IMO for Sleep Apnea/cervical - where to get one?

[NoZZZ's]

Hello All,

I am planning on filing a claim for sleep apnea, which was not diagnosed while I was on active duty, as well as cervical pain and Allergic Rhinitis, which were noted in STR's but not officially diagnosed until a few years later, despite continuous treatment for them by the VA. While there is some reference to sleep issues while I was deployed, and treatment records in service for the other two, I want to make my claim as strong as possible from the start.

Having read through many of the posts here and elsewhere regarding the nexus to service connection, I believe I will need an IMO to connect the in service event (injury on deployment) and my current diagnosis for sleep apnea, since it was diagnosed about 9 years after I left active service. My spouse is willing to write a statement regarding the symptoms she has witnessed since I left service until my diagnosis, and I have had two sleep studies confirming a diagnosis of sleep apnea (both done at the VA, 6 years apart).  I plan on trying for direct service connection (unlikely but worth a shot) as well as secondary service connection (I have other SC conditions, but only rated at 20%, to connect it to). The pulmonologist at VA said my chronic pain likely contributes to my sleep apnea, but I am guessing this is not affirmative enough language for the  VA rater, which is why I plan on seeking an IMO, for all three issues I am claiming.

My primary care Dr is at the VA, and tends to write in generalities, so I don't think she will be a good choice for writing the IMO/DBQ (she tells me I have to wear my CPAP or I will stop breathing or die in a car accident, but only writes in my chart that "CPAP is recommended"). I have been looking (unsuccessfully) online for doctors who specialize in providing IMO's, and have read about the ones reviewed here, but was wondering about another I keep seeing pop up in the google searches - VA Claims Insider. Seems like a one stop shop, but I have not found much information about them other than what is offered on their website and Youtube channel.  Also, the idea of paying after a claim increase seems like a good option, since multiple IMO's can be expensive, but I would think this could present a conflict in the eyes of the VA, since the fee increases with the size of the award.  Also, I'm not going to lie, I think it would be great to have someone go over my records and possibly identify issues that I can rightfully claim that I am just not aware of. That seems to be the service they also provide, along with IMO's.

So, any guidance or reviews would be appreciated.  I am pretty confident that I will need the IMO's. I just don't know where to get them without a potentially awkward first visit to a new Dr, "Hi, I know that we just met, but can you write this very detailed letter for me so I can get disability compensation. No pressure."

Thanks, and thank you all for the great info on this site.

P.S. - I do not intend for this to become a thread to bash one service over another, or to endorse any particular service. I would just like some honest opinions about any of the people you folks have used. The nexus letter seems to me to be the deciding factor in many of the BVA appeals I have read. Despite its importance, I have had difficulty finding solid info and advice about getting one.  Also, I assume VA Claims Insider probably reads this forum, and I don't want to disparage anyone who is trying to help vets.

[NoZZZ's]

Ok, I have an ebenefits question.  I am in the process of filing my FDC claim in ebenefits. I am at the lart where they ask for dates for VA medical treatments. Do I put all of the dates I went to the VA for the conditions I am filing for? That would be a lot of dates (but, fewer than my total record, of course).  

[GeekySquid]

27 minutes ago, NoZZZ's said:

Do I put all of the dates I went to the VA for the conditions I am filing for?

@NoZZZ's

that is an interesting question.

When I filled out my latest claim on May 8th, i used my latest date here at this RO. 

After thinking about the question I went with the idea they are just asking if you are getting treatment currently with the VA and at what VAMC.

I think the next question was if I had been treated at another VAMC or something like that.

If I am right it might be an attempt to narrow down where the VA might have the records of treatment.

Either way I got a C&P schedule call about 7 days after I filed, the C&P is on the 28th, about 20 days from filing. That date reflects limits I have as opposed to VA being afu.

I will be curious to see what others think about your question and about what you finally decide.

 

[NoZZZ's]

An update...

So, I filed the claim successfully. The date that I used for the VA records was the first date I went to the VA for treatment. I left the closing date blank. I did find instructions that this was the proper method if you are still being treated at that facility. The VA just wants to know which facility to request your records from. When you submit the claim, you do get an error that there is no end date entered, but it also says to ignore the error if the treatment is ongoing.

Received the call for a C&P about a week after filing, and attended a week after that. It was done at the VA, so I was able to pull up the exam on the Blue Button report about a week later. Sleep apnea was not included in this C&P, so I guess I will have another one for that at a later date. All the other conditions were opined by the examiner as service connected, so I hope that is a good sign.

I did spend a lot of time writing a summary for each condition. I decided to use a chronological list for each condition which included every treatment, from diagnosis to present, with the attachment (with page number) where that medical record could be found. I uploaded all of my medical records, including the VA ones they already have access to, to be as comprehensive as possible.  

So, I guess I am now waiting for the claim to be compiled and forwarded to a rater, pending what may happen (or not happen) with the SA claim.

This is such a curious process. Even though I know what conditions I have filed for (since I suffer from them), I still do not know what I will actually be rated for, and at what percentages.

Time will tell.