Nexus question

[Johhny_Drama]

Hello everybody 

I hope everyone is having a Good Friday. 
Almost 18 months ago I submitted through the vfw a appeal and this went to the board. After reviewing they remanded the decision back to my local VA office. There was evidence that was not included and I guess errors. 
In the meantime I am working with a provider that’s working a nexus letter. Should be done in the next week. 
with that in mind I expected the appeal to get denied and it took a while. I figured if I can get a nexus letter and send it then it could be added to the claim. Now that the appeal is back with the local va can I just send this to the intake center or upload ? I would ask my local vfw but their offices are closed up. 
also about my provider. He is not a doctor but I believe a MSW or CSW with 35 years of working with the dept of VA treating PTSD. I am rated with ptsd. I’m trying to get my sleep apnea rated secondary. I know this is talked about a lot however my question is will the va toss the nexus because the person is not a doctor ? I’d think 30 plus years working with the VA and working primarily with ptsd patients should count for something. He was licensed and just couldn’t prescribe meds. I like to avoid meds altogether and get to the square root of my issues. 
I appreciate any feedback. I’m glad the board didn’t Just deny me. I think I have a good argument and this nexus will help. 

[Hucast21]

In my opinion, your nexus will more than likely be tossed out because your provider is not a board-certified sleep specialist.

You need a medical doctor, particularly a board-certified specialist, to render you a nexus letter if you want to connect sleep apnea secondary to PTSD.

[broncovet]

The VA would have egg all over their face if they toss out your nexus "based solely" on the fact your medical professional was not an MD because:

1.  The VA uses NP's all the time for c and p exams.  

2.  If they use them, how can they tell us our NP or otherwise, is no good?  

You need only show "medical competence" not an MD.  This person (IMO DOC) is acting as an "expert witness".  

My audiologists opinion (she is not a doctor) was sufficient to get me hearing loss.  

You dont need a MD, but you do need an "expert witness" on the subject.  Many medical professionals are not MD's, but they still have great opinions.  If VA tossed out your nexus because he did not have an md, then VA would have to fire about 80 percent of their QTC examiners, who are also not always MD's.   They wear a white coat, and carry a stethescope, so Vets assume they are MD's, when often they are not.  

Bottom line:  Have your Nexus professional submit a CV documenting his expertise in the field and his competence to opine.  

[Hucast21]

1 hour ago, broncovet said:

The VA would have egg all over their face if they toss out your nexus "based solely" on the fact your medical professional was not an MD because:

1.  The VA uses NP's all the time for c and p exams.  

2.  If they use them, how can they tell us our NP or otherwise, is no good?  

You need only show "medical competence" not an MD.  This person (IMO DOC) is acting as an "expert witness".  

My audiologists opinion (she is not a doctor) was sufficient to get me hearing loss.  

You dont need a MD, but you do need an "expert witness" on the subject.  Many medical professionals are not MD's, but they still have great opinions.  If VA tossed out your nexus because he did not have an md, then VA would have to fire about 80 percent of their QTC examiners, who are also not always MD's.   They wear a white coat, and carry a stethescope, so Vets assume they are MD's, when often they are not.  

Bottom line:  Have your Nexus professional submit a CV documenting his expertise in the field and his competence to opine.  

Yes, the VA uses NP’s all the time for C&P exams but the VA can set its own rules though. You know this.

If an NP gave a veteran an unfavorable C&P exam, and the veteran countered with an IMO from another NP, it won’t cut it imo. The best way to discredit an unfavorable exam from an NP is to get a 2nd opinion from a board-certified specialist.

The OP is asking if a nexus statement from a MSW is sufficient. I don’t think it is.

The VA shot down my IMO from a board-certified specialist because the rater considered it “telehealth”, despite the VA doing telehealth appointments and certain C&P exams due to COVID.

The VA are hypocrites and don’t follow their own rules.

[Buck52]

Oh filing a secondary claim  from PTSD  to Sleep Apnea  check with your MH Dr  the ones that can prescribe meds, this is a specialist Dr  and he/she can give their medical opinion as to why your medications you take for PTSD is and can be related to OSA.

I HAVE SLEEP APNEA   WHICH I Never had it in the Military.

  I have CHRONIC PTSD and take heavy medications for high Anxiety and other meds  but also I take a strong sleep medication to hopefully target the nightmares   and it puts me in a deep deep sleep  I snore and have breathing episodes as to I stop breathing and good thing my brain is working it tells my body to start breathing < According to my sleep Doc) Anyway  my wife notice this and I mention it to my MH Doc  she sent me to the VA Sleep Clinic and they had me take an outside private sleep study   because the VA Clinic was booked up for the next 6 months,  so they could not get me in   and sent me to a private sleep study, the VA got the results back and diagnose me with mid-to severe Sleep Apnea  and prescribe me a C-Pap Machine...I never filed a secondary claim off my PTSD but I could if I wanted to.......

I am ok with what the VA Rated me and have 100 %  &  2 SMC's   so no more $$ in it for me  and my original disability is over 10 years  so actually no benefit for the sleep apnea for me  money wise.

If a veteran died after 10 years of being rated 100%or IU  for any of his  S.C. Conditions  his spouse is eligible for  the DIC

So yeah a good nexus from your sleep Dr would certainly help or your MH Dr.

I PERSONALLY WOULD NOT WANT A  N.P.  BUT I THINK THEY CAN GIVE THEIR MEDICAL OPINION ALSO...AND THE VA WOULD TAKE IT.

JUST HAVE TO WAIT AND SEE?

File for it today  if you have not filed it yet...sooner the better.

Edited November 15, 2020 by Buck52

[Buck52]

Test Test???

[Johhny_Drama]

I’m trying to reply to all that responded. I really appreciate everyone taking the time to answer my question. 
 

some background info. I in have rated PTSD. I also took a sleep study. Sleep study said I’m severe case I stop breathing 97 times a hour or something. My provider worked at the VA for 35 plus years. His picture is hanging up in the VA hospital. He specializes and is a expert in PTSD. He also said he’s written nexus to show how PTSD will aggravate the sleep apnea. 
 

I’ll say that his knowledge has helped me a lot. I have nightmares and I have weird routines like checking areas of my house I’ll wake up waking around. Then I’ll sit in a up position for hours ... I never understood this. It’s because when you’re out in the field up might be back to back with someone ...this really made sense. Just identifying the things I do. My guy has so much knowledge and I’m just hoping they can see how the ptsd can relate with sleep issues. We will see. I have to send the info next week. Lots of the offices are closed. I don’t even know if the intake center is open and benefits has been down.