Reopening Sleep Apnea Claim- Options?

[Willy P]

Good Evening Everyone,

I'll make the background story as clear as I can before I get to my situation:

Active Duty 9.5 years, 2006-August 19, 2015.

Six Months after separating, diagnosed with central and obstructive sleep apnea (February 2016).

No previous diagnosis in service, but in 2013 I complained to my doctor about trouble falling sleep, sleep trouble, and starting to snore.  He prescribed decongestants to try and open my nasal passages better.  I never followed up.

Submitted a claim in May 2016 and included a DBQ, Sleep Study records, and the 2013 doctor's record mentioned above.

C&P Exam went well, and the examiner opined that my sleep apnea was "at least as likely as not" caused by military service.

Va denied the claim in August 2016.  I did not appeal because I had nothing else to provide.

Fast forward to present, and I've been realizing that an IMO nexus letter may be all that I was missing.  My current doctor will not write one, so I've had a couple of emails/calls with Dr. Anaise and Dr. Bash.  Both have offered a nexus letter/IMO and said that I should have a decent chance of getting it approved.

My questions are as follows:

1- Dr. Bash mentioned that I should win a CUE based on the positive C&P and the evidence that I provided that I complained of the symptoms in 2013 while still on active duty.  Reading about CUEs has me pretty nervous on this, and I don't want to jeopardize a positive decision just for back pay.  Should I pursue a CUE, try to reopen the claim, or just submit a new FDC after receiving the IMO/Nexus letter?

2- Dr. Anaise offered the Nexus letter for about 1/3 of the price.  I've read that Dr. Bash was expensive but worth it.  Do you think it's worth spending the extra money in this case?  Dr. Bash also said he would fill out the DBQ for me.

3- Is it a reasonable goal to go after back pay to the first claim?  I figured since I missed the appeals window that I would have no shot, but have seen a couple of success stories on here with CUE or a notice of disagreement.

[GBArmy]

Congrats! Hopefully, what you were told shows up in your decision letter. I come from the school that seeing it in writing rather than verbal. Just got to get that letter.

[Buck52]

 Sounds like you need to file to Reopen this claim?  but doing so you lose the EED.

If your not service connected for any disability?   you need to get your sleep apnea service connected and a rating .

usually depending on how bad your S.A. is   if its severe  then usually a 100% rating  if it is just a mild  S.A. it may be only rated 10/to30%

  if your Dr states you need to use a C=PAP AND ITS MEDICALLY NECESSARY for you to use the C=PAP/BI-PAP Machine  then that's usually an automatic 50%.....so its up to you if you think paying these Dr's for their services IS WORTH IT?

   if you think its worth it or not   most veterans do , but you also have the opportunity to choose a local Sleep Dr  that will give his medical opinion/nexus letter and usually they are a lot cheaper.

All you need to do is go back to the sleep study Dr  ask him to write you out what you need to send in to the VA TO BE RATED and you can explain to that Dr just what you need. or better yet a sleep specialist they my not be as expensive as the other Dr's

I'd think long and Hard to file a CUE FOR S.A.

 IF YOU HAVE THE RECORDS TO PROVE IT THEN THERE'S  NO SENSE IN FILING A CUE.

YOU ONLY GET ONE SHOT AT CUE  AND IF YOU MISS IT  YOU CAN'T GO BACK.  UNLESS YOU CAN PROVE THEY NEVER READ YOUR EVIDENCE WHEN YOU SUBMITTED IT.AND IT WOULD CHANGE THE OUTCOME OF YOUR CLAIM TO YOUR FAVOR.

 

[Willy P]

Update 7/3.

It's official- the HLR on VA.gov shows up as closed and my ebenefits effective date on the disability tab goes back to the day after discharge.  Success!

 

 

Now my only question- it looks like when I try to generate a letter, it keeps showing an effective date of December 1, 2019.  Is this just because that is when the 50% monthly compensation rate was last updated, or is there a mistake?

[Willy P]

Update 7/8.

Money in the bank!  Success!  Looks like the back pay is all the way back to the time I left active duty.

[Tbird]

On 7/3/2020 at 10:20 PM, Willy P said:

Update 7/3.

It's official- the HLR on VA.gov shows up as closed and my ebenefits effective date on the disability tab goes back to the day after discharge.  Success!

 

 

Now my only question- it looks like when I try to generate a letter, it keeps showing an effective date of December 1, 2019.  Is this just because that is when the 50% monthly compensation rate was last updated, or is there a mistake?

Congratulations