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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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JaeNobe

Primary Physician for Sleep Apnea C&P

Question

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 by JaeNobe

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2 hours ago, JaeNobe said:

Thank you so much... 

Is there a difference in at least as "likely as not" and "more likely than not" (more than 50 percent)  - This is what my IMO says.

  1. “is due to” (100% sure)
  2. “more likely than not” (greater than 50%)
  3. “at least as likely as not” (equal to or greater than 50%)
  4. “not at least as likely as not” (less than 50%)
  5. “is not due to” (0%) "

Wonderful! As long as you have one of the top 3 you have a favorable nexus of opinion. #3. Is the minimum threshold for a favorable nexus.

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On 2/8/2019 at 5:35 PM, doc25 said:
  1. “is due to” (100% sure)
  2. “more likely than not” (greater than 50%)
  3. “at least as likely as not” (equal to or greater than 50%)
  4. “not at least as likely as not” (less than 50%)
  5. “is not due to” (0%) "

Wonderful! As long as you have one of the top 3 you have a favorable nexus of opinion. #3. Is the minimum threshold for a favorable nexus.

Thank you so much... that gives me so much hope. I appreciate it!

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5 hours ago, JaeNobe said:

Thank you so much... that gives me so much hope. I appreciate it!

The hope is incredible, isn't it? My whole life has been turned around through my disability awards.

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5 hours ago, Wanderer said:

The hope is incredible, isn't it? My whole life has been turned around through my disability awards.

Indeed it is Wanderer.

In 2014, I was pretty much at the end of my rope. All I had been getting was 20% that didn't start until 2012. I was married with a baby and unemployed(eventually did find work.) I wasn't aware that I could get an increase to the 10% PTSD with MDD I had and I wasn't aware about secondary Sleep Apnea until 2015(initial claim for increase) and 2017(granted sleep apnea), respectively.

In 2016, I was awarded 70% PTSD with Depression, 10% Tinnitus, 0% Hearing loss, and 10% L Knee Patellofemoral Syndrome. My VSO asked me after my award if I had Sleep Apnea by any chance. I said,"Yes. Why?" She said that I could secondary connect Sleep Apnea to PTSD.

So, I submitted the secondary claim, which was DENIED twice. I had the first two parts for secondary connection of OSA:

#1. Must have a SC condition.

#2. Must have a current diagnosis for secondary condition claimed, plus a CPAP and it said "medically necessery" .

#3. NO NEXUS OF OPINION

I was able to re-open my OSA claim with a filled out DBQ from a pulmonologist. Got sent to a C&P exam at another VA and that's where I received the favorable nexus of opinion for secondary OSA.

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10 hours ago, doc25 said:

Indeed it is Wanderer.

In 2014, I was pretty much at the end of my rope. All I had been getting was 20% that didn't start until 2012. I was married with a baby and unemployed(eventually did find work.) I wasn't aware that I could get an increase to the 10% PTSD with MDD I had and I wasn't aware about secondary Sleep Apnea until 2015(initial claim for increase) and 2017(granted sleep apnea), respectively.

In 2016, I was awarded 70% PTSD with Depression, 10% Tinnitus, 0% Hearing loss, and 10% L Knee Patellofemoral Syndrome. My VSO asked me after my award if I had Sleep Apnea by any chance. I said,"Yes. Why?" She said that I could secondary connect Sleep Apnea to PTSD.

So, I submitted the secondary claim, which was DENIED twice. I had the first two parts for secondary connection of OSA:

#1. Must have a SC condition.

#2. Must have a current diagnosis for secondary condition claimed, plus a CPAP and it said "medically necessery" .

#3. NO NEXUS OF OPINION

I was able to re-open my OSA claim with a filled out DBQ from a pulmonologist. Got sent to a C&P exam at another VA and that's where I received the favorable nexus of opinion for secondary OSA.

One more question... my Sleep Apnea notes in the VA systems state "Necessity of the CPAP" as a subject line. She then goes on to list education etc... About two paragraphs down she states that "Treatment for your sleep apnea is critical." I'm hoping that will suffice as its "medically necessary

My C&P is Tuesday. I'm hoping for the best!

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