How do I create nexus for sleep apnea and sinusitis?

[weep4souls]

I'm a Gulf War veteran with 90% S/C for various conditions. Some conditions that have been denied have been frustrating since I'm still suffering with symptoms. How can I create a Nexus for sinusitis and sleep apnea? I'm 30% for asthma and tried to create a relation between sleep apnea and asthma, but that was a no go. I was thinking trying again and tying my PTSD to that. Any thoughts? 

I was also shot down on sinusitis from the get go, but I thought all I had to do was tie my gulf war time to that condition. I guess I was wrong.

Edited July 25, 2019 by weep4souls
Misspelled word

[broncovet]

You dont "create" a nexus.  This must be done by a medical professional.  (Doctor, NP, Voc Rehab specialist, Sleep specialist, etc.  )

You can try "asking" your doc for a nexus.  Do so subtly:  Doctor, do you think this sleep apnea I have could have been caused by (name your in service event, such as a punch in the face, etc) or related to your (SC) sinitus?   

    If the doc says yes, ask him to document it in your records.  VA docs "sometimes" provide a nexus.  Mine did.  He has been with the VA a long time, and he pretty much can not get fired doing so.  

    Or, get an IMO/IME from a private sleep specialist (Sleep doc).  

[ShrekTheTank]

Ok so I don't this that is a part of the presumptive list.  As for a nexus you need a Doctor to write this out for you to show the link.  They will not accept anything from you saying how it is related.  You probably have a case for the asthma as sleep apnea could aggravate it.  Making it a secondary condition.  If you are trying for a direct service connection you are going to have a much harder time.  

Anyway you need a Doctor to do an IMO of how they are linked.  

[paulstrgn]

I am assuming you have been diagnosed with sleep apnea (SA). You will probably need an IMO stating that your SA is caused by your PTSD. Make sure that the doctor states he reviewed all your medical records with making this medical opinion. The IMO also must clearly state how PTSD caused your SA. It may still be denied but you will stand a better chance with the BVA. I would also suggest buddy letters as well as a personal statement indicating your signs and symptoms. This is what I did and finally got my SA SC at the BVA.

[Richard1954]

5 hours ago, broncovet said:

he pretty much can not get fired doing so.  

The VA will not fire employees for providing Nexus statements .. in fact the VA has published guidelines for  medical personal to write statements and fill out forms when requested to do so by the veteran, and they really have no choice but to comply with the request. The veteran may not like what the letter or statements say, but they can get a   written statement.

VHA Directive 2000-029 VA doctor statements.pdf VHA Directive 1134.1 Provision of Medical statements and forms by va doctors.pdf

[Richard1954]

20 hours ago, weep4souls said:

I'm 30% for asthma and tried to create a relation between sleep apnea and asthma, but that was a no go

Actually there  is medical evidence that asthma can lead to sleep apnea... it was this connection that allowed me to get a rating for the apnea. Dr. Anise supplied me a nexus statement (which I didn't need )  but my C/P examiner who was also a veteran said that based on my medical history with asthma/copd  that it was more likely than not that the asthma caused or contributed to my sleep apnea problems. 

Edited July 26, 2019 by Richard1954
spelling

[GBArmy]

This site might get you a connection by way of medical opinion Sometimes you can get a specialist to write an IMO if you give him someplace to start.

http://www.jnmjournal.org/main.html 

Good luck.