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Sleep apnea feedback

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mccarthy0826

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Morning everyone,

I have a pending claim for sleep apnea that originally was not rated but partially denied for a sleep exam. However the VA had on file three completed studies from my private care and cpap compliance etc for over five years. Myself and my VSO guess that it is positive where  it would be waste of investment in the test to find the outcome they already had valid documentation for.

I went to another C&P exam before thanksgiving and the doctor agreed there was no need for any further testing. My claim passed review and is back in preparation for decision notification(reviewer agreed with examiner to not require another study). 

Just looking for any feedback if anyone has been there with their sleep apnea? Should the point of a test and cost to VA matter in my thoughts? 

I know the biggest part of the game here is connection and I'm never trusting fully of the VA. So I am 50/50 hopeful that where they didn't deny it with all the info they needed to do so if they desired, that the further inquiry to my condition could be just to firm up a rating and more forward with a payment. It also could just be further checking all their bases to deny.

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Do you have access to Blue Button on MyHealthVet? You should be able to see your C&P report on there, if it wasn't done by a contractor outside the VA. I was able to pull up my C&P notes from the last few times I had them for MH, and whatnot, and based on that could get a pretty good idea after looking up the ratings criteria what the decision would be. You can search it by date range for up to 3 years, and pull down all kinds of stuff- your treatment notes, MH notes from sessions, etc. Its a wealth of info. 

 

The big question is "is your apnea service connected".  You can have sleep apnea that is not service connected directly, have a CPAP, and not be rated for it since its not service connected. Some people just develop it. I don't know your situation and im not projecting anything onto it, just laying out the thought process. My apnea is not directly related to anything like PTSD central nervous system apnea, but is a secondary affect of the pain killers and sleep meds that I take causing me to relax so much that it is a aggravated condition cause due to another rated condition. That is how mine ended up SC. It took an appeal, though, probably due to lack of sufficient treatment notes and longevity of condition on my part. Some things, as tempting as it may be to file for right off to preserve the filing date require a duration of treatment to firm up the diagnosis. MH issues, for example- how do you determine severe depression caused by SC conditions or PTSD vs having a really bad few months? I think I waited until id been going to sessions for about 6 months before I filed for MH issues just because if I couldn't sort out the root of it, how was a therapist supposed to do it on 1 or 2 sessions, you know? 

Edited by brokensoldier244th
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What is the Medical Problem that you believe is the cause of your 5 years of an SC SA Award? Not sounding too strong by your talks.

Have a non-VA Sleep Specialist completed either SA DBQ or his Clinician Reports supping a Mil or VA Problem has been deterred the original SA CPAP or BIPAP to start?  Are you RX'd as OSA, CSA or MSA?

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Get your medical and C file.  Be proactive.  READ your file and see if all three Caluza elements are documented.  Make sure the doc said your cpap was "medically necessary".  

You are either going to need some type of "in service event" or aggravation, OR you need to try to SC the OSA to some other SC condition, such as PTSD.  

If you read your file, and all 3 caluza elements are documented, you should be good to go.  

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If you want to claim disability for your obstructive sleep apnea, it’s really hard, but if you can show central apnea are related to an event while on active duty, you stand a better chance. I suggest you hire a disability attorney to help you navigate the system. 
That said, even if you suffer from mild or moderate unrelated obstructive sleep apnea, the new BongoRx is fully covered by the VA and the BongoRX company can ship it right to you. You need a prescription to get a real EPAP like BongoRx, but at least there’s no out of pocket costs. Get one of those rings to monitor your oxygen saturation while you sleep if you can afford the 39 bucks plus shipping. You can get them online. 

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