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I have looked for guidance online pertaining to my unique situation for quite a while and I could not find any useful information, so I thought I would post it here after discovering this amazing website and after seeing so many knowledgeable individuals in these forums helping others. I truly apologize if I am giving more information than what is needed.
I'll preface this by saying that I was not seen during my time in service for Sleep Apnea directly, but had developed the symptoms during my service, and was not even aware of the condition myself. I was hesitant to file for something that I was not seen for, but because of the insistence of my wife, I included it in my claim. I separated from the United States Army in APR 2017 and filed an initial disability claim on January 25, 2018. I went to a sleep study on March 3, 2018. A decision was made for this claim on March 28, 2018.
I was granted 70% service connection for the following:
- Sleep Apnea - 30% - Bilateral Pes Planus (claimed as bilateral flatfoot) - 30% - Lumbosacral Strain (claimed as low back condition) - 10% - Radiculopath Right Lower Extremity - 10% - Radiculopath Left Lower Extremity - 10% - GERD - 10% - Right Shin Splint - 0% - Left Shin Splint - 0% I filed for an increase on the Sleep Apnea condition in OCT 2018 after the VA scheduled an additional sleep study in OCT 2018 where the provider advised that I needed a CPAP. I am unsure why they determined I needed a CPAP in OCT 2018 when I had an initial sleep study in MAR 2018, but I was just following the VA's directions. I had suffered through these symptoms for years without the use of any CPAP therapy, so I was still unaware when I would receive a CPAP. I ended up purchasing one out of pocket. The VA sent a decision in NOV 2018 stating the following: 1. The rating dated March 28, 2018 was clearly and unmistakably in error for granting service connection for obstructive sleep apnea. We are proposing to discontinue service connection for this condition. 2. A decision as to whether the rating dated March 28, 2018, was clearly and unmistakably in error for granting service connection for Lumbosacral Strain is deferred. 3. A decision as to whether the rating dated March 28, 2018, was clearly and unmistakably in error for granting service connection for Radiculopathy Right Lower Extremity is deferred. 4. A decision as to whether the rating dated March 28, 2018, was clearly and unmistakably in error for granting service connection for Radiculopathy Left Lower Extremity is deferred. 5. The rating dated March 28, 2018 was clearly and unmistakably in error for granting service connection for GERD. We are proposing to discontinue service connection for this condition. At this point, I'm unsure what to do and what option to pursue, so I decide to not challenge their decision. About a year later, I receive a Decision Letter on 10/3/2019 stating: - Sleep Apnea 30% - Severed - 1/1/2020 - GERD - Severed - 1/1/2020 - Lumbosacral Strain (claimed as low back condition) - 10% - Continued - Radiculopath Right Lower Extremity - 10% - Continued - Radiculopath Left Lower Extremity - 10% - Continued During the entire process after separating the military, I was clueless on how to schedule appointments through the VA, how to log in to ebenefits (Now VA.gov), and how to access additional resources. Fast forward to MAR 2021. I am at an appt with my provider and she is looking through my medical history and sees the sleep study scans. I advised her that I have a CPAP, but tell her the VA never sent me one and they severed the service connection due to me not being seen while in service. She then submits a referral for the VA to send me a CPAP and advises I should try and appeal this. She states that if I did not have the symptoms before the military, filed within a year of separating, and the sleep studies show that I currently have obstructive sleep apnea, then I should appeal it. I reluctantly go to the VA office in my city and present this situation. He echoes the statement of the initial claim filed within one year of my separation and the sleep study results showing OSA. I do some research and see that Sleep Apnea is not a condition mentioned in the list that the VA considers for automatic service connection. The VA representative assists me in submitting a supplemental claim on July 9, 2021. I thought this was past the year mark of appealing, but he submits it anyway. On July 15, 2021, I receive a decision stating it was denied. The VA rep advises me that in the system he is looking at, the decision notes state there is no nexus link, so I would need to get a Nexus Statement from my provider and it should finally help get it approved. My provider has no appointments until 2022, so I do research. I find Dr. Joseph Krainin with www.singularsleep.com. I get in contact with them, and after reviewing my medical history, they advise that they can provide me a Nexus Letter linking my Sleep Apnea secondary to my Lumbosacral Strain and Bilateral Radiculopathy, as well as providing additional information on the likeliness of the Sleep Apnea developing during my service since it was reported on my MEPS document. I spend $800 on this document and hope it will change something. I submitted this appeal on August 24, 2018 containing this Nexus Statement document. In conclusion, based on how this decision goes, should I give up on the Sleep Apnea service connection after this? Without me being seen during my actual service, is it likely that the VA will not grant it? I hope this was not too much information once again. Thank you all for any help you can provide!
I'm planning on filing a claim with the VA for Sleep Apnea. I do not currently have a CPAP machine and have not had a sleep study done at this point by my local VA Hospital. Should I have a CPAP machine and sleep study completed by my local VA Hospital before I file my claim?
I had my test last week and found my notes on Ebenefits. Nobody has called me and I do not have any appointments. Just wondering if anybody knows what some numbers mean? They don't have an average next to them. During my night recording i had 120 hypopneas, 7 obstructive apneas and 6 central apneas generating an overall AHI of 17.5/hour. The lowest oxygen saturation is recorded at 86%. Not sure if this is normal or not. I don't think I have anyway to SC it but at least they will take care of everything. Any expert advice would be much appreciated. Thanks all.
Denial Letter missing? Where can I get a copy? I have a Premium online VA account but cant find it...By Wico1337
I did not see my most recent decision denial letter in the mail. Anyone know where I can get ALL of my past denial letters and their reasonings for denying me? Also, is there a way to see all of my service connections and their wording on why they were able to service connect me?
One reason I also want to know the reasons I am service connected to things is because I was recently approved for Hypertension. They denied me Sleep apnea in the past because of my weight. But I believe in this recent decision, I leveraged the fact that I gained weight due to my mental health service connection. And I was able to use that as a nexus for hypertension. I am now wanting to point toward that service connection approval and use it as an "It was recognized in my Hypertension claim that I gained weight from Anxiety/depression service connection. I am wanting to transfer that recognition to my reasoning for my service connection to sleep apnea. Since the VA had prior listed the reason that I have sleep apnea is due to my weight."
Anyone know where I can get past approval and denial letters with details of connections?
I try to keep it short and hopefully make sense.
2011 Aug - Got out did Pre discharge Disability Claim with VSO on base before I went on final leave.
2011 December - VA Examination, Chronic Fatigue Syndrome, I dont have a copy of this exam only the one from 2013.
2013 June - Chronic Fatigue Syndrome DBQ
This Dr. typed in section #1 Diagnosis;
If there are additional diagnoses that pertain to chronic fatigue syndrome, list using above format: The veteran was misdiagnosed in May 2011. He does not and he never did have chronic fatigue syndrome.
in section #2 Medical History:
a. Describe the history (including onset and course) of the veteran chronic fatigue syndrome: Veteran was tired and sleepy for a couple of weeks and was fine one month later. Asymptomatic at this time.
2013 Aug - Rating Decision from the 2011 claim it took 2yrs to complete.
in this rating Decision there is no mention of the DBQ for Chronic Fatigue Syndrome in the denial area and there are no deferred claims. There are 9 claims some granted and denied but nothing about the Chronic fatigue.
They only mention the Chronic Fatigue DBQ in the All evidence considered section:
2017 - VA Neurologist put on the comments for my Primary Care Dr.
For Fatigue please consider sleep study
2021 - Was diagnosed with Obstructive Sleep Apnea by private Sleep Doctor
2021 - I got a Rating Code sheet and there no mention of Chronic Fatigue Syndrome.
When I filled the Pre discharge Disability I dont recall we talked about Fatigue syndrome so I am pretty sure it was not part of the claim, but somehow the VA ordered a DBQ for it maybe because it was within the 1yr mark since I got out that I was diagnoses with Chronic Fatigue Syndrome.
Would this be considered some type of Duty to assist error? as the C&P Doctor said I was misdiagnosed but then the VA did not order a sleep study to figure out my fatigue back then.
So all this time I been having low energy levels / fatigue / sleepiness due to the Sleep Apnea since I got out but I was misdiagnosed and not given a sleep study. Heck even my primary care Doctor failed to follow the Neurologist suggestion to order me a Sleep study.
What are the chances that the VA would grant Sleep Apnea back to 2011 since I dont recall claiming it but again somehow they did a DBQ for the fatigue issue.
broncovet posted a question in VA Disability Compensation Benefits Claims Research Forum,The NVLSP launched its Burn Claim Assistance program: Details at the NVLSP website:
I have a C&P exam scheduled for next week for sleep apnea. I completed an at home sleep study sent by VES. However, I just visited ebenefits and noticed that my claim has been closed before my scheduled exam. Anyone ever experience this?
rebabevets posted a question in VA Disability Compensation Benefits Claims Research Forum,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
Ddsr posted a question in VA Disability Compensation Benefits Claims Research Forum,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.
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)
broncovet posted an answer to a question,While the BVA has some discretion here, often they "chop up claims". For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.
I hate that its that way. The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.