they find sometimes.

I use mine machine at least 8 hrs a night or longer  and took my machine in and the VA Sleep Clinic Dr took the sims card and stuck it in her adapter on her computer and it read I only used it average 2 or 3 hours   The requirement to use it is at least 6 or more hours per night..for compensation purpose  .

.I don't have a SLEEP APNEA Claim in....but.the Dr had thought I did and wrote up all kinds of crap in my Progress notes, 

I went back and mention to the Dr I did use it at least 8 hours  something must be wrong with the test?  she made light of our conversation.

So

for you guys &gals that have a required OSA Machine and your rated for it getting compensation you better use it  other wise you may be getting a reduction in your benefit's.

Edited by Buck52

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