Primary Physician for Sleep Apnea C&P

[JaeNobe]

Hello All, 

I recently submitted a claim for Sleep Apnea secondary to depressive disorder on Friday (1/25). Along with submitting the claim I submitted and IMO from a non-VA doctor.  Today Tuesday 1/29 got a call to schedule my C&P. (World Record to me) Was wondering if anyone else thought this was weird and they also said that my C&P exam was going to be conducted with a Primary Physician not a Sleep Specialist.  I also just thought about it. I didn't submit a DBQ with my initial claim. Could this be the reason? Just seemed off I'm not going to a specialist.

Edited January 29, 2019 by JaeNobe

[doc25]

14 minutes ago, JaeNobe said:

no that is the doctor that did my sleep study at the VA and then the same name shows up on the Article you posted. 

My IMO was done by Dr. David Anaise

Wow! What are the odds?

Now you have more added weight to your claim.

[broncovet]

You just discovered another VA "gotcha".  They did the same to me.  I applied for OSA secondary to depression.  They sent me to a c and p doc "with no experince in sleep medicine".  

That is like hiring an expert witness who is not an expert..he is not even "in that field"!!!

You will need to overcome this.  My recommendation is simply wait until you get the c and p exam report.  Check to see if you have all Caluza elements:  Since this is secondary, there are only 2:

1.  diagnosis of sleep apnea, and for 50 percent comp, you need a prescription for a cpap and a doc statement that your cpap is "medically necessary". 

2.  You will also need a nexus, that is, a statement from a doc that your sleep apnea is "at least as likely as not" due to your sc depression.  The doc then should give a medical rationale as to why your sleep apnea is related to depression.  

     You dont need an "in service event" since that was already established with your depression service connection and it need not be repeated. 

Follow these 2 things carefully..if your c and p exam is unfavorable, this may be the time to dispute the qualifications of the examiner, if the doc has no expertise is sleep medicine.  You dont need to bring that up, tho, unless the exam is unfavorable.   

[JaeNobe]

20 hours ago, broncovet said:

You just discovered another VA "gotcha".  They did the same to me.  I applied for OSA secondary to depression.  They sent me to a c and p doc "with no experince in sleep medicine".  

That is like hiring an expert witness who is not an expert..he is not even "in that field"!!!

You will need to overcome this.  My recommendation is simply wait until you get the c and p exam report.  Check to see if you have all Caluza elements:  Since this is secondary, there are only 2:

1.  diagnosis of sleep apnea, and for 50 percent comp, you need a prescription for a cpap and a doc statement that your cpap is "medically necessary". 

2.  You will also need a nexus, that is, a statement from a doc that your sleep apnea is "at least as likely as not" due to your sc depression.  The doc then should give a medical rationale as to why your sleep apnea is related to depression.  

     You dont need an "in service event" since that was already established with your depression service connection and it need not be repeated. 

Follow these 2 things carefully..if your c and p exam is unfavorable, this may be the time to dispute the qualifications of the examiner, if the doc has no expertise is sleep medicine.  You dont need to bring that up, tho, unless the exam is unfavorable.   

Thank you broncovet for you info. 

 

I have an IMO from Dr. David Anaise.  He does use the term "more likely than not (more than 50 percent) level" several times.  Also, my sleep study shows that its necessary.  Im hoping that the RO is just needing an actual Dr. to fill out the Sleep Apnea DBQ. 

[Wanderer]

Now, sleep apnea secondary to depression is a new one on me. What does secondary mean? I have 30 for asthma and 70 for bipolar and have a sleep apnea C&P exam for next week that I'm pretty sure is secondary to asthma. 

How exactly would sleep apnea be related to a mood disorder? Should I look into that route, too? 

[ShrekTheTank]

2 hours ago, Wanderer said:

Now, sleep apnea secondary to depression is a new one on me. What does secondary mean? I have 30 for asthma and 70 for bipolar and have a sleep apnea C&P exam for next week that I'm pretty sure is secondary to asthma. 

How exactly would sleep apnea be related to a mood disorder? Should I look into that route, too? 

So the reason OSA is secondary to a condition is because 

1.  you have OSA and were not diagnosed while in service 

2.  OSA is agrivated by the condition ie (ptsd, asthma).  Could be many others

You need documentation showing where doctors show the condition being agrivated by the service connected condition. Also a nexus would not hurt.

[Vync]

3 hours ago, Wanderer said:

Now, sleep apnea secondary to depression is a new one on me. What does secondary mean? I have 30 for asthma and 70 for bipolar and have a sleep apnea C&P exam for next week that I'm pretty sure is secondary to asthma. 

How exactly would sleep apnea be related to a mood disorder? Should I look into that route, too? 

Central SA has a neurological cause. There could be many, but people with certain MH disorders can develop SA.

Obstructive SA is often seen in people with weight issues or other respiratory issues.