Sleep Apnea Claim Process (my experience, could use advice)

[Diotima]

- So I got out of the military in June 2014 and I had a sleep study later on that year in Sept 2014 as part of my Original Claim. Part of that claim was to see if I could claim Sleep Apnea so I bundled it into the original claim despite having no "evidence" besides as lay statement.

- My home sleep study was "abnormal" not enough data so I was sent to a sleep lab  and told I did not have sleep apnea but that I did have Hypersomnia (according to doctors notes)

- At no time did my doctor relay this note from the sleep lab about Hypersomnia but I did notice they said it was "likely" not connected to my service, so denied essentially... the end right?

- Well I continued feeling very tired and displaying all the classic signs of sleep apnea in my view for several more years. My mother told me as I was sleeping over at her place that it sounded like I had trouble breathing and stopped breathing... so she was notably concerned.

- This jumpstarted the process to get a 2nd sleep study in 2019. This time I received a positive diagnosis for Mild Sleep Apnea and I now have a CPAP

- I am thinking about to my time in the military, working shifts, long hours, and generally having very poor sleep for years due to this. My military records show several entries where I told doctors I was taking Unisom... this was basically added due to having a adverse reaction to Unisom after my other sleep aide ran out and I didn't know any better. This should be indicative of sleeping difficulties as this went on for some time... leading towards a 2nd hospitalization in Al'Udeid after having a 2nd reaction to Unisom (at the time I did not know what caused the initial adverse reaction from the 1st time).

I think someone, such as myself, could tell a compelling story that my health due to a sleep disorder deteriorated starting during the military and aggravated by the military due to various factors. 

Does anyone think I have a possible case or is my evidence to thin? 

 

[doc25]

 

Since you did not have a diagnosis for sleep apnea in-service. Secondary connection is the path of least resistance to take.

You can try to re-open the previous denial in the Supplemental Claim lane with "new and relevant" evidence. A nexus of opinion would re-open the denied Sleep apnea claim.

If you have a service connected disability like a mental health disorder, respiratory/nasal/sinus disorder, or heart condition; you may secondary connect Sleep Apnea to either of those. 

What are you service-connected with and I'll look up medical literature if there's a link.

[Diotima]

9 hours ago, doc25 said:

 

Since you did not have a diagnosis for sleep apnea in-service. Secondary connection is the path of least resistance to take.

You can try to re-open the previous denial in the Supplemental Claim lane with "new and relevant" evidence. A nexus of opinion would re-open the denied Sleep apnea claim.

If you have a service connected disability like a mental health disorder, respiratory/nasal/sinus disorder, or heart condition; you may secondary connect Sleep Apnea to either of those. 

What are you service-connected with and I'll look up medical literature if there's a link.

That was my idea doing a Supplemental Claim but from what I can gather those claims can only be done within 1 year. Since it's been a few years since the original claim that seems like it would not work. I heard you can reopen the original claim and try to go that route however.

I'll look into that nexus of opinion, although that is the first I've heard of that.

I do have a in-service general anxiety diagnosis but nothing that would fit in respiratory/nasal/sinus/heart. I did have to see a cardiologist for a vasovagal syncope they were concerned about but from what I gather the doctor thought I was healthy after seeing him.

Apart from my general anxiety in-service connection I also have tinnitus and spinal issues (30/10/10)

[kanewnut]

10 hours ago, Diotima said:

That was my idea doing a Supplemental Claim but from what I can gather those claims can only be done within 1 year. Since it's been a few years since the original claim that seems like it would not work.

I don't quite understand this. Its been a few years back but I have secondary issues that were granted more than 15 years after ETSing. 

[Richard1954]

On 6/25/2019 at 1:27 PM, Diotima said:

I think someone, such as myself, could tell a compelling story that my health due to a sleep disorder deteriorated starting during the military and aggravated by the military due to various factors. 

Does anyone think I have a possible case or is my evidence to thin?

When I received service connected for sleep apnea, I related to the examiner what my wife had told me years earlier... if that helped me or not I do not know... In my case sleep apnea was service connected secondary to asthma/copd...  Usually  a veterans statement is just that a statement.. while we cannot get medical evidence we can give our opinion, and I go one step further and find articles on the internet that back up what I think. What you really need is a independent medical statement since sleep apnea was not diagnosed when you were on active duty... ( mine wasn't either).  It would also take a medical expert to link all the tests you had otherwise separately they are useless to a claim of sleep apnea. My opinion is that since someone in 2014 determined you had Hypersomnia  there really is no way to dispute that opinion.... the time to dispute it would have been when  the test was completed, not years latter.  I also don't think any doctor can go back to that date and come up with a different diagnoses because they did not conduct the test , or see you while you were sleeping.  It was possible for me to get service connection but only as a secondary issue, direct service connection years later ( after you got out of service)  may be hard to get, because of the results and opinion of the first sleep apnea test which I think really hinders your case.  Best of luck..... 

[Richard1954]

39 minutes ago, kanewnut said:

I don't quite understand this. Its been a few years back but I have secondary issues that were granted more than 15 years after ETSing. 

I also have secondary issues and some direct service connected issues that were service connected as long as 33 years after my retirement.... but it is really hard to get direct service connection  years later unless there is something in the medical records... secondary service connection is usually much easier either way... I think most cases years after separation will require an independent medical opinion that is well reasoned and explained completely....

[doc25]

17 hours ago, Diotima said:

That was my idea doing a Supplemental Claim but from what I can gather those claims can only be done within 1 year. Since it's been a few years since the original claim that seems like it would not work. I heard you can reopen the original claim and try to go that route however.

I'll look into that nexus of opinion, although that is the first I've heard of that.

I do have a in-service general anxiety diagnosis but nothing that would fit in respiratory/nasal/sinus/heart. I did have to see a cardiologist for a vasovagal syncope they were concerned about but from what I gather the doctor thought I was healthy after seeing him.

Apart from my general anxiety in-service connection I also have tinnitus and spinal issues (30/10/10)

There's some good news. Sleep Apnea can be Secondary connected to Mental disorders; in your case, your anxiety disorder. It's tough, but doable. 

Below is a medical research that links Sleep Apnea to Psychiatric disorders.

Be advised, going the secondary connection route will re-start the effective date; meaning you'll lose the original effective date because it will be considered a new claim. Sorry to be a debbie downer. Weigh the risks.

Vasovagal syncope can worsen Sleep Apnea, according to some studies,but you are not service-connected for it. If you're not service connected, you can't use it to secondary connect.

SecondarySleepApneaArticle.pdf