should I get my own DBQ

[Wifey]

We're getting ready to file a claim for sleep apnea, secondary to Fibromyalgia.  I have a nexus letter but I know that sleep apnea claims are one of the toughest to get approved.  For those who have gone through this, do you think we should get our own DBQ and submit it with the claim?  Would they just order another one anyway because they do everything they can to prove a claim isn't good enough.  If they have our lay statements, a nexus letter and a completed DBQ both signed by physicians it would be 4 pieces of positive evidence with no negatives.  I'm planning to submit this as a decision ready claim.  I also have his sleep study from the VA confirming his diagnosis in 2014 (severe apnea, CPAP required)  

What do you think?

 

[broncovet]

I think you should also get a letter from your sleep doc that the cpap is "medically necessary".   You should neither underthink nor over think this.  Get the Caluza elements documented.  "Multiple" DBQ's are likely to confuse.  Dont do that "unless" you have an issue that needs clarification.  

If "one" DBQ is "good" then more is not necessarily better.  Be thorough, but focus on the basics of the Caluza elements AND get a letter that says your cpap is necessary medically.  

Im not even real crazy about applying for "secondary" SC, let the VA do their job and consider all methods of entitlement:  Primary, Secondary, and Presumptive.  

Sometimes, we are "too" smart for our own good.  

[Wifey]

3 hours ago, broncovet said:

I think you should also get a letter from your sleep doc that the cpap is "medically necessary".   You should neither underthink nor over think this.  Get the Caluza elements documented.  "Multiple" DBQ's are likely to confuse.  Dont do that "unless" you have an issue that needs clarification.  

If "one" DBQ is "good" then more is not necessarily better.  Be thorough, but focus on the basics of the Caluza elements AND get a letter that says your cpap is necessary medically.  

Im not even real crazy about applying for "secondary" SC, let the VA do their job and consider all methods of entitlement:  Primary, Secondary, and Presumptive.  

Sometimes, we are "too" smart for our own good.  

Thanks, going to submit what we have tomorrow.  I think we have it covered. 

[doc25]

9 hours ago, Wifey said:

We're getting ready to file a claim for sleep apnea, secondary to Fibromyalgia.  I have a nexus letter but I know that sleep apnea claims are one of the toughest to get approved.  For those who have gone through this, do you think we should get our own DBQ and submit it with the claim?  Would they just order another one anyway because they do everything they can to prove a claim isn't good enough.  If they have our lay statements, a nexus letter and a completed DBQ both signed by physicians it would be 4 pieces of positive evidence with no negatives.  I'm planning to submit this as a decision ready claim.  I also have his sleep study from the VA confirming his diagnosis in 2014 (severe apnea, CPAP required)  

What do you think?

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783078/ Research this article. It links OSA to Fibromyalgia. 

The DBQ and nexus letter combined adds weight to the claim, but the nexus of opinion must contain the minimum threshold of "at least as likely as not" the claimed condition is due to or the result of the veteran's service connected Fibromyalgia.

The research article can be added as the rationale. 

You're ahead of the curve with the diagnosis, sleep study; does any of the documentation state "medically necessary/required" CPAP?

[Wifey]

5 hours ago, doc25 said:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783078/ Research this article. It links OSA to Fibromyalgia. 

The DBQ and nexus letter combined adds weight to the claim, but the nexus of opinion must contain the minimum threshold of "at least as likely as not" the claimed condition is due to or the result of the veteran's service connected Fibromyalgia.

The research article can be added as the rationale. 

You're ahead of the curve with the diagnosis, sleep study; does any of the documentation state "medically necessary/required" CPAP?

Thanks for the article.  The nexus letter does contain the magic words and has a medical journal attached but I'm not sure if it is this one. I'll include both. 

I do think we need to get a statement saying "required ". It says Severe apnea and recommend initiation of Aito PAP therapy.  I'll put a request in ASAP to his DR.

[Wifey]

I have searched and searched on line for what are the medical requirements for when a CPAP is REQUIRED vs. recommended and I can't find one article telling this.  I found hundreds that say severe apnea is treated with a CPAP among other options like surgery etc. But not one saying it is REQUIRED.  I found articles defining mild, moderate and severe (anything over 30 per hour is severe and he has 64 per hour). I know that this letter has to come from a Dr. but I just wanted to at least find the guidelines so I could make it easier.  We have had ZERO luck getting any VA doc to ever write anything.

[doc25]

34 minutes ago, Wifey said:

I have searched and searched on line for what are the medical requirements for when a CPAP is REQUIRED vs. recommended and I can't find one article telling this.  I found hundreds that say severe apnea is treated with a CPAP among other options like surgery etc. But not one saying it is REQUIRED.  I found articles defining mild, moderate and severe (anything over 30 per hour is severe and he has 64 per hour). I know that this letter has to come from a Dr. but I just wanted to at least find the guidelines so I could make it easier.  We have had ZERO luck getting any VA doc to ever write anything.

This veterans law article will clarify what we mean 

https://veterans.perkinslawtalk.com/post/bad-secret-change-to-va-sleep-apnea/