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Avi8tor66

2nd Sleep Apnea Exam

Question

I have a claim in for sleep apnea and I had a complete sleep study 9 months ago. My claim was filed complete with the sleep study records and  a completed DBQ. My study was not done with the VA, my PCP set it up with a local sleep clinic at the hospital. I have a diagnosis of moderate OSA (Cpap needed) with occasional central episodes, RBD ( acting out your dreams) and PLMD/RLS. 

The VA contractor (VES) called to set up an appt. and they did not have a copy of my sleep study or medical records mentioned above. The VA has the records so I am confused...is this appt to set up another sleep study? Or possibly to have the NP doing the exam review the DBQ and offer a Nexus?  I am hoping I do not have to do a sleep study again...I have SC PTSD and sleeping is very difficult for me anyway, much less in a hospital setting, strange surroundings, etc. 

My question is  has anyone had to have an additional C&P exam (sleep study) when the one they had before was only a few months before?  Also when there was a completed DBQ submitted along with the study notes and records that documents the diagnosis?

Any help is appreciated!

 

 

 

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23 hours ago, Avi8tor66 said:

I have a claim in for sleep apnea and I had a complete sleep study 9 months ago. My claim was filed complete with the sleep study records and  a completed DBQ. My study was not done with the VA, my PCP set it up with a local sleep clinic at the hospital. I have a diagnosis of moderate OSA (Cpap needed) with occasional central episodes, RBD ( acting out your dreams) and PLMD/RLS. 

The VA contractor (VES) called to set up an appt. and they did not have a copy of my sleep study or medical records mentioned above. The VA has the records so I am confused...is this appt to set up another sleep study? Or possibly to have the NP doing the exam review the DBQ and offer a Nexus?  I am hoping I do not have to do a sleep study again...I have SC PTSD and sleeping is very difficult for me anyway, much less in a hospital setting, strange surroundings, etc. 

My question is  has anyone had to have an additional C&P exam (sleep study) when the one they had before was only a few months before?  Also when there was a completed DBQ submitted along with the study notes and records that documents the diagnosis?

Any help is appreciated!

 

 

 

I have a few questions.

#1. Did you claim OSA, as secondary to PTSD? Or as a Direct-Service Connection claim?

#2. Do you have a copy of your DBQ and sleep study?  

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You will more than likely need to file a secondary claim to PTSD DUE to the medications that would cause the OSA (Sleep Apnea) as required a necessary medical condition to use a C-PAP Machine prescribe by the VA THIS MUST BE STATED BY A QUALIFIED Dr.

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As with many Vets, you have gotten the cart before the horse.  Did you check your documentation of the Caluza elements??  You wont get any benefits without them.  

I dont know why your c and p exam did not review the sleep study.  Did you give a copy of that private sleep study to VA?  

Remember, the doc does not have to necessarily have a "paper" copy of your records, an electronic record will suffice.  So, if you gave VA a copy of your sleep study, it "should" have been entered into your electronic medical records.  

To have much of a chance of winning your claim, you need to make sure that your sleep study IS entered into your VA medical records.  The VA has made an additional requirement for sc for oSA:  The doc has to say the cpap is "medically necessary".  In order to do that, the doc would need to view your sleep study as that demonstrates whether you need a cpap or not.  

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On 1/6/2019 at 9:55 PM, doc25 said:

I have a few questions.

#1. Did you claim OSA, as secondary to PTSD? Or as a Direct-Service Connection claim?

#2. Do you have a copy of your DBQ and sleep study?  

Yes I did claim Amy OSA as secondary to PTSD. I did do a sleep study (not through VA) and have a completed DBQ. The VA has the copies of everything. 

I just got back from my C&P exam with VES, and the NP was nice, asked me some questions, had not and did not look at any of my records, sleep study, etc. She said the VA has them. Should I be concerned that she hadn’t and didn’t review my records? My wife said perhaps she was gonna look at my records later, prior to sending in her report to the VA.  

Any input, etc is appreciated!  Thanks! 

 

 

 

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On 1/7/2019 at 6:19 AM, broncovet said:

As with many Vets, you have gotten the cart before the horse.  Did you check your documentation of the Caluza elements??  You wont get any benefits without them.  

I dont know why your c and p exam did not review the sleep study.  Did you give a copy of that private sleep study to VA?  

Remember, the doc does not have to necessarily have a "paper" copy of your records, an electronic record will suffice.  So, if you gave VA a copy of your sleep study, it "should" have been entered into your electronic medical records.  

To have much of a chance of winning your claim, you need to make sure that your sleep study IS entered into your VA medical records.  The VA has made an additional requirement for sc for oSA:  The doc has to say the cpap is "medically necessary".  In order to do that, the doc would need to view your sleep study as that demonstrates whether you need a cpap or not.  

Thank you for your response. Yes, the VA has an electronic copy of my records, sleep study, DBQ, etc.  

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