Do I have enough for secondary service connection?

[Fat]

I have always thought rhinitis  and sleep apnea had a casual relationship. In the past I asked two pulmonary doctors about the relationship, but they didn't see the connection. So I left the issue alone for years.

To my surprise after going through paperwork, I found a 2017 office visit note which confirmed my belief.

I initially had a sleep apnea test in 2014.  Afterwards I had surgery to remove the tonsils and tissue from nose (rhinoplasty). The surgery was to help with better air flow.

I went back to the doctor in 2016 to see if the surgery improved the sleep apnea.

The doctor's office visit notes stated, "patient is back to reassess since surgery. He still has significant symptoms and has a large amount of nasal congestion brought about by his atopic rhinitis. His atopic rhinitis leads to increased airflow resistance in the upper airway which also leads to airway collapse and would predispose the patient to apnea. He needs a follow up sleep study to reconfirm apnea.

I subsequentially had a another sleep test and was diagnosed with central sleep apnea.

I was service connected with Rhinitis in 2015.

After reading the 2016 notes, I called the sleep center to schedule an appointment with the doctor; however he is retired and playing golf in Arizona.

For secondary service connection I have a service connected disability, a diagnosis of sleep apnea, and it appears a nexus statement connecting the two.

Would the statement on the 2016 doctors note be sufficient?

 

All opinions are welcomed?

 

 

[vetquest]

For your nexus you need a doctor to state that they have reviewed all of your records, including service records and a statement that the apnea is at least as likely as not due to your SC rhinitis.  Without this you will most likely be denied.  It is usually the hardest hurdle to surmount when we try to get benefits with a private nexus.  We all have gone through this at one time or another.  Most civilian doctors will not do this for a SC nexus, this leaves you searching for a specialist in IME/IMO's who is not wary of the VA.  I really wish we could guarantee doctors that they will not be called up by the VA to testify as it is this that most doctors appear to be wary of.

 

[GBArmy]

Vetquest is spot on. Your posted bio says you are rated now at 20%; SA with use of a CPAP machine diagnosed, is a 50% hit. If that is your symptoms, I'd recommend getting the IMO to submit. It could pull you up to a combined 60% rating. That would be IMO a pretty good investment.

[broncovet]

Ask your doctor to say the magic words:  "Your sleep apnea is at least as likely as not due to your SC rhinitis".  

Its like a password that is case sensitive..you wont get "in" unless you have the password.  Vetquest nailed it.  

Edited February 28, 2020 by broncovet

[deedub75]

5 hours ago, Fat said:

I have always thought rhinitis  and sleep apnea had a casual relationship. In the past I asked two pulmonary doctors about the relationship, but they didn't see the connection. So I left the issue alone for years.

To my surprise after going through paperwork, I found a 2017 office visit note which confirmed my belief.

I initially had a sleep apnea test in 2014.  Afterwards I had surgery to remove the tonsils and tissue from nose (rhinoplasty). The surgery was to help with better air flow.

I went back to the doctor in 2016 to see if the surgery improved the sleep apnea.

The doctor's office visit notes stated, "patient is back to reassess since surgery. He still has significant symptoms and has a large amount of nasal congestion brought about by his atopic rhinitis. His atopic rhinitis leads to increased airflow resistance in the upper airway which also leads to airway collapse and would predispose the patient to apnea. He needs a follow up sleep study to reconfirm apnea.

I subsequentially had a another sleep test and was diagnosed with central sleep apnea.

I was service connected with Rhinitis in 2015.

After reading the 2016 notes, I called the sleep center to schedule an appointment with the doctor; however he is retired and playing golf in Arizona.

For secondary service connection I have a service connected disability, a diagnosis of sleep apnea, and it appears a nexus statement connecting the two.

Would the statement on the 2016 doctors note be sufficient?

 

All opinions are welcomed?

 

 

I was service connected for both allergies and chronic sinusitis.  I got into the VA system so I could see and allergist and start allergy injections.  I also convinced the VA primary care doctor to order a sleep study.  The sleep study showed that I had mild sleep apnea and low oxygen while sleeping but I was just below the threshold of requiring a cpap.  I asked my primary care doctor if my allergies and sinusitis could cause sleep apnea and he said they were likely the cause of my sleep apnea and he wrote that in my records.  I did end up going to an outside neurologist who reviewed my sleep study and he said that what the VA ordered was inadequate so he ordered a new, more comprehensive sleep study.  The new study show i had moderate sleep apnea.  I submitted the new sleep study for my sleep apnea claim.  Based on the one sentence in my records where the doctor said my sleep apnea was likely caused by my allergies and sinusitis and my sleep study, I was service connected for sleep apnea.  

[Fat]

I appreciate all the comments.

I will visit the sleep center where the 2016 study was done and hope the current doctor will be sympathetic.

The 2016 doctor has retired, but he was well known in the sleep study community.

Edited March 2, 2020 by Fat

[Fat]

Will a DBQ or IMO be necessary for Sleep Apnea Claim?

The sleep study/lab report will be attached diagnosing SA with the nexus letter (hopefully).

The severity of the SA will be well documented on the report.