Sleep Apnea (secondary or direct connection)

[Wooderson]

I know this type of question has been asked over and over, but my searches did address some questions i had. Been off active duty for about 9 years and was diagnosed with OSA in 2017 (CPAP prescribed). I would like to attempt to file for the OSA.

I have PTSD, bilateral knee (10% each), and degenerative disc in my back and cervical neck ratings. While on active duty I never received a sleep study, but have a couple of buddy letters attesting to showing symptoms (gasping for air, excessive snoring, etc..) of sleep apnea while on active duty in Iraq.

I do have a memorandum for record from a treating physician who saw me while i was deployed (all SMR were lost/destroyed in country by the military and his letter specifically addresses those facts--this is the same letter I used and that the VA used gaining service connection for my other issues). In the letter the physician specifically stated that he treated me for several issues, including sleep disturbances.

After returning (while out-processing and still on active duty) i was also shown by the VA dentist to have severe bruxism (which the VA themselves have shown to be a symptom of sleep apnea), possibly to the combat stress that caused the PTSD.

So should i file direct service or secondary to PTSD and the knee and back issues. I have gained some weight since coming off active duty due to the fact that I cant workout like before, but I wouldn't say I'm morbidly obese. 6'0", 205.  Thanks.

[brokensoldier244th]

Be aware that sleep disturbance is not the same as sleep apnea. Most likely you’r your disturbances are already covered in your ptsd rating. It’s also not attributable directly to your back and knees unless you want to go the long somewhat painful route of osa by way of obesity, caused by pain and inactivity.
 

Obesity itself is not service connectable but it can be caused by certain combinations of disabilities that then manifest as things like osa. that’s how my claim was constructed. It still took an appeal, though that may have been my fault for jumping the gun and not having enough anecdotal and medical evidence when I filed the first time. 

however, if you aren’t obese then that horse might not fly. Your bruxism might also already be accounted for in your ptsd rating as well. 

[broncovet]

Ask for both.  Why burn down any bridges?  Let the rating specialists figure it out.  However, if one or more of your doctors has provided a nexus statement to PTSD, then go for it (secondary).  If, on the other hand, one or more of your doctors has opined your OSA is at least as likely as not due to an (in service event), then go for primary.  

Its not your job to determine if OSA is secondary, primary, direct, or presumptive.  "Unless you plan on going to work for VA as a rating specialist, I dont suggest you do their job for them.  Just ask for OSA

"both primary and secondary to PTSD" and let them figure it out.  They wont take your word for it anyway, and, if you guess wrong, then you could be causing delays and additional appeals.  

[Wooderson]

2 hours ago, brokensoldier244th said:

Be aware that sleep disturbance is not the same as sleep apnea.

Yea I totally get that, but my line of thinking (since there wasn't a diagnosis on active duty) was that it may  at least show there there was at least some type of sleep issues that were complained about and documented. Was it OSA? Who knows, but I have read hundreds of BVA decisions that say something the effect that the service member has NO complaints of sleep disturbances. So at least I show something which I was thinking was better than  nothing in my service records. am i on the right track at all? Thanks

[Wooderson]

...and regarding the knee/back issues I was trying to hopefully show that my weight gain (205 at sleep testing, weighed about 170 coming off active duty) was possibly due to my knees/back. At 205 my BMI would be around 28 so just trying to have something in my case if VA says the OSA is possibly due to weight gain (even though im not really obese). 

[Slick]

Going back a number of years I filed for PTSD and OSA.

PTSD approvbed. OSA was denied as I didn't have any record in my book abouit being treated for it.

After some research in the Board of Veterans Appeals I went with OSA as secondary to PTSD.  I thik the VA broke the land speed record in producing a positive decition.

 

[USMC_VET]

16 hours ago, Wooderson said:

I know this type of question has been asked over and over, but my searches did address some questions i had. Been off active duty for about 9 years and was diagnosed with OSA in 2017 (CPAP prescribed). I would like to attempt to file for the OSA.

I have PTSD, bilateral knee (10% each), and degenerative disc in my back and cervical neck ratings. While on active duty I never received a sleep study, but have a couple of buddy letters attesting to showing symptoms (gasping for air, excessive snoring, etc..) of sleep apnea while on active duty in Iraq.

I do have a memorandum for record from a treating physician who saw me while i was deployed (all SMR were lost/destroyed in country by the military and his letter specifically addresses those facts--this is the same letter I used and that the VA used gaining service connection for my other issues). In the letter the physician specifically stated that he treated me for several issues, including sleep disturbances.

After returning (while out-processing and still on active duty) i was also shown by the VA dentist to have severe bruxism (which the VA themselves have shown to be a symptom of sleep apnea), possibly to the combat stress that caused the PTSD.

So should i file direct service or secondary to PTSD and the knee and back issues. I have gained some weight since coming off active duty due to the fact that I cant workout like before, but I wouldn't say I'm morbidly obese. 6'0", 205.  Thanks.

After a couple of failed claims early this year i bit the bullet and forked over $1500 for Dr. Anaise who wrote the nexus letter that my PTSD aggravated my Sleep Apnea due to nightmares and other sleep disturbances that caused me to rip off the mask during the night.  I filed as a Supplemental Claim in April and had the decision letter, granted, by June.