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jamesriley1990

Reconsideration of Decision

Question

I filed a claim for sleep apnea and PTSD. Originally with my claim, I only had buddy statements for both conditions with the addition of a diagnosis from a doctor for my Sleep Apnea. My claim went to a decision of denied Sleep Apnea due to no complaints in service and PTSD being denied due to lack of diagnosis in my medical records. During the claim period, I was able to obtain a letter from my Psychologist diagnosing me with PTSD and 2 additional eye witness buddy statements. My VSO said we will file a reconsideration instead of an appeal. Has anyone done a reconsideration? All the research I have done states that the VA will reset my effective date, and to not do a reconsideration. My VSO says he's been "swamped" with work to locate all my necessary files to give the VA specific areas in my evidence for them to focus on. 

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14 hours ago, Berta said:

Due to one of my  past suggestions to the VA, they have changed the NOD timeframe under Reconsideration.(2018)

It is explained here:

https://community.hadit.com/topic/73392-file-a-nod-nor-or-wait-for-pending-meb/?page=3#comment-456954

Since it appears you have filed for the Reconsideration already, and if it was for both of your disabilities,you will need new and material evidence for both of them.

," I submitted new material evidence for the reconsideration to include the diagnosis from my psychologist and new buddy statements for proof of in-service trauma."

That might be enough for the PTSD claim.

Can you tell us why they denied for the sleep apnea?

This might be possible as Buck said :

"For the S.A. Claim this maybe the only way to file....file it secondary to your new prescribe PTSD Meds,"

but that will take a strong medical nexus from a doctor.

The sleep apnea was denied due to no complaints in service. Although, I have many buddy statements to include from my wife that state I was witnessed to stop breathing while sleeping. And On my exit physical exam, I stated to the Navy that I had a sleep issue which was not followed up on. And within my year of exiting the service, I claimed a sleep disorder which the VA deemed that I had Insomnia with a mental psychosis. And my psychologist states that my sleep apnea and insomnia stem from my PTSD diagnosis. 

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"And my psychologist states that my sleep apnea and insomnia stem from my PTSD diagnosis. "

If he gives a clear medical rationale for that ( I sggest that you give him a copy of our IMO/IME format in the  IMO forum, that excludes any other etiology of the SA and insomnia, except for the PTSD, then that along with the buddy statements could help gets this service connected.

If it is caused  by  any PTSD meds you take, he needs to state what med, and then bolster that opinion with some good absrracts/ treatices, from medica texts, along with a print out of the med's side affects, to advance that theory of entitlement.

My husband had PTSD and I certainly am familiar with how it interrupted his sleep patterns.Not Sleep Apnea, just dreams of the war trauma.

---------------------------------------------------------------

!!!!!

Disregard the above- but keep the advice in mind-I just went over a few of your past posts-

Your PTSD claim- --has that been denied? You cannot really claim secondary to a disabiity that VA has already denied as SC .

If it has been denied , please scan and attach a copy of the denial and the evidence list.And the date of the denial.

Cover your C file # , name, address, prior to scanning it.

My VSO says he's been "swamped" with work to locate all my necessary files to give the VA specific areas in my evidence for them to focus on. "

That is expecting too much from any VSO. That is our job as claimants.

Do you have copies of all of your inservice SMRS, to include your military personnel file as well as copies of all of your medical records?

VSOs and vet reps often have hundreds of claims in progress.Most of us here only have one or two claims in progress at the same time.We have to locate the "necessary files", and "specific areas" ourselves.And then we have the evidence they (VA)  , as your VSO said, has evidence to " focus on".

They (VA) won't consider a secondary claim if the prime disability ,claimed as it's cause, is not service connected yet.

 

 

 

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On 1/28/2019 at 5:36 AM, Berta said:

"And my psychologist states that my sleep apnea and insomnia stem from my PTSD diagnosis. "

If he gives a clear medical rationale for that ( I sggest that you give him a copy of our IMO/IME format in the  IMO forum, that excludes any other etiology of the SA and insomnia, except for the PTSD, then that along with the buddy statements could help gets this service connected.

If it is caused  by  any PTSD meds you take, he needs to state what med, and then bolster that opinion with some good absrracts/ treatices, from medica texts, along with a print out of the med's side affects, to advance that theory of entitlement.

My husband had PTSD and I certainly am familiar with how it interrupted his sleep patterns.Not Sleep Apnea, just dreams of the war trauma.

---------------------------------------------------------------

!!!!!

Disregard the above- but keep the advice in mind-I just went over a few of your past posts-

Your PTSD claim- --has that been denied? You cannot really claim secondary to a disabiity that VA has already denied as SC .

If it has been denied , please scan and attach a copy of the denial and the evidence list.And the date of the denial.

Cover your C file # , name, address, prior to scanning it.

My VSO says he's been "swamped" with work to locate all my necessary files to give the VA specific areas in my evidence for them to focus on. "

That is expecting too much from any VSO. That is our job as claimants.

Do you have copies of all of your inservice SMRS, to include your military personnel file as well as copies of all of your medical records?

VSOs and vet reps often have hundreds of claims in progress.Most of us here only have one or two claims in progress at the same time.We have to locate the "necessary files", and "specific areas" ourselves.And then we have the evidence they (VA)  , as your VSO said, has evidence to " focus on".

They (VA) won't consider a secondary claim if the prime disability ,claimed as it's cause, is not service connected yet.

 

 

 

Yes my PTSD claim was denied. It was denied for lack of diagnosis. My VSO finally submitted my Reconsideration on 2/1/2019 which included a diagnosis letter from my psychologist to the VA and buddy statements to servicemembers who witnessed my stressor event.

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That is GREAT !!!!!  Keep us informed of what VA does next.....

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On 2/5/2019 at 6:07 AM, Berta said:

That is GREAT !!!!!  Keep us informed of what VA does next.....

Just an update, my claim went to preparation for decision and my claim now only states it is reopened for PTSD. I am unsure if it is relevant or not but my Primary Care doctor called and asked me if I was using my CPAP machine and told me to tell the Triation technicians the problems that I have using the machine. I do not know if the VA contacted my doctor or what, but I've only had the machine for 4 months. I am assuming my claim is going to be denied again without an exam from the VA since I wasn't diagnosed with PTSD from a VA doctor.

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