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historic diagnose will VA Accept one 10 years old?
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Buck52
Question
Will the va take an older diagnose that was in the veterans medical records? say 5/10 years ago?
Like a Veteran was diagnose for Sleep apnea back in 2010...but never filed a claim for it now this veteran wants to put in a claim for it.
He uses the VA PRESCRIBE C-PAP
He has a Mild Diagnose for Sleep Apnea but no where in his records does it say is medically required...so under the M-21 it says must necessary medically to use''
the manual now says,
“Use absent a medical determination that the device is necessary does not qualify. The regulation requires that the device be necessary and this is a medical question.
He never had OSA in military but has it now years later after separation due to his PTSD.
His VA M.H. Phyistrist Suggested he see the VA sleep clinic & he did a sleep study and they diagnose him with the Mild OSA and gave him a C-pap TO USE (*THIS WAS 10 YEARS AGO*) But no where I can find in his records the Dr said it is medically necessary to use''??
I mention to him they will go by the date he filed his claim for sleep apnea but we have not filed it yet...I am trying to get all his T's and I's crossed we don't want a denial.
How will he over come the new regulation in M-21 below
“Use absent a medical determination that the device is necessary does not qualify.
I am thinking he needs a Sleep Dr or a Qualified Dr to render his medical opinion that the C-pap machine is medically ''REQUIRED'' this veteran is necessary to use his c-pap machine prescribe by the VA
We are going to file a secondary to his PTSD. AS SOON AS I CAN GET HIM TO SEE A SPECIALIST OPINION FOR THE C-PAP MACHINE REQUIRED USE AND MEDICALLY NECESSARY TO USE FOR HIS WELL BEING
Need some opinions on this please.
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Buck52 10 posts
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JKWilliamsSr
Normally it would be assumed that using a CPAP is medically necessary. The reason for this is you can only get one via a prescription. I have Asthma and Sleep Apnea. I see a Pulmonologist for
brokensoldier244th
VA didn't just give away cpaps, they are expensive. If he has one, it's medically necessary.
brokensoldier244th
Sure, if he bought the cpap himself, but if it's prescribed by VA they expect it to be used. They wouldn't have prescribed it if it medically necessary.
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