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?

 

[Wifey]

9 minutes ago, doc25 said:

This veterans law article will clarify what we mean 

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

thank you for that link.  I actually did read that but like so many thought it just didn't apply to us because his apnea is "severe", of course he has to use a CPAP.  I'm definitely going to call the VA hospital tomorrow and see if they will put it in writing.  This is just crazy.

I just finished filing the claim and uploaded everything I have.  I'm only missing the nexus letter which should arrive tomorrow and the note from the doctor that says the CPAP is required.  I'll run my butt off to get that ASAP.  I know they won't decide anything that fast so I can still upload those things tomorrow.

Problem, I hit the submit claim button, it showed that everything was complete, but then when I went to look at my open claims it wasn't there.  Does it take a few hours to show up?  sure hope so.

[acesup]

To satisfy the requirements of Medicare and my private insurance, my civilian doctor had to provide a "Certificate of Medical Necessity (CMN)".  I think any doctor (and their staff) will know what a CMN is.  I would also think any doctor who would "recommend" a C-PAP would supply a CMN if you ask for it.  Good luck with your claim.

[doc25]

20 minutes ago, Wifey said:

thank you for that link.  I actually did read that but like so many thought it just didn't apply to us because his apnea is "severe", of course he has to use a CPAP.  I'm definitely going to call the VA hospital tomorrow and see if they will put it in writing.  This is just crazy.

I just finished filing the claim and uploaded everything I have.  I'm only missing the nexus letter which should arrive tomorrow and the note from the doctor that says the CPAP is required.  I'll run my butt off to get that ASAP.  I know they won't decide anything that fast so I can still upload those things tomorrow.

Problem, I hit the submit claim button, it showed that everything was complete, but then when I went to look at my open claims it wasn't there.  Does it take a few hours to show up?  sure hope so.

Request to speak to a patient advocate and explain the circumstances that an addendum needs to be made to the Dr. Note that established the sleep apnea diagnosis that : use of a medically necessary cpap machine is required.