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Going after Sleep Apnea again
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By AngelJames
I am prior Active Service, and completed the rest on my 20yrs in the Guard. like me, I never went to the doctor however prior to retirement I was put on tittle 32 order (single days) active orders. On these single days of active duty, I was diagnosed with asthma, and sleep apnea. is this enough to be considered "in service"... the VA so is technical. PLEASE HELP
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By dajoker12
Moderator, you might want to Pin this somewhere, as this seems to be a recurring trend.
I have given out this information to others, but I will post it here so that others can find it rather than searching through the forum.
First and foremost, claiming and getting sleep apnea secondary to PTSD or Mental disorder is not easy. I have personally seen more lost than won, however, it can be obtained and I myself have personally received it.
If you had sleep apnea diagnosed while in active duty, it is usually a slam dunk........for the rest of those trying to get it, it could require a lot of work. I suggest trying to get it both direct and secondary service connected.
It is easier to get sleep apnea as a direct service connection obviously, however, most Veterans do not get it diagnosed while in service. Best way to get that resolved is through buddy statements. I suggest getting 3-4 (I personally had 7-8) or more. Do not have them only say that they saw you snoring.......that is great and all, but that is not a symptom of sleep apnea.......it is incidental. They would need to say that they saw you gasping for air, choking, etc. Preferably roommates. If you were deployed, it would be easy to have many people saying that they saw/heard this as you would have more than likely been in an open bay setting at some point in time. You can also have your spouse write up a statement. This all needs to be during active duty periods of times and dates need to be included. M21-1 reference III.iii.2.E.2.b "Types of Evidence VA May Use To Supplement or as a Substitute for STRs" allows for buddy statements to act as STRs for medical evidence.........if they are certified "buddy" statements or affidavits.............having them written on VA Form 21-4138 solves this issue as it has the appropriate verbiage written near the bottom. Under M21-1 reference III.iii.1.B.7.a and 38 CFR 3.200, it meets the certification criteria..........problem solved. From my experience, getting all of the buddy statements needed can take longer than you originally anticipate....plan ahead.
Now, for secondary criteria.
Have you ever been diagnosed with alcohol abuse (it is frequently written as "ETOH")? If so, has it been attributed to your mental disorder or did it exist prior to that and is it considered willful? If you have been diagnosed with alcohol abuse, and it is attributable to your mental disorder, guess what, alcohol consumption is attributable to sleep apnea.
would suggest that you start doing your own academic research. You might be able to locate peer-reviewed academic journal articles (those are the types of articles that you want to submit) through https://www.researchgate.net/. If not, another alternative is using a college database to search academic journals through. Ah, but you need to be a college student to use the database to search academic journals through. One might make an argument that you could register for classes at a local community college (you can even register online nowadays without even stepping foot on campus) and even register for "late start" classes, and have access to the aforementioned database immediately (hint hint, look in the academic journal Chest); one could easily find within a 60 minute search at least 5 appropriate and recent journal articles clearly establishing a link between specific mental disorders and sleep apnea; there is a clear link between PTSD, anxiety disorders, depression, and especially schizophrenia. One might make an argument that you could simply then disenroll from the classes that you enrolled in by the date specified in order to get a full refund, thereby being charged nothing. Save the academic journal articles as pdf files, and create a work cited page (bibliography) for them in APA format (google is your friend.)
You now have a choice...........
Submit your claim with the buddy statements, mental health notes from a private provider, and evidence that you have and go with either a VA exam or vendor exam (whichever is given) or you can get an IME and IMO from private providers. If go the latter route, I would schedule one with a sleep specialist, why, because sleep apnea is their specialty. Pulmonologists also fall within this scope as well, though I suspect that you will have better luck finding a sleep specialist believing there to be a link between mental disorders and sleep apnea. You will get a Sleep Apnea DBQ and an IMO. Make sure that you have your C - File first as an examiner is required to have access to it and state that they have seen it on the DBQ for it to acceptable proof to the VA.
I would also get one from your psychologists/psychiatrist (Make sure that they are a psychiatrist or a psychologist.....if a psychologist, they need to be PsyD or Ph.D., or under the observation of a Ph.D.).
Make sure before you solicit those medical opinions, that you acquire "buddy statements" from 3-4 (or even more) people with whom you served. Roommates would be best, or people who slept in close proximity to you.........again, this is only if you believe that sleep apnea developed while you were in Active Duty service. Make sure that they are written on VA Form 21-4138. Make sure they say that they witnessed clear symptoms of sleep apnea i.e. gasping for air, choking sounds, moments where they visibly or auditorily could determine that you ceased breathing etc.
Remember, you will want the sleep specialist and the psych professional to have your academic journal articles and buddy statements.
Once you have all of them, solicit your medical opinions from the two aforementioned providers.
Ideally, you would love for the IMOs to say that they believe that you could be both direct service connected for sleep apnea or secondary due to mental disorder, possibly even say that the mental disorder and sleep apnea aggravate one another (which there is medical evidence to support.)
If you opt to go the route of getting the private IMO and IME, you will obviously submit those with your claim, and all medical records from private providers pertinent to sleep apnea and your mental health treatment, buddy statements, academic journal articles, and a nicely written statement written by yourself on a VA Form 21-4138 talking about the issue at hand and summarizing everything concisely. Mention everything that you are providing that you wont to be considered for the claim, and when the issue first manifested.
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By Dfinnusmc
Hello,
I just completed a C&P but am unable to see the C&P notes in ebenefits.Not sure why
i was told by the C&P doctor that I was service connected for all claims from my med board physical.
Anyone's thoughts would be greatly appreciated
Thank you to the Hadit community!
ED secondary to 200Mg Setraline for Combat PTSD currently 70%
Left knee injury,the md just looked at my knee after removing brace and since I could not bend it she told me to put the brace back on
but no measurements were taken.I showed her the notes from Military xray saying there was arthritis.
Pes Cavus:the doctor looked at my feet and then had me put my shoes back on?
Notes from VA podiatrist:
ORTHOPEDIC DEFORMITIES- HIGH ARCH BL WITH BUNIONS BL, LEFT MORE THAN RIGHT. +TENDER SUB 1ST MET HEAD BL, TENDER ARCH BL,PAIN INFERIOR MEDIAL HEEL BILATERAL RT>LT INVERTED HEEL POSITION BL CONTRACTION OF DIGITS BL LOWER EXTREMITY NEUROLOGIC STATUS GROSSLY INTACT B/L WITH 5.07 SEMMS X-RAY 1/2016 BILATERAL FOOT Impression: Mild degenerative changes bilaterally as described without acute fracture or dislocation. Nonspecific erosion in the medial head of the left first metatarsal. Tiny bilateral calcaneal heel spurs. ASSESSMENT: CAVUS FOOT AGGREVATED BY STRESSES OF CARRYING HEAVY PACKS IN SERVICE, WITH RESULTANT FASCIITIS BL [RIGHT MORE THAN LEFT]. POOR PROGNOSIS. R/O CHARCOT MARIE TOOTH VARIENT FASCITIS BUNIONS BL CLAW TOES
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I already get compensation for bladder cancer for Camp Lejeune Water issue, now that it is added to Agent Orange does it mean that the VA should pay me the difference between Camp Lejeune and 1992 when I retired from the Marine Corps or do I have to re-apply for it for Agent Orange, or will the VA look at at current cases already receiving bladder cancer compensation. I’m considered 100% Disabled Permanently-
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The 5, 10, 20 year rules...
Five Year Rule) If you have had the same rating for five or more years, the VA cannot reduce your rating unless your condition has improved on a sustained basis. All the medical evidence, not just the reexamination report, must support the conclusion that your improvement is more than temporary.
Ten Year Rule) The 10 year rule is after 10 years, the service connection is protected from being dropped.
Twenty Year Rule) If your disability has been continuously rated at or above a certain rating level for 20 or more years, the VA cannot reduce your rating unless it finds the rating was based on fraud. This is a very high standard and it's unlikely the rating would get reduced.
If you are 100% for 20 years (Either 100% schedular or 100% TDIU - Total Disability based on Individual Unemployability or IU), you are automatically Permanent & Total (P&T). And, that after 20 years the total disability (100% or IU) is protected from reduction for the remainder of the person's life. "M-21-1-IX.ii.2.1.j. When a P&T Disability Exists"
At 55, P&T (Permanent & Total) or a few other reasons the VBA will not initiate a review. Here is the graphic below for that. However if the Veteran files a new compensation claim or files for an increase, then it is YOU that initiated to possible review.
NOTE: Until a percentage is in place for 10 years, the service connection can be removed. After that, the service connection is protected.
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Example for 2020 using the same disability rating
1998 - Initially Service Connected @ 10%
RESULT: Service Connection Protected in 2008
RESULT: 10% Protected from reduction in 2018 (20 years)
2020 - Service Connection Increased @ 30%
RESULT: 30% is Protected from reduction in 2040 (20 years)-
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thegat 0
Hey guys, another question. I'm going after Sleep Apnea again this time through secondary claim from PTSD. Probably should have done it this way to begin with. Rated at 30% for PTSD but going for an increase on that too. Am I wasting my time?
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shrekthetank1
I am in the same boat with you and it is never a waste of time. Keep fighting. Remember this is what they want is for us to doubt ourselves and give up. If we give up they win! I just sent min
brokensoldier244th
https://cck-law.com/blog/obesity-and-va-disability-compensation/ There is other stuff out there about it as well. My SA claim was granted by way of this in 2014. I have both physical and m
GBArmy
I agree of course with Shrek and Broken. Go for it if you can get an IMO to back it up as secondary. Remember, you're not a doctor, so you need one qualified to opine the connection, even if it is obv
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