Sleep apnea- does the DBQ cover the "medically necessary/required" language?

[chibears3531]

Hey everybody! Long time lurker, first time poster.

My question is regarding the sleep apnea language that specifies that a prescription of a breathing assistance device is "medically necessary" for a 50% rating:

Assuming that a vet is already prescribed a CPAP/APAP by the VA, does the sleep apnea DBQ portion under 2B "IS CONTINUOUS MEDICATION REQUIRED FOR CONTROL OF A SLEEP DISORDER CONDITION?" fulfill that language requirement?

Edited December 6, 2018 by chibears3531

[chibears3531]

6 hours ago, doc25 said:

I have to correct myself. In a VA note dated 2-10-16, my pulmonologist documented:

SLEEP LAB REVIEW AND MANAGEMENT NOTE

Subjective: Sleep lab was available for review. Dr. jeffys supplied it.
I have reviewed this sleep study which was performed on 4/27/2009
It was performed at Zerenity Sleep Center, 
Necessity for a cpap was demonstrated. The study demonstrated that 
abnormal respiratory events were abolished by 8 cm h2O pressure.

Assessment: Sleep apnea severe enough to use CPAP

Interesting. Looks like I'll probably have to see if a private doc will write me the medical necessity letter.

[Buck52]

 IT'S GETTING IT SERVICE CONNECTED IS THE HARD PART  ONCE THATS DONE   THEN IT'S JUST A MATTER OF ASKING THE DR THAT PRESCRIBE THE C-PAP IF HE/SHE WOULD WRITE YOU UP A SHORT LETTER,

If you were prescribe a C-PAP I WOULD THINK THE DR THAT PRESCRIBE IT WOULD SAY ITS MEDICALLY NECESSARY TO USE WHILE SLEEPING.

  OTHER WISE WHY DID HE/SHE PRESCRIBE IT.?.

.THEY USAULLY WILL WRITE YOU UP A LETTER  IF YOUR OPEN AND HONEST WITH THEM  ,& LET THEM KNOW YOUR GOING TO FILE A CLAIM FOR YOUR SLEEP APNEA. 

you might go back an recheck your medical records/notes , this maybe in them already? that the c-pap is medically necessary to use for your health. if it just happens to be, then copy it and hi-lite that part with a hi-liter  and send in as part of your evidence.

Nothing wrong with that.

Edited December 8, 2018 by Buck52

[brokensoldier244th]

On 12/6/2018 at 10:18 PM, chibears3531 said:

I'm claiming OSA as secondary to TBI.

Thank you for the journal article. If anyone is reading this or lurking like I was and is seeking more academic journal articles linking PTSD and OSA, the following are strong sources of evidence in my opinion:

http://jcsm.aasm.org/ViewAbstract.aspx?pid=29881

https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201407-299FR

https://www.ncbi.nlm.nih.gov/pubmed/15253098

http://jcsm.aasm.org/viewabstract.aspx?pid=30015

https://journal.chestnet.org/article/S0012-3692(15)00129-4/fulltext

https://www.sciencedirect.com/science/article/pii/S0022399900001471

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5443749/

https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201407-299FR

The problem with journals is that they cover the problem generally, as related to the study participants. They won't aid a presumption of service connection or secondary service connection for 'you'. They help in getting you to a place where you can say "hey, this is whats happening to me, too...." but you still have to have a doctor or the C&P doc opine that YOUR SA is service connected or secondary connected to medicines or PTSD or whatever . 

[chibears3531]

5 hours ago, brokensoldier244th said:

The problem with journals is that they cover the problem generally, as related to the study participants. They won't aid a presumption of service connection or secondary service connection for 'you'. They help in getting you to a place where you can say "hey, this is whats happening to me, too...." but you still have to have a doctor or the C&P doc opine that YOUR SA is service connected or secondary connected to medicines or PTSD or whatever . 

If a doctor has written a medical opinion already, are journal articles even helpful to include in the claim? I was under the impression that I was supposed to include journal articles in the claim that support the independent medical opinion.

[brokensoldier244th]

Unless those journals are about you they aren't useful at all. The claim is based on your service and records, so sending a bunch of links to the examiner just adds more stuff for them to go through. The doctors making an opinion about you is what you want. 

Edited December 10, 2018 by brokensoldier244th

[chibears3531]

5 hours ago, brokensoldier244th said:

Unless those journals are about you they aren't useful at all. The claim is based on your service and records, so sending a bunch of links to the examiner just adds more stuff for them to go through. The doctors making an opinion about you is what you want. 

But what if I'm claiming a secondary condition, the IMO states a causal link between the two conditions, AND the journal articles I've dug up found a causal link between the two conditions thus supporting the theory in the IMO?