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    • Howdy all,

      The VA DRO denied my claim for an earlier effective date for my sleep apnea. They originally denied it in 2008 but granted it in Nov 2019 secondary to my GERD. I was rated for GERD in 2001. So I had it in 2008. I have attached the 2008 denial, 2018 approval, and the NOD SOC. All of my medical files and the medical articles and VA Citations referenced were in existence in or before Jan 2008. The only new items were the NEXUS letter from Dr Bash and a few extra buddy letters. The original denial states that my medical records show no diagnosis or treatment and only isolated complaints of symptoms. The denial does not even list my wife's or my lay statements as evidence reviewed. I have symptoms listed numerous times in my SMRs:

      a. Medical visit dated 24 Feb 76 for problem sleeping and depression.
      b. Physical exam dated 24 Jan 79 listed frequent/severe headaches" dizziness, and
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      c. Physical exam dated 07 Nov 83 listed frequent/severe headaches.
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rexlan

Question - how to proceed with sleep apnea denial

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I filed for sleep apnea and it was denied as service connected.  I have all the documents and use a CPAP daily so the issue is secondary to PTSD and service connected. 

I am inclined to just let this go; however, I started my sleep issues in Viet Nam but back in the mid 60's most folks did not look for help because Viet Nam was pretty unpopular with the folks back home.  I have had sleep issues all my life after military.  But in fairness I was just 18 when I went in (4 active USMC).

My question is if it is worth an appeal or a supplemental claim?  I can get my doctor to give me an opinion letter and state how the sleep issues relate to PTSD.  But the big question is if I already screwed up by letting the VA nurse have here say first.  My regular doctor filled out the original DBQ but we did not offer an opinion at that time.

I am 70% for PTSD and don't need more money but I would like to get 100% so I can get the full benefit of what we were originally promised. 

Advice or personal experience with the supplemental claim process - thanks very much.

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Rexlan One way to connect SA or OSA is secondary to PTSD by way of weight gain. If you are overweight or obese, and you take PTSD meds that tend to make you put on weight, you might have a case. Look up the side effects of your prescribed VA meds and see if they do. Look up obesity charts and see if you are classified as over weight or obese based on your height, called BMI.  If this matches up, it may work for you. I assume you never asked medical help on sleep problems while in the service, so direct disability is going to be a tough nut to crack.

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Posted (edited)

This is a big deal, and no, I would not let it go.  Since your profile says you are at 70 percent, you have a potential of 100 percent plus smc s.  That's a huge raise for you to about 3500 per month, from where you are now.  

I have no opinion on what your doctor "would or would not do", because I have never even met him.  Its simple, tho.  If he wont "connect" your sleep apnea to PTSD (secondary) or to military service (primary), then you need to make it happen with another doctor.  Yes, it may cost you.  Lets say you have to pay a doc 2000 for a nexus.  Now thats a bargain, because, if your sleep apnea gets you to 100 percent plus smc s (and I cant guarantee that), you would pay for your IMO in 1 or 2 months, tops.  

Im assuming here, that you are prescribed and using a CPAP or Bipap.  OSA with a cpap is 50 percent.  

Are you currently working?  If not, then consider filing for an increase in ptsd and tdiu.  Let the VA sort out which applies to you..granting an increase to 100 percent for PTSD or granting tdiu.  

To Proceed:  File a NOD, and my opinion is you should select BVA with evidence submission, in case you need a nexus (additional evidence).  Of course, review your file to see if it is already there, it may be and cost you zero.  You wont know till you review your records.  

 

Edited by broncovet

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GB 

The only thing about weight gain is they can go back years and check a Veteran weight , if you were over weight before filing for sleep apnea  they can and will use that against you to deny s.a../ osa claim...by checking medical records for the past years  or before a MH Condition was approved...like PTSD

I been over weight for years  normally my weight should be around 170 lbs  according to my BMI..But since I had to stop working   because of my s.c. disabilities   I've really put on the weight I am up around 255 lbs  some 85 lbs over weight.

I have sleep apnea and was prescribe a C-pap machine medically necessary to use for my well being  but have not filed a claim for Sleep apnea I might later on  but for now I am ok with what I am rated for  although I do have some complints as to how they rated me back in 2002/2003  different dates on my award letters and the EED but as long as they are called typo errors  I have no defence in getting a better EED, BUT THIS IS COMPLETELY DIFFERENT from the OP Question.

It could work using the obese excuse,  but most of the time  a veteran will need more than that to win the sleep apnea claim.

If a Veteran has been diagnosed for PTSD AND PRESCRIBE medications like to help him sleep and ease of night mares ect,,,ect,,,   this is called sudation to relax...to be able to sleep  with a C-pap machine, the thing is  a veteran will need  a Dr to opine that the meds he takes for his mental health condition to help him sleep  will cause or can be related to his now OSA/Sleep Apnea and can be secondary to his mental health condition (PTSD)

if a spouse wakes up in the middle of the night and notice her hubby not breathing or gasping for air  this needs to be addressed with his MH Clinic, they(normally) in turn will contact the sleep clinic and a sleep study will be order and if the veteran is diagnose for sleep  apnea and prescribe a C-pap Machine  necessary medically to use and the medications he takes for his PTSD/SLEEP /ANXIETY/STRESS   ECT,,,ECT,,,  then he has the tools to use  for his sleep apnea claim medically to file a secondary claim to his PTSD

Actually this is how I got my Sleep apnea and was diagnose for mild to moderate OSA.

I may file a claim for it later...but right now for me is not a good time to be filing anything  were moving and keep running into problems  like the home we were going to buy a few days ago   did not pass inspection and needed way to much things the seller would not fix  like a roof, and havc unit, breaker box in the garage was unsafe with bare hot wires exposed  as a fire hazard, hot water heater was 20 years old, cracks in the walls, and a bunch of other things to many to mention the seller decline to fix or replace any of this  so we backed out   of course it cost us 400.00 bucks for this inspection  but glad to pay that and not invest in this home.

so I am waIting to get settled into my new home address before I file anything with the VA.

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Buck so your saying when he got s-c for PTSD is a key element relative to his weight gain. Hadn't considered that, but it make sense the VA would use that logic to deny. Good point!

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    • Howdy all,

      The VA DRO denied my claim for an earlier effective date for my sleep apnea. They originally denied it in 2008 but granted it in Nov 2019 secondary to my GERD. I was rated for GERD in 2001. So I had it in 2008. I have attached the 2008 denial, 2018 approval, and the NOD SOC. All of my medical files and the medical articles and VA Citations referenced were in existence in or before Jan 2008. The only new items were the NEXUS letter from Dr Bash and a few extra buddy letters. The original denial states that my medical records show no diagnosis or treatment and only isolated complaints of symptoms. The denial does not even list my wife's or my lay statements as evidence reviewed. I have symptoms listed numerous times in my SMRs:

      a. Medical visit dated 24 Feb 76 for problem sleeping and depression.
      b. Physical exam dated 24 Jan 79 listed frequent/severe headaches" dizziness, and
      nervousness.
      c. Physical exam dated 07 Nov 83 listed frequent/severe headaches.
      d. Physical exam dated 16 Jan 85 listed frequent/severe headaches.
      e. Admitted to hospital 05 Aug 86 for chest pains and anxiety.
      f. Medical visit dated 14 Jul 87 for problem sleeping and morning confusion.
      g. Physical exam dated 25 Feb 88 listed dizziness.
      h. Physical exam dated 07 Oct 91 listed frequent/severe headaches
      i. Physical exam dated 25 Aug 93 listed headache.
      j. Hernia repair surgery dated 22 Ang 94 surgeon had to insert devices of some
      kind in each of my nostrils that went down into my throat to keep rny airway
      open and stop my disruptive snoring.
      k. Physical exam dated 29 Sep 99 listed frequent/severe headaches.

      So could you all take a look and let me know what you think.

      Redacted VA NOD SOC 04-09-2020.pdf
      VA 2008 Denial of OSA Redacted.pdf
      VA Claim Decision Ltr 08 Nov 2018 Redacted.PDF
      • 3 replies
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