Unattended HSAT for Existing Diagnosis?

[TampaMac]

Background:  Treated for DX of Sleep Apnea not otherwise specified (both obstructive and central) events for eight months prior to medical retirement.  Also diagnosed with Narcolepsy without cataplexy, periodic limb movement, and hypermedia.  Compliance reports all 90% + (100% last 90 days).  I've had three sleep studies done.  First diagnosed sleep apnea.  Second was an MSLT.  Third was a titration study were they watched me overnight and played with the pressure to get the best benefit.  THREE lab studies.  

I submitted a claim for Sleep Apnea a few weeks ago now that the IDES process finished.  Again, DX was made while I was active duty so service connection isn't an issue... and I've had three sleep studies. I was contacted today to schedule appointments related to the claim.  One is for the DBQ which makes sense.  The second is for an unattended in home HSAT test.  That makes no sense.  Has anyone else had to go through this?  The last sleep study was done November 2018.  Doctor has explicitly stated that CPAP is required.  CPAP logs how many events I have each night.  I'm really confused on this.  Hoping someone else has been through this.  I'm concerned that they'll get the results of a home study that they can skew to support I don't have it.  Even if they did, I have three sleep studies showing a DX of sleep apnea, and with conflicting evidence benefit would have to go to me, correct?  Especially since the sleep lab studies are monitored and the in home isn't, I feel that would increase the weight of the lab studies if there was a conflict.

 

Thanks in advance.

[ShrekTheTank]

There really is no need for another sleep study.  You already have a diagnosis and multiple sleep studies.  I would give the WH a call and ask what is going on and why they are trying to delay this process when they have all the evidence they need?  Then I would put in and IRIS complaint and see what is going on.  Then and I would probably do this first is go to you local va hospital and talk to your C&P officer.  They will be able to look it up and see what is going on.  Bring a copy of your prior sleep studies to prove it.  I would still do what they ask, but fight them as there is no need for this.  

[TampaMac]

That's great info, thanks.  I don't think they are necessarily trying to delay it because they are trying schedule within two weeks... but it's just asinine.   It's just like they are trying to find an excuse not to accept the subject info they have.  I know they won't accept a claim without a lab study, so I don't know why an unattended in home study is even in their though process.   I

I've been reading about people getting jerked around for BMI.  I'm going to lose my shit if they throw a hissy about BMI.  At 10% BF at 6'1" and 190, in the middle of the day my BMI works out to be just over 25.  That's also well within military height/weight standards. I feel like one of those kermit the frog memes would go great right now.  I'm like 187 in the morning... so I guess just don't eat or drink before the exam?  

[ShrekTheTank]

Your BMI has nothing to do with sleep apnea.  Especially if you have both!  This is a common tactic to delay/deny if they can.  

If it were me I would fight it as it might stop them from doing it to another vet!

[TampaMac]

I filed an IRIS question so more to follow on that.  C&P people: no impact no idea on who to talk to.  I called the numbers for the C&P and they went to an auto attendant with no way to talk to an actual person.  I talked to the  VSOs representing the claim, and they couldn't see any notes why.  Their best guess was that it had to do with the other claims of narcolepsy, hypersomnia, and periodic limb movement (all diagnosed prior to discharge).  Could any of that factor in?

For my education, what sequence of events does the WH call trigger?  I definitely do want to fight this.  I have my shit together for this: Med records documenting diagnoses while AD, PCM notes for the appointments where sleep issues were discussed and diagnosed, Pulmonary notes from all my appointments (includes "CPAP IS REQUIRED), labs for the last year showing no signs of deficiencies and ruling out possible thyroid issues, and CPAP compliance report for the last year.  I also have statements from two co-workers basically saying my fatigue is clearly noticeable, effects my performance,  I set up remote work days based on when I'm too tired to come in, and that I leave early when I get a sudden spike of fatigue.  

VSO did say that this also might be a check in the box thing they have to go through.  Could there be any truth to that?

[GBArmy]

It's only been 3 weeks if I read your stuff correctly. I'd give it a little time to settle out before I called the WH. It's the VA, man. You are going to wear yourself out. As a couple of guys say, get yourself a hobby to keep busy. JMO

[CuriousVet]

Was there any follow up information on how this case went?