Uvulopalatopharyngoplasty

[rlmorales21]

Hello.. first time posting here.  Here is a quick brief and I am looking for assistance on how to proceed.  I am 20 year retired Vet.. In 1996, I opted for Uvulopalatopharyngoplasty (UPPP). When I was about to retire I asked for another sleep study and I was found to still have still have sleep apnea.  I retired in 2007.  I received 0% service connected for it.  I appealed it but was denied.  I would like to appeal it again.  I am going back to request another sleep study. Does anyone have any information that can assist me to hopefully get a higher rating. Thanks in advance.

[Berta]

Can you scan and post their denial here- to include the Evidence list?

https://www.verywellhealth.com/what-is-uppp-uvulopalatopharyngoplasty-1192060

I had to google this.

The schedule of ratings is here in a separate forum-I suggest you look up the sleep apnea ratings there to see what rating you should have fallen into in 2007 and what rating the medical evidence would warrant now.

That procedure is supposed to relieve Sleep apnea, and it is possible the "0" % was right -at that time.

If it is worse now, then by all means claim re-open that claim with New medical evidence.

It used to be "new and material" , now it is called New and Relevant evidence.

This is an excellent article by Chris Attig, hadit member and vet attorney explaining that.

https://www.veteranslawblog.org/va-appeals-modernization-ramp-supplemental-claim/

This is one of many BVA decisions with sleep apnea and UPPP in them.

"ORDER Service connection for obstructive sleep apnea is granted. Service connection for residuals of uvulopalatopharyngoplasty is granted. Service connection for residuals of Hashimoto's disease is granted. Service connection for temporomandibular joint syndrome is granted. The appeal for sinusitis is dismissed."

https://www.va.gov/vetapp18/files1/1800645.txt

But this vet's claim failed:

https://www.va.gov/vetapp18/files5/1828946.txt

A full reading of his SMRs by a real doctor with expertise in the field of SA, in an IMO/IME-which might have been costly- but possibly worth obtaining, might have warranted a far different result.

IMO-IME Independent Medical Opinion or Examination-we have a full forum here on that.

 

 

 

 

 

 

 

[paulstrgn]

It took me four years to get my SA SC, it was approved by the BVA. I got a referral through my PCM to see a sleep specialist (it was paid through Tricare - I am also retired) and had a sleep study. I was prescribed a CPAP by the doctor. Now I had to pay the doctor $450 to write a medical opinion (I thought that was a lot but it was low compared to most). I also had buddy letters, one from my NCOIC, ex-wife and daughter. I also wrote out a statement concerning my issues. I originally filed for this in 7/2015 (that is when I filed my first claim with the VA, which was 20 years after retirement). But it took the BVA to approve my SA, I got no where with the RO or higher reviews. TI filed the appeal to the BVA 8/2018 and it was approved by the BVA 7/2/2019. But remember in order to get rated at the 50% you must be required to use a CPAP machine. 

Get a new sleep study and have the doctor write up an IMO. Good luck.

[broncovet]

Do you use a cpap??  Unless you are using a cpap AND your sleep doc puts a note in that your CPAP is "medically required", then you cant get 50 percent for sleep apnea.  

https://www.law.cornell.edu/cfr/text/38/4.97

Above is the criteria for sleep apnea.  It ranges from 100 percent for central sleep apnea, to 0 percent for asymptomatic.  

The usual rating is 50 percent provided that you use a cpap.  If you are not using a cpap, then the best you could get is 30 percent.  Or, more likely, 0 percent.  

The VA is required to use the criteria.  

 

 

 

[Berta]

That 50% SC  would surely put you in the criteria for CRDP.

https://community.hadit.com/topic/70182-ptsdmst-crsc/

That link contains the links to CRDP from Mil.com- if the links dont work let me know-

 

 

 

[Berta]

Good -they work-

https://www.dfas.mil/retiredmilitary/disability/comparison.html

CRDP is automatic if you reach 50% or more SC- CRSC has to be applied or and you can only choose one benefit-CRDP or CRSC, as sometimes they both might apply.

[rlmorales21]

Thanks everyone for the advice/help.. I will look into everything.. I have a sleep study schedule for the 06 Aug 2019.  I will update this and time goes with the results.