Sleep Apnea secondary to PTSD and Sinusitis

[MrStryker]

I had made another post but I think this title is more appropriate.

I got my RAMP decision letter for my OSA denial.  In a nutshell,

"The evidence does not show that sleep apnea is related to the service-connected condition of PTSD personal trauma, alcohol use disorder, nor is there any evidence of this disability during military service. In general, there is not a relationship of sleep apnea to post traumatic stress disorder. Sleep apnea involves the respiratory system and the airway where as PTSD is a mental condition. However, all cases are different. If you have a medical opinion from a physician stating that your sleep apnea is caused by PTSD with a reasonable rationale, please submit it and we will reconsider."

Not mentioned even on the evidence list was my IMO from Dr Anaise.  The only mention was the DBQ from my psychiatrist which gives an opinion relating PTSD and sinusitis, which are both service connected.  The IMO and DBQ addresses PTSD and sinusitis.  The evidence was submitted using E-Benefits.  The legacy system doesn't allow uploads of documents but RAMP does.  I'm not sure if the rater didn't check the upload folder? 

Should I do another supplemental and resubmit my IMO?  I also got an IME from Dr. Ellis that was not part of the original appeal.  I was under the impression the VA rater isn't supposed to make a decision without opposing medical evidence?  Also he/she mentions that sleep apnea is a respiratory problem....  Is the rater even allowed to say that without having a C&P exam?

Edited February 12, 2019 by MrStryker

[broncovet]

Have you read Dr. Anise's opinion??  Did he say your osa was related to ptsd?  If so, then you could presume that the va "did not have" the doc's report, thus you could submit it as new evidence.  

Yours will NOT be the first time VA has ever lost evidence, and its unlikely to be the last, either.  Was his report listed in the evidence section?? 

[MrStryker]

9 minutes ago, broncovet said:

Have you read Dr. Anise's opinion??  Did he say your osa was related to ptsd?  If so, then you could presume that the va "did not have" the doc's report, thus you could submit it as new evidence.  

Yours will NOT be the first time VA has ever lost evidence, and its unlikely to be the last, either.  Was his report listed in the evidence section?? 

Yes his report addresses the relationship between PTSD and sleep apnea and gives a more likely than not opinion.  It was NOT listed as evidence on the decision letter, even though it was submitted via E-benefits.  On RAMP appeals it shows under claims and you're able to upload docs.

[Wayne TX]

We're in the same OSA boat.  I sent VA an IMO from Dr. Anaise and another from a Physician Assistant - both stated more likely than not s/c to existing secondaries.   VA still denied OSA........been diagnosed twice and on CPAP since 2015.......they said their two VA Examiners stated less likely than not.   What happen with tie going to the runner?  They did not attack either of my IMO's, but went into a lot stating why their VA Examiners denied.   They said my SMR is silent for OSA , but the Appeal was based on OSA being a secondary claim.  Fishy BS.....I put in another NOD immediately and this time for a Board Hearing....done with High Level Reviews by flunkies finding examiners or making them up to deny. .

[MrStryker]

4 hours ago, Wayne TX said:

We're in the same OSA boat.  I sent VA an IMO from Dr. Anaise and another from a Physician Assistant - both stated more likely than not s/c to existing secondaries.   VA still denied OSA........been diagnosed twice and on CPAP since 2015.......they said their two VA Examiners stated less likely than not.   What happen with tie going to the runner?  They did not attack either of my IMO's, but went into a lot stating why their VA Examiners denied.   They said my SMR is silent for OSA , but the Appeal was based on OSA being a secondary claim.  Fishy BS.....I put in another NOD immediately and this time for a Board Hearing....done with High Level Reviews by flunkies finding examiners or making them up to deny. .

My evidence wasn't even listed. That's what makes me mad. 

[vetquest]

Don't get mad, file an appeal.  If you can get to the BVA they will read all of the evidence and usually award.  I had this many times were the VA refused to consider all evidence.

[Holllie Greene]

Great advice from Vetquest "don't get mad, file an appeal".

Just my two cents worth.