Sleep Apnea Secondary to PTSD & EED

[Buck52]

I am gathering up my evidence to file a Sleep Apnea Claim.

I know I need a SLEEP STUDY confirmation  and also a Diagnose for Sleep Apnea

Ok I got that.

what I don't have is a Qualified Dr  or Sleep Specialist mention that  that hey have read my OSA Records and it is his/her professional opinion that this Veteran OSA is at least 50%  less likely as not  is caused by or related to his PTSD,  C-PAP Machine medically necessary to use for his health by the VA Sleep Clinic.

Lay statements from spouse.  Dr's notes Anything favorable to help my claim

I have check my C-file and the diagnose is there the cpap prescription is there  but they sleep study diagnose me wIth Mild Sleep Apnea...but that has got worse  its probably  Moderate to severe now?

I hat to take another Sleep study to prove its got worse so I would be ok just with a service connected secondary condition on the Sleep Apnea  its just 50%  but that be ok as long as I can get it service connected.

I don't think they would be any more $$ in it for me UNLESS they S.C. it at 100% which I doubt they will.  but the S.C. is worth a shot.

my current ratings is as follow

90% Combined Rating  given TDIU -P&T 2003

10%Tinnitus Rated 10% 2002 being paid at the 100%  Rate

Moving up through the years= 17 or so Years later

Chronic  PTSD  Rated 70% Feb 2017 SMC S  Awarded at this time with a 100% final rating

E.D. claim secondary to my PTSD Meds   service connected but at 0% but paid a 108** monthly payment in addition to all my compensation.  so this will not count as for as my rating percentages.

My Question is I am fairly sure they will S.C. this Sleep Apnea at 50%

My Question is can I ask them to go back to the date I was diagnose (June 2015) If I remember this date from reading my C-File last night?

  I have over 5000 pls pages to read in my C-file  but scanning through it  I found  where they DX me and prescribe a C-PAP and also the CHOICE Sleep Study is in there  where the VA MENTION THAT THEY COULD NOT GET ME IN WITH A SLEEP STUDY AT THE VA AT THIS TIME , SO THEY USED THE CHOICE ACT BACK THEN  ITS ALL IN MY C-FILE

I was sent for a Private Sleep Study The VA  Paid for  its also in my C-FILE

Even the phone call to my home  from the VA Sleep Clinic To set up my Sleep Study Appointment  Ect,,,,ect,,,,  When VA Got the sleep study back thids is when they called me and said I had Mild Sleep Apnea and will require a C=PAP Machine

If the service connected this for Mild Sleep apnea and give me a 50% rating will they use the date I filed the claim  or can they use the date I was first  Dx ?

Remember this is For Sleep Apnea Secondary  Claim to my 70% PTSD.

Any Advice  or Tips is Appreciated.

 

[GBArmy]

Buck, just read this post so it goes along with the last one I just did. IMO, diagnostic code 6847 says if the CPAP machine is required for sleep, it is rated at 50%. It doesn't talk to mild, moderate, severe, whatever. Just if CPAP is required it is 50%. Now you can double check with the dbq and see it there is a mismatch somehow, but that is what the symptom says. If it is in your medical records, and the VA ordered you the CPAP, I think you are in. If you wanted to double down, you could go back to the same (or different) sleep clinic prescribed by the VA before and speak with the doc. Bring a copy of your last study, but he should also have it on file. Tell him/her you will pay for another one (Medicare???)BUT, you want him to say at least...50% etc. and reference a study. You can find a study if you fish hard enough and provide it to him; besides, this is your stay at home job while your wife recoops. If you had that as a back up to what else you already have in your medical records, you have to have a damn good shot at it.

[Dustoff1970]

It would be nice indeed if you can find a private or VA doctor to give you a positive statement/opinion that your OSA is caused by or worsened by your PTSD and also state the same on a DBQ.  I have to rely on medical treatment notes and test etc as none of my private or VA doctors will do this for me as they flat out said they will not take time of themselves and staff to do this even when I offered to pay for the DBQ.  IMHO they are just lazy.

So here is what I did and this is my response on another forum "Although BVA decisions are non binding on VARO adjudicators I still use them among my other arguments and evidence I submit with my claims/appeals to the VARO/BVA as it makes me feel good.  In order of importance I do list them and mention them toward end of my wordy claims/appeals processes that have been mostly successful.  You of course must have qualified medical evidence/opinions to submit in your favor to the VARO. Here are just a few that the BVA granted Obstructive Sleep Apnea (OSA) as secondary to PTSD, etc.  There are quite a few others that I have copied and saved and you can also find searching the BVA decisions on their website.

BVA decision citation 1506771 and dated Feb 13, 2015.         BVA decision Citation Nr: 1648003

Decision Date: 12/27/16    Archive Date: 01/06/17.   

These BVA decisions along with CAVC court decisions almost always discuss how they arrived at their final conclusion/orders and this is most useful to me.   A win by any means is still a win and thinking outside the box sometimes wins the day.     Cheers and good luck to you.   

There are also recognized reputable studies by outfits like Mayo, Harvard and others that conclude that Obstructive Sleep Apnea is caused and/or worsened by PTSD and somewhere I have saved this information to disk.   These studies can also be used as medical evidence in support of your OSA claim. Note on another forum the VSOs and former VSOs are constantly telling vets that only being obese or overweight causes Obstructive (OSA) Sleep Apnea and that is pure BS. I am not an attorney, paralegal or VSO.

[vetquest]

I have OSA and am using a CPAP.  I am somewhat obese because I am physically disabled and cannot work out like I used to.  The VA will not rate me for being obese and I am not asking them to.  All I am saying is that being physically disabled can lead to obesity.  I have lost weight but still have OSA and will have it if I get down to my recommended weight.  Pure VA shenanigans when VSO's say only obesity leads to OSA.

[Buck52]

7 hours ago, GBArmy said:

Buck, just read this post so it goes along with the last one I just did. IMO, diagnostic code 6847 says if the CPAP machine is required for sleep, it is rated at 50%. It doesn't talk to mild, moderate, severe, whatever. Just if CPAP is required it is 50%. Now you can double check with the dbq and see it there is a mismatch somehow, but that is what the symptom says. If it is in your medical records, and the VA ordered you the CPAP, I think you are in. If you wanted to double down, you could go back to the same (or different) sleep clinic prescribed by the VA before and speak with the doc. Bring a copy of your last study, but he should also have it on file. Tell him/her you will pay for another one (Medicare???)BUT, you want him to say at least...50% etc. and reference a study. You can find a study if you fish hard enough and provide it to him; besides, this is your stay at home job while your wife recoops. If you had that as a back up to what else you already have in your medical records, you have to have a damn good shot at it.

Yes  the double down is more likely   beings I never had any SLEEP DISTURBANCE IN MILITARY.

  I don't have a copy of the sleep study report? I'm looking for it in my C-file,,,so for no luck  the VA-  Sleep Clinic. Dr's have mention what the apneas were when and how many  ect,,ect,, from the sleep study  that's how they set the correct pressure .

I think these codes are in the normal rage of sleep apnea with

Adult obstructive sleep apnea, mild

Adult obstructive sleep apnea, moderate

  but I don't have the private sleep study report? unless I can't find it in my C-file ? 

I might go back to the sleep study place I did the study and ask them  they are super friendly. it was in Plano Tx

but I need to read through thousands of pages in my C-file  I thought it might be close to where they mention my sleep study   they mention it  that like 8 times  in between my other medical records  eh!

But I can go back to where I had the sleep study  not sure they will still have it in their files  its been about 4 years ago.

Edited November 3, 2019 by Buck52

[Buck52]

Vetquest  don't worry about obesity to file Sleep Apnea. actually being obese helps I would think.

..if your like me I am filing it secondary to my 70% PTSD...just need to get a nexus  to connect the two.  and the nexus has to come from a qualified Dr or sleep specialist.

  I might ask my MH Phyistrist to fill out the Sleep Apnea  DBQ...She probably won't but I am asking her if she will.

if not I'll ask the tech that did my sleep study  if his boss a Sleep specialist   will fill it out or give me an impression letter  stating that it is least likely as not this veteran OSA is caused by or related to his PTSD. AND KNOWN MEDS FOR PTSD AND DEPRESSION.

...I seen where one of the Phyistrist that seen me last time because mine was on vacation  and they tele video me with her she was at her home I was at the VA MH Clinic  on skype  I think  anyway she mention on record  my MDD has worsen and its tied into my PTSD.   But rated for the PTSD   if that makes a lick of sense?

we were talking about my PTSD in the video  its in Myhealthevet notes.

I may start my INT soon....but before I file a claim Iam getting my evidence and what I need to send in with the claim.

[Buck52]

BTW

The   VA MH Dr's a are the ones that referred me to the VA Sleep Clinic..they could not get me into a sleep study  with in 3 months  so they choice it out at the time which was around june 2015  my spouse had mention to  me that I stop breathing while I sleep since take the PTSD Meds, she wakes me up..I mention that to the VA Phyistrist and the reason they set me up a sleep study  all this wa sin my records at the time they rated me for PTSD  THIS JUST GO TO SHOW THEY DO NOT READ ALL OUR RECORDS   F THEY DID i PROBABLE WOULD HAVE BEEN RATED FOR THE SLEEP APNEA...BUT i DIDN'T FILE A CLAIM FOR IT.  EH!