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Sleep Apnea


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Question

Has anyone tried to connect sleep apnea to being caused by working a rotating schedule.  I worked 2 days 2 swings 2 mid for about 13 years out of my 20.  Rest of my career was rotating schedule but it was not as xtreme. 

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  • HadIt.com Elder

You can have some other type of disorder, but sleep apnea is caused by a physical or neurological short between your brain and the muscular action of breathing. Shiftwork disorder might be a possibility, maybe, but probably not sleep apnea. Off kilter work schedules can aggravate existing sleep apnea, though. Note this study discusses apnea events being more prevalent in people that already have sleep apnea. 

 

https://www.ncbi.nlm.nih.gov/pubmed/18204146

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Well as I was reading the Sleep Apnea field manual I read about the Obstructive and Central Sleep Apnea.  I was diagnosed with complex sleep apnea which is a combo of the tow.  Anyway I have found many studies on shift work disorder that cause obesity, well Obesity is directly linked to Obstructive sleep apnea.  I also have 3 herniated disk in my back neck that I have been rated on.  which falls under damage to the neck cervical spine nerve paths and have been diagnosed with sciatic nerve.  Wonder if they can be linked back to my sleep apnea as a secondary service connection.   

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  • HadIt.com Elder

My SA is secondary to my back (lower nerve impingement just above caudal area) and inactivity due to pain and obesity, so THAT is doable. I had to appeal mine the first time, but I did succeed. 

The SA would be secondary to your back and/or shift work disorder- you'd have to get a doctor, obviously, to connect it, though. I don't know much about shift work disorder, other than its a thing so Im not sure if you would have a sleep study, or what for that. Good luck! 

 

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If you have had a sleep apnea study done at a private or VA sleep clinic they might be able to answer your question on shift work causing and or aggravating SA (especially a private sleep clinic or sleep doctor specialist).

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Its "all about the evidence".  Has a doctor opined that your OSA is at least as likely as not due to your shift rotations in the military?  If so, you should be able to get SC.  

If none of your docs have made that or a similar nexus, then you would need an IMO/IME stating the same.  

I dont know if a IMO/IME doc will make such an opinion or not.  YOu can contact them and ask them.  

It really does not matter if WE think shift work is related to sleep apnea, it matters what the docs say.  You could call a sleep docs specialist near you and ask them.  

Its my opinion that VA docs are unlikely to do that, but they might.  

I have an extremely "Veteran Friendly" VA doc.  I "happened" on this doc "by chance" (or, more likely, because God has blessed me).  

If you dont already have a favorable nexus in your file (the only way to know that is to get your medical files and read them) , try asking around.   You "might" be able to get a Veteran friendly doc by going to your VAMC sleep doc waiting room, and ask Vets there if Doc "(your doc)" is Vet friendly when it comes to writing a favorable nexus.  If your doc is not "Veteran friendly" ask to change your doc, until you find one that is Vet friendly.

Now that method is for Vets "who can not afford" the costs of an IMO/IME, which can run from about 500 for a low, to 10,000 plus.  

One "other" method that works well if you can not afford an IMO/IME: 

After your denial, get you a Vets attorney, Nova certified.  I have heard of more than one who will "up front the cost of an IMO/IME" to deserving Vets (where the attorney feels an IMO will seal the deal).   (Mine did).  I paid for the IMO "only after" I got my retro check.  

Edited by broncovet
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Not sure I know I was finally treated with sleep apnea at my local VA hospital given a cpap machine and told I have a circadium  rhythm issue preventing me from grave yard shift and sleeping during the day so I tried and I would spend 3 to 4 days up straight every other week for four months before I had to give it up the shift. But my case isn’t yours I have lumped in with my sTBI residuals sleep disturbances and insomnia which would probably make it impossible to try and separate sleep apnea since I have 3 other issues connected with the TBI. But barring you don’t have anything else related to sleep apnea or anything you could claim as secondary with already other issues tied to it I don’t see why not.... sorry if thats confusing ask if you want anything else clarified 

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  • HadIt.com Elder

To a point, however just finding a doctor to say what you want won't get you a good IME. Lots of people go to the courthouse all the time with IME's of all sorts of disabilities and things during lawsuits, where they literally pay a doctor to say whatever they want. Some doctors will. Its unethical, and they should have their licenses removed. 

I don't consider doctors that charge 500-10,000 dollars and advertise on the internet as 'vet friendly'. I consider they to be predatory. There is no way a doctor can churn out IME's for veterans like some of them do and still treat patients or stay abreast of current medical knowledge- you know, 'being a doctor' stuff. They have ceased becoming doctors and are akin to prescription mill docs that will sign off on anything- for a fee. *plink plink* My two cents. 

 

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I think 500 for a vocation assessment and or doctors opinion isn’t the far off. I paid 500 for one after one person tried to charge me 10k because it was sTBI and knew I had years of retro l obviously didn’t pay the 10k and he missed out on a dime...

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After having read hundreds of BVA and CAVC veterans court decisions over past thirty years and up to present day I can tell other vets that many paid for private doctor IMOs made the difference in the BVA granting a vet his disability appeal as in many of these BVA decisions the BVA law Judge stated that Dr. Jones or whoever detailed medical opinion was more credible or probative evidence than the VA C&P Examiner's negative opinion against the vet's claim and especially that the C&P examiner did not offer up any detailed rationale explanation to justify his opinion against the vet.

Yes it is typical that the initial VA raters ignore or downplay the private doctors IMO thus forcing the vet to win his claim on a drawn out five year appeal. No coincidence there.

From my experience and experience of many others many private and VA treating doctors and specialist for all sorts of reasons including laziness will not get involved in helping vets with nexus medical opinions to help their disabilities claims.

My late family doctor of 50 years did write nexus letters on my behalf but of course the GD VA raters completely ignored his opinion.  Now some veterans are fortunate enough to have a veteran friendly private or VA doctor that do the DBQs and nexus letters for them and some of these vets bragg about this a great deal on another forum. Typical 

I find many apologist for the VA claims system are full of BS.  My information is not legal advice as I am not an attorney, paralegal, or VSO.

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Why should you have to pay more for an opinion? It's their job.

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@brokensoldier244th They may have been a victim of some VA C&P examiners doing a poor and inadequate job. I know I had a couple of C&P exams last year that were really sloppy and I'm planning to appeal on that basis.

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I think brokensoldier has missed the whole point of my post on the subject of non treating private doctors IMOs.

Except for family doctor whose a long time friend I don't know of many private civilian doctors that do anything for free unless they happen to be your paid for treating doctor collecting payment from you or your insurance to provide you with health care and many of them will still not provide nexus letters or DBQs.  This should be as clear as a glass bell.  Good grief.

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On 1/8/2020 at 10:02 AM, brokensoldier244th said:

Why should you have to pay more for an opinion? It's their job.

Your paying for them to review all of your medical evidence and state their opinion and they have their license. Your a random  person in need of evidence it not their job to take hours to go over your records and give an educated doctors opinion... 10k is way to much I agree 

Edited by jfrei
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I disagree. If you don't have a relationship with them as a patient they shouldn't be writing things up for you. Those are the doctors that Better Call Saul hires for insurance hit jobs. If you have a relationship with your doctor, part of their job is rendering diagnosis and knowing your history. Spending a few hours with your records and listening to you complain about your issues in a letter or over the phone is not a patient doctor relationship. I think doctors should get paid, but they shouldn't hire themselves out on the side for people they have never treated. They are basically lying- they have never treated you, or even met you (royal 'you'). They are just reading your notes and writing up something- and since you are paying them a disgusting amount of money why wouldn't they write something favorable? Even if you lose your claim they still have the money. Its a racket. 

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Any time you pay A Dr for his/ her service  they become the Dr'Patient

As for a a Relationship   this is a relationship your telling the Dr what you need from him, its a short relationship but never the less its a relationship

After you let this privateDr know want from him and he understands what your needing and reads some of your military records   not all of them but the one  that pertains to your claim and you guys make a deal  or how much the Dr is going to charge you to write his / her professional medical opinion  If he examines you thenthis is a IME   I  should say this is why I use the private Dr (specialist)  because the VA Dr's will not do it   or most of them won't you get a VA Dr that will help then sure use him/her   but this whole thing is about getting a Dr to create a nexus FOR US TO WIN OUR CLAIMS.

its an IMO/IME

I really don't know why you don't Agree with this method.?

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To begin with these private paid for Doctor IMOs are perfectly legal and acceptable by the Board of Veterans Appeals and Federal Courts including CAVC and Fed Appeals Circuit in D.C. as credible medical evidence for many decades.

From my own 35 years personal experience filing claims and appeals with VA/BVA many VA raters, adjudicators, DROs and C&P examiners are outright dishonest in evaluating our disability claims in that they outright lie on their written reports and decisions and I have given many examples of this in my other many post on this and other forums so therefore there is nothing unethical about vets paying for support and assistance from outside doctors and lawyers.  What is good for the goose blah blah blah.

I notice there are some vets that post this high moorlastic  crap on this and another forum over and over and over again and also ask the same questions and make same statements on both fourm over over and over again.

feeling lonely I guess

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The system is broken. The VA hires medical people to do inadequate exams, that are incomplete,  way too short of time for the task involved, without complete medical files to review for the C&P, sometimes by people not qualified to make appropriate evaluations because of lack of expertise, and somehow, if we get an outside medical opinion to support the veteran's claim, that is wrong??? It's the VA's systems; you have to play by their rules. It is allowed. If you need extra help, it's allowed and you don't do it, you're stepping up to the plate with a strike already called before you get into the batter's box.

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Well its ok if some members want to disagree with getting outside Dr to help with our claims or to get their medical opinion,  After all we pay them good money for their professional opinion  and None of us are asking them to lie....a good example  I had a VA Dr that flat out lied his teeth off   (why) we don't know why? other than they love to take a veterans benefits away because of their POWER.

Well the VA has to take his word and usually the Veteran ends up with a denial and We have to Appeal  the whole enchilada goes out the window,,,,and basically the Veteran has to start over  with the exception of his EED, if he/she continues his appeal on a timeline.

Well we go see a Private Doc and talk to him and let him know what we need  let this other Dr read what this VA Dr IS SAYING ABOUT YOUR MEDICAL HISTORY AND YOUR HEALTH ect,,,ect,,,

..ok he reads your records or the petient record about what your claiming  and after he examines you and reads your pertaint records about what it is your claiming  then this Dr (prefer a specialist) Board Certified ,let this specialist give his medical opinion on you and he uses the VA Guidelines and Rules and goes by the CFR's  the whole bottle of wax...this takes time so it's not like these Dr or not earning their $$ and it is us Veterans that are going to pay these Dr  for their medical opinion and that helps us out  rather or not for a condition or whatever the case maybe   he can go up agianst this VA Dr and with a through explanation and with his medical expertise the VA usually will go with the specialist in most cases.

These private Dr's bassaicly do what the VA Dr's should have done in the first place.

Now some times we need to let these Dr's know some about our claims & ourself and how the VA likes things worded  like as least likely as not   ''is likely as not'' or ''related to '' ect,,,ect,, and how the VA treats us , and you can tell him that  as he reads some of your records that you take for him to read, these Dr are just as smart or smarter as the VA Dr's and if a Veteran needs a second opinion because of a VA Dr That don't put out enough information favorable to the Veteran  then this is why we need these Dr's for their expertise and opinion...it really makes these VA Dr's seem like Idiots.

Let these Dr's know  how the VA lIkes things worded  ie likely as not   is at least likely as not   or is 50%greater  its basically saying it is  more likely  than saying direct yes it is related to or yes it is  ect,,,,ect,,,,

This is good for the private Dr if they have ANY Legal concerns   if they use the VA Lingo.

Edited by Buck52
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6 hours ago, GBArmy said:

The system is broken. The VA hires medical people to do inadequate exams, that are incomplete,  way too short of time for the task involved, without complete medical files to review for the C&P, sometimes by people not qualified to make appropriate evaluations because of lack of expertise, and somehow, if we get an outside medical opinion to support the veteran's claim, that is wrong??? It's the VA's systems; you have to play by their rules. It is allowed. If you need extra help, it's allowed and you don't do it, you're stepping up to the plate with a strike already called before you get into the batter's box.

I didnt say getting an outside medical opinion is wrong. What is wrong, and toeing the line of doctor shopping, is paying a doctor unreasonable amounts of money, that barely knows you, to write up a claim and opinion based on stuff you send them in the mail or via email. Especially when they advertise themselves as professional IMO writers. 

I get it, some doctors suck, and VA medical side doesn't like to get involved with VA benefit side for whatever reason. I know thats a pain- It probably cost me my SS hearing and appeal because my VA doctors would not fill out FCE paperwork which was being requested by the SSA. Still, as far as VA claims go, ive only ever had to see my own doctor, use the notes from my VA doctors and highlight the relevant parts, and I was referred to one specialist by my non-VA doc for some neurological stuff. Cost me about 100 in co-pays-Because I already have a relationship with my non-VA doctor, and they don't advertise themselves as professional writers of VA opinions. 

 

Call me moralistic, I don't care. *shrug* I just don't think that its all that helpful to refer vets looking for claims assistance to doctors that charge sometimes thousands of dollars for things that any doctor can look through and write up. Its not like there is a special thing that IMO writers have that any doctor can't do. Its just connecting the dots that are in your file and rendering a diagnosis with some specific wording that we all already know. You know- regular doctor stuff. No reason to refer vets to people that are going to charge them a bunch of money they probably don't have. 

Edited by brokensoldier244th
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For years now on at least two forums a vet has said this same thing over and over again to the boredom of many and I never read more than first one or two lines of his **.  I for one and do not know of any vets who has paid an outrageous sum of $10, 000 for a private IMO of course there are always a few (???) exceptions as in every endeavor.   There are many other competent qualified doctors who charge much less less than this by over half. 

I am off this boring topic.  SCHISH!!!!!!

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