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Higher-Level Review Closed


RetiredNavy

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I filed a new claim for disability for Sleep Apnea secondary to PTSD in April, 2020. In November, 2019 the VA (at their recommendation) had me do a sleep study through the VA. The next day, the VA Doctor called me and stated: “The results of your sleep study done on 11/25/2019 show that you have sleep apnea which is overall severe. On average you took too shallow a breath or had brief pauses in your breathing 48 times per hour throughout the night (apnea-hypopnea index of 48), when normal is less than 5.” The VA immediately issued a CPAP machine to me.

As I stated, I filed the claim in April as a fully developed claim. I included the VA “Blue Button” record which included the above Sleep study report; a DBQ from a private physician;  a nexus letter from the same doctor for OSA from PTSD, and four approved VA case law Board of Veteran Appeals documents specific to secondary OSA from PTSD.

I had a stupid C&P exam via the phone from QTC in May for the Sleep Apnea. The claim was quickly denied, with the rating decision stated that although I have Sleep Apnea, it’s not related to PTSD. The examiner had stated that there is no relationship between Sleep Apnea and PTSD; and that’s it’s less likely that the PTSD and Sleep Apnea are related. 
I filed the higher level review on June 3rd. It took until October 20 to get a phone call from the VA for the informal conference. I explained to the reviewer why I believe the initial decision was inaccurate, and discussed my DBQ and letter, the Sleep apnea Sleep study, my diagnosis of severe sleep apnea, and the associated case law documentation I submitted with the claim. She advised that I’d see or hear something within a couple weeks. She also stated that “maybe the previous rarer didn’t review all the documents.”

well, I saw the closed higher level review in VA.gov today. As stated in the title that’s it’s closed. There are no changes in web edits and va.for. My current disabilities listed one benefits have not changed at all, and still list Sleep Apnea not service connected.

is this a denial? How could the VA possibly deny this claim with all my provided documentation?!! I am so sick of the VA!!

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RetiredNavy Hang in there brother. It's not over until you quit trying. If the HLR gave that encouraging remark, it might win. Don'y expect VA.gov or ebenefits to be reliable or timely. We say it over and over; wait until you get your decision letter. 7-10 days.

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I might add that if your appeal didn't win, you still could appeal thru BVA. The BVA has approved many OSA as secondary to PTSD. You might need a stronger nexus. Again, wait for your decision and post here again.

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