David Anaise MD for OSA secondary to PTSD

[USMC_VET]

After Denials for OSA both direct and secondary to PTSD, this spring I decided to spend the money on a IMO and do the claim right.  I contacted Dr. Anaise and was told to send all my records, decision letters and $1500.  

After about a week I was emailed with a final IMO report that was around 40-50 pages.  It was excellent & well researched. Within 6 weeks of submitting the IMO with a supplemental claim OSA secondary to PTSD was approved.

Yes IMO's dont guarantee anything and they can be expensive but they are definitely worth it when you have been denied already and have nothing else to submit and someone like Dr. Anaise will always outweight the NP the VA usually has doing exams.

[63Charlie]

 

Thanks for the feedback on the quality of his service.

Based on this, I may hire him in the future if necessary.

[Buck52]

If you have OSA./SLEEP APNEA 63 CHARLIE ? and want to get it service connected & rating FILE A CLAIM SECONDARY TO YOUR PTSD

IF YOU HAVE S.C. AND A RATING FOR PTSD.?.

CHECK WITH YOUR MH Dr;s ask them if your PTSD AND THE MEDICATIONS YOU TAKE WILL CAUSE OR CAN BE RELATED TO OSA? SLEEP APNEA?

IF THEY TELL YOU YES THEY CAN THEN REPORT YOUR OSA/SLEEP APNEA TO THEM RIGHT THEN , LET THEM KNOW YOUR SPOUSE HAS MENTION TO YOU ABOUT YOUR OSA  THAT SHE WAKES UP IN MIDDLE OF THE NIGHT AND YOUR EITHER SNORING OR BREATHING WEIRD AND AT TIMES SHE NOTICE YOU GASP FOR AIR....THESE MH Dr's SHOULD SET YOU UP A SLEEP STUDY TO Do  ASAP. (IF SHE DOES?_

DON'T MENTION A CLAIM  JUST SIMPLY ASK THEM THIS QUESTION   THEY SHOULD BE ABLE TO AT LEAST GIVE YOU THEIR MEDICAL OPINION ON THIS.

IF YOUR DIAGNOSE FOR SLEEP APNEA   BY THE VA  THEY SHOULD PRESCRIBE YOU A C-PAP MACHINE  MEDICALLY  NECESSARY FOR YOU TO USE EACH NIGHT   THIS IS A 50% RATING  DEPENDING ON HOW SEVERE YOUR OSA IS ?    IT CAN BE RATED AS HIGH AS 100%

OSA IS A DANGEROUS EVEN AT A MILD DIAGNOSES. 

IF THEY DO THIS  CHECK YOUR MYHEALTHEVET NOTES  AFTER 3 DAYS MAKE FAVORABLE COPIES OF WHAT THE MH Dr MENTION TO YOU ABOUT YOUR QUESTION.  SUBMIT THEM AS PART OF YOUR EVIDENCE.

THIS WILL SAVE YOU FROM HAVING TO GET THE EXPENSIVE IMO.

[deedub75]

I was able to get OSA secondary to my service connected chronic sinusitis and allergic rhinitis by simply asking my VA if primary care doctor if my OSA was caused by allergies and sinusitis. He said yes and he made a note in my records that my OSA was more than likely caused my allergies and sinusitis. He was the one who ordered my sleep study as well. 

[USMC_VET]

19 hours ago, Buck52 said:

If you have OSA./SLEEP APNEA 63 CHARLIE ? and want to get it service connected & rating FILE A CLAIM SECONDARY TO YOUR PTSD

IF YOU HAVE S.C. AND A RATING FOR PTSD.?.

CHECK WITH YOUR MH Dr;s ask them if your PTSD AND THE MEDICATIONS YOU TAKE WILL CAUSE OR CAN BE RELATED TO OSA? SLEEP APNEA?

IF THEY TELL YOU YES THEY CAN THEN REPORT YOUR OSA/SLEEP APNEA TO THEM RIGHT THEN , LET THEM KNOW YOUR SPOUSE HAS MENTION TO YOU ABOUT YOUR OSA  THAT SHE WAKES UP IN MIDDLE OF THE NIGHT AND YOUR EITHER SNORING OR BREATHING WEIRD AND AT TIMES SHE NOTICE YOU GASP FOR AIR....THESE MH Dr's SHOULD SET YOU UP A SLEEP STUDY TO Do  ASAP. (IF SHE DOES?_

DON'T MENTION A CLAIM  JUST SIMPLY ASK THEM THIS QUESTION   THEY SHOULD BE ABLE TO AT LEAST GIVE YOU THEIR MEDICAL OPINION ON THIS.

IF YOUR DIAGNOSE FOR SLEEP APNEA   BY THE VA  THEY SHOULD PRESCRIBE YOU A C-PAP MACHINE  MEDICALLY  NECESSARY FOR YOU TO USE EACH NIGHT   THIS IS A 50% RATING  DEPENDING ON HOW SEVERE YOUR OSA IS ?    IT CAN BE RATED AS HIGH AS 100%

OSA IS A DANGEROUS EVEN AT A MILD DIAGNOSES. 

IF THEY DO THIS  CHECK YOUR MYHEALTHEVET NOTES  AFTER 3 DAYS MAKE FAVORABLE COPIES OF WHAT THE MH Dr MENTION TO YOU ABOUT YOUR QUESTION.  SUBMIT THEM AS PART OF YOUR EVIDENCE.

THIS WILL SAVE YOU FROM HAVING TO GET THE EXPENSIVE IMO.

I had a OSA diagnosis in 2015 from the VA and two VA sleep studies and was ordered a CPAP.  My claim with all this evidence AND a OSA diagnosis did not get me a OSA Service Connection.The VA didnt dispute that i had PTSD or OSA, they acknowledged it but they did not consider them connected or that it was direct service connection.  I had multiple buddy statements that i would snore loudly and stop  breathing while in service but was still denied.  It was eventually granted with the IMO because the connection via Medical opinion by Dr. Anaise that PTSD is comorbid with OSA and that my nightmares caused me to rip the mask off at night which aggravates my symptoms.  I know i am Direct SC but I was willing to take an aggravation as a connection.  I agree that maybe you should try to direct SC and then IMO in the appeal but everyones situation is different.

[Buck52]

5 minutes ago, USMC_VET said:

I had a OSA diagnosis in 2015 from the VA and two VA sleep studies and was ordered a CPAP.  My claim with all this evidence AND a OSA diagnosis did not get me a OSA Service Connection.The VA didnt dispute that i had PTSD or OSA, they acknowledged it but they did not consider them connected or that it was direct service connection.  I had multiple buddy statements that i would snore loudly and stop  breathing while in service but was still denied.  It was eventually granted with the IMO because the connection via Medical opinion by Dr. Anaise that PTSD is comorbid with OSA and that my nightmares caused me to rip the mask off at night which aggravates my symptoms.  I know i am Direct SC but I was willing to take an aggravation as a connection.  I agree that maybe you should try to direct SC and then IMO in the appeal but everyones situation is different.

Yes I certainly understand about all your evidence with buddy letters your osa diagnosis and sleep studies but the VA requires us to have a Dr to opine ..it normally takes a Dr word on it ....> that  is what gets service connection  if you notice it wasn't until your Dr Anaise gave his medical opinion  that they finally service connected you .

   The Dr opinion that your PTSD was likely as not related in some way to your osa.(they need to go in detail about how its related or caused by your PTSD AND MEDICATIONS..they will not take our word for it even with buddy letters and our lay statements, So it basically comes down to rather or not a Qualified Dr gives his pro-opinion in he veterans favor.

OSA/Sleep Apnea is very hard to get service connected  if the veteran don't have documentations/Records for any type sleep disturbance with in military,   usually if its s.c. it needs to be a secondary condition that helped get it.

[JKWilliamsSr]

I hired an attorney to handle my appeal based on the fact that the VA has just about ignored every piece of evidence I submitted.  I used the Ellis Clinic for an  IME and after consulting with my attorney he felt there are some things that Dr. Ellis missed when writing the IME.  He stated the IME was very good and fantastic when it comes to the rating I should get but the VA tends to want specific jargon and if they do the search on the document and don't see it (or ignore it) the claim gets denied.

I am using this attorney based on the recommendation from fellow vet who used them.  He was in the same boat that I am in. He used the Ellis Clinic and while the IME was good it missed certain keywords.  They got an IMO and used that with the Ellis Clinic IME to get him 100% P&T.  The IMO cost $1895 and covers 5 disabilities.

It is important for me to go this route because the VA examiners clearly ignore some factors.  They are supposed to help you with your claim but do not.  I am service connected for Asthma which can easily be used to connect to Sleep Apnea but the VA will not do it.  I have to do it myself.

[GBArmy]

JK I think you are doing what you think is best and most comfortable with. Dr Ellis is very good and if you want to beef-up your chances, go right ahead. If that means going with a lawyer, so be it. Others may disagree, but you are the best advocate for your claim. Last thing you want to do is 2nd guess yourself, not get the legal help, and be denied again. Getting 3/4ths of a pie is a lot better than no pie at all. Wish you well.

[ShuMan]

David Anaise MD is legit! I won my sleep apnea claim secondary to MDD using his IMO!

[JKWilliamsSr]

On 7/7/2020 at 1:26 PM, deedub75 said:

I was able to get OSA secondary to my service connected chronic sinusitis and allergic rhinitis by simply asking my VA if primary care doctor if my OSA was caused by allergies and sinusitis. He said yes and he made a note in my records that my OSA was more than likely caused my allergies and sinusitis. He was the one who ordered my sleep study as well. 

I have sinusitus and Asthma and I am service connected for both and they are known issues that can cause sleep apnea which I have and have a CPAP machine.  Yet the VA denied me so I hired and attorney and got a second IMO to go with my Dr. Ellis IMO and have appealed to the BVA.

[ammo6998]

My husband has just contacted Dr Anaise for an IMO for his OSA. According to his VSO, it appears no weight was given to the buddy statements and his medical records from his last deployment states that he had insomnia. He was moved to nights while on deployment so his roommate could sleep but apparently that wasn't enough for the SC. 

So now I'm in the process of going through all his paperwork to send over to Dr Anaise's office. Reading these threads gives us hope. 

[GBArmy]

Ammo6998 Getting OSA disability, a 50% rating if you need a CPAP, is no easy deal anymore with the VA. Did your friend's buddy letter state he witnessed his symptoms prior to his move to the night shift? You can also provide a buddy letter if you witnessed ( continue to witness) his OSA since he got home. Dr. Anise is a lawyer and a doctor. If he takes your case it means he believes you have a good shot at winning. He's not cheap, but it sometimes makes more sense to go with a proven winner. You already were denied, so IMHO going with a top gun makes a lot of sense.

[ammo6998]

1 hour ago, GBArmy said:

Ammo6998 Getting OSA disability, a 50% rating if you need a CPAP, is no easy deal anymore with the VA. Did your friend's buddy letter state he witnessed his symptoms prior to his move to the night shift? You can also provide a buddy letter if you witnessed ( continue to witness) his OSA since he got home. Dr. Anise is a lawyer and a doctor. If he takes your case it means he believes you have a good shot at winning. He's not cheap, but it sometimes makes more sense to go with a proven winner. You already were denied, so IMHO going with a top gun makes a lot of sense.

The buddy letter was from his CO who put him on nights because of the roommate's complaints. We did realize that due to the denial it would be an upward battle. We are very grateful that it appears he does have a shot at s-c because we are coming out of pocket for his treatment and the accessories are not cheap.