Sleep Apnea Secondary to PTSD

[JonathanAD]

I filed a claim for Sleep Apnea secondary to my PTSD, which is service connected.  I have been diagnosed from the VA as having sleep apnea, and given a CPAP to wear at night.  I used Carpenter Chartered Law Firm to do the claim, but got this denial letter (attached is an excerpt).  In it, it says "In the absence of other major risk factors such as obesity it would be reasonable to attribute OSA to PTSD as this is considered a risk factor for OSA from uptodate.com".

My thought is that if both obesity and PTSD are considered risk factors, shouldn't it be a 50% chance that it could be either obesity or PTSD, and go to the veteran's favor?  And doesn't that mean that attributing OSA to obesity is just as speculative as attributing it to my PTSD?

I had Carpenter Chartered start an appeal, so I am hopeful to get it approved.  

[Dustoff1970]

Yes I in this one instance I obtained a paid for medical nexus statement from Dr. Anaise stating my OSA Sleep Apnea was caused by aggravated by my VN long term PTSD and PTSD medications and also My VA VN service connected IHD Agent Orange Heart disease.  He sent the board a 22 page explanation and listing many medical treatise as support for his contentions that won me my BVA appeal.  The C&P examiner and VARO used the excuse I was 30lbs overweight for many years to deny my claim but this did not fly with the BVA.

Even though you may meet the criterial and qualifications for a VA service connection disability you may not be able to receive an important formal doctors nexus opinion or DBQ stating your disability is due to your service or another service connected condition because some doctors and their staffs are lazy, indifferent or hostile to vets receiving VA money.

Here is what has worked for me since 1987 to present day.  I have submitted copies of VA, Army, private medical records and other evidence with my numerous claims and appeals with almost 100 percent success and won those claims/appeals without a doctors nexus statement with only one recent exception where the paid for opinion was also successful.  I have been 100% P&T since 98 and now also with SMC-S.  

IF you contact me I can send you a detailed list of the medical and other evidence that has won my claims and appeals.  What has worked for me is no guarantee it will work for you.

It is a disservice IMHO for anyone to discourage a vet from filing a disability claim just because they cannot get some chicken*** doctor to fill out a DBQ or sign a nexus statement as the vet may still have the other medical and non medical evidence in their files or possession to win. 

I encourage vets to seek opinions of others and do their own research as I have done.

Some vets like to brag about their receiving a VA or private doctors nexus opinion free of charge or it was paid for by their insurance or others and I congratulate them on their good fortune.  I have learned and worked the hard way for my benefits and proud of it.

I learned many years ago to in my case to correctly assume the VARO will deny my claim with a BS statement like "NO EVIDENCE" and then I have to appeal to the BVA or higher U.S. CAVC court which I have done on my own successfully.  This has created jealously on part of some other vets.  Too Bad they can still get happy.

My comment is not legal advice as I am not a lawyer, paralegal or VSO representative.

Edited March 30, 2022 by Dustoff 11

[JKWilliamsSr]

This is a clear example on how the VA is very inconsistent in decisions.  They just want to deny because for some reason the believed their pay will be docked to pay for your increase.....lol.

When I filed my initial claim for sleep apnea I filed it using obesity as an intermediate step.  I stated that my service connected disabilities prevented me from exercising and led to my gaining weight I had an IME that supported my statements.  In the denial the VA examiner used their examiners opinion stating that my obesity was because of my personal choices such as eating habits.  He went on the state that my service connected disabilities do not prevent me from "ALL" exercises and used in his rationale that paraplegics find alternate exercises and maintain a proper BMI......(I can't make this stuff up)

I personally do not have PTSD but I have friends with it and a couple of them eat quite a bit when they are stressed.  It is part of how they cope.  The VA examiner IMO failed miserably at his job.  A statement he made in his rationale shows how clueless the are.  They stated that " You submitted many articles re: mental disorders and OSA but these studies show correlation and not causation."   Here is the problem with that.  A service connected disability does not have to "cause" a condition to be service connected as a secondary condition.   Just aggravating the condition would be enough.   I am service connected for Type II Diabetes because my sleep apnea aggravates it" and was granted by a BVA judge for that reason.

[Dustoff1970]

Yes I in this one instance I obtained a paid for medical nexus statement from Dr. Anaise stating my OSA Sleep Apnea was caused by aggravated by my VN long term PTSD and PTSD medications and also My VA VN service connected IHD Agent Orange Heart disease.  He sent the board a 22 page explanation and listing many medical treatise as support for his contentions that won me my BVA appeal.  The C&P examiner and VARO used the excuse I was 30lbs overweight for many years to deny my claim but this did fly with the BVA.

Even though you may meet the criterial and qualifications for a VA service connection disability you may not be able to receive an important formal doctors nexus opinion or DBQ stating your disability is due to your service or another service connected condition because some doctors and their staffs are lazy, indifferent or hostile to vets receiving VA money.

Here is what has worked for me since 1987 to present day.  I have submitted copies of VA, Army, private medical records and other evidence with my numerous claims and appeals with almost 100 percent success and won those claims/appeals without a doctors nexus statement with only one recent exception where the paid for opinion was also successful.  I have been 100% P&T since 98 and now also with SMC-S.  

IF you contact me I can send you a detailed list of the medical and other evidence that has won my claims and appeals.  What has worked for me is no guarantee it will work for you.

It is a disservice IMHO for anyone to discourage a vet from filing a disability claim just because they cannot get some chicken*** doctor to fill out a DBQ or sign a nexus statement as the vet may still have the other medical and non medical evidence in their files or possession to win. 

I encourage vets to seek opinions of others and do their own research as I have done.

Some vets like to brag about their receiving a VA or private doctors nexus opinion free of charge or it was paid for by their insurance or others and I congratulate them on their good fortune.  I have learned and worked the hard way for my benefits and proud of it.

I learned many years ago to in my case to correctly assume the VARO will deny my claim with a BS statement like "NO EVIDENCE" and then I have to appeal to the BVA or higher U.S. CAVC court which I have done on my own successfully.  This has created jealously on part of some other vets.  Too Bad they can still get happy.

My comment is not legal advice as I am not a lawyer, paralegal or VSO representative.

[Dustoff1970]

IMHO and based upon my many years of self represented in successful claims and appeals you stand a better than 50% chance of winning your appeal for a few of the following reason.  1.  Your Carpenter law firm has been successfully wining many hundreds of appeals at both the BVA and CAVC Court for many many years as I have read many of the court decisions granting vets their disability claims due to Carpenter representing them. 2. I have read many numerous BVA decisions over the years granting obese and overweight vets such as me and you OSA Sleep Apnea due to PTSD.  I just recently won A BVA Sleep Apnea appeal due to PTSD  and due in part to nexus opinion statement from Dr. David Anaise (22 pages with many treatise references). 

Very often the BVA will note the inadequate quality reasoning for both the VARO rating and the VA C&P examiner and will compare this to a very good nexus opinion from your doctor and/or other favorable medical evidence introduced into the claims and appeal by you or your VSO or lawyer.  Just being overweight or Obese is not a bar to winning the appeal.

For example I introduced as evidence many numerous medical studies from reputable institutions like May Clinic, Harvard Medical School and others showing the both PTSD stress and PTSD medications cause and aggravates veterans to gain weight by both physical side effects and also over eating due to depression that is a symptom of PTSD.

Some vets on some locations constantly on first reply tell the vet he cannot meet the criteria for service connection for OSA due to overweight/obese  and this is absolute BS.  The yahoos know better and deliberately fail to tell the vet about those others who won their claims or appeals with the above methods in part.

This type of misleading BS discourages a vet from even filing or pursuing a claim or appeal and adds to their depression with loss of hope. 

 

Even though you may meet the criterial and qualifications for a VA service connection disability you may not be able to receive an important formal doctors nexus opinion or DBQ stating your disability is due to your service or another service connected condition because some doctors and their staffs are lazy, indifferent or hostile to vets receiving VA money.

Here is what has worked for me since 1987 to present day.  I have submitted copies of VA, Army, private medical records and other evidence with my numerous claims and appeals with almost 100 percent success and won those claims/appeals without a doctors nexus statement with only one recent exception where the paid for opinion was also successful.  I have been 100% P&T since 98 and now also with SMC-S.  

IF you contact me I can send you a detailed list of the medical and other evidence that has won my claims and appeals.  What has worked for me is no guarantee it will work for you.

It is a disservice IMHO for anyone to discourage a vet from filing a disability claim just because they cannot get some chicken*** doctor to fill out a DBQ or sign a nexus statement as the vet may still have the other medical and non medical evidence in their files or possession to win. 

I encourage vets to seek opinions of others and do their own research as I have done.

Some vets like to brag about their receiving a VA or private doctors nexus opinion free of charge or it was paid for by their insurance or others and I congratulate them on their good fortune.  I have learned and worked the hard way for my benefits and proud of it.

I learned many years ago to in my case to correctly assume the VARO will deny my claim with a BS statement like "NO EVIDENCE" and then I have to appeal to the BVA or higher U.S. CAVC court which I have done on my own successfully.  This has created jealously on part of some other vets.  Too Bad they can still get happy.

My comment is not legal advice as I am not a lawyer, paralegal or VSO representative.

[JKWilliamsSr]

Here are several things I think people should do before filing a claim if at all possible.

1.  Start an intent to file.  This will set your start date because the next step could take a while.

2. Get a copy of your C-File.  This will allow you to see what the VA has and can save you years of bullshit.

3. Submit any relevant SMR's with your claim. Even if they are in your C-File, do not rely on the VA to look at them all.  In my 2002 foot claim the rated stated that my claimed condition was not in my SMR's.  They said the same thing when I reapplied in 2009.  In 2018 I got my C-File and found SMR's that showed the condition.  I submitted those SMR's with my claim and they had no choice but to reopen.