Super fast denial

[Riplip]

So I opened a claim for OSA 2 weeks ago secondary to my vestibular disorder stating that the vertigo and balance issues make it impossible to keep and excercising routine and the weight gain I have at this point is due to the lack of excercise and the meds. I'm on for Anxiety / depression which is also service connected due to my severe hearing loss. They sent a paper saying the outsourced people will call if they need to for a physical. No calls. I checked my work in process and both were denied. I didn't even put it in for a fully developed claim yet because I have my follow up appointment with my sleep doctor this Friday. I guess they don't even let you get all your info. in before denying now. My other claims never went this way. Not sure what to do at this point. Didn't even get a chance this time. Hope you all are having a better day. Thanks

[Carl the Engineer]

Hmmmm,

I would wait a couple days and give it another look.  What we see online can change hour by hour, much less day by day.

You could look at your disabilities list on the old Ebenefits site.  If it shows up there, not service connected, then you are probably right, but still wait for the envelope.

Good luck,

Hamslice

 

[Riplip]

3 minutes ago, Hamslice said:

Hmmmm,

I would wait a couple days and give it another look.  What we see online can change hour by hour, much less day by day.

You could look at your disabilities list on the old Ebenefits site.  If it shows up there, not service connected, then you are probably right, but still wait for the envelope.

Good luck,

Hamslice

 

Yes it is on the old benefits stating denied in my disabilities list. 

 

[pacmanx1]

25 minutes ago, Riplip said:

Not sure what to do at this point.

Bottom line, you are going to need an IMO (INDEPENDENT MEDICAL OPINION). If you can get one from one of your VAMC doctors that would be great, but you are definitely going to need one. Some have paid out of pocket. I could never afford one and seem to find a way to get my VAMC doctors to write one. Even if they write a statement in your progress reports that will do but you are going to need it to overcome this decision. I used a CCP (COMMUNITY CARE PROVIDER) to fill out one of my DBQs and got service connected that way. It needs to say that your sleep apnea is as least likely as not (50/50 probability) caused by or the result of your service-connected disability and name that service-connected disability and give a good medical rationale (reason how they connect). The sleep specialist could do it also. Keep in mind to get the 50% rating you are going to have to be on the CPAP machine and using it as a medical necessity. 

Your disability shows that you are currently 90%. A Sleep Apnea award with a 50% rating would most likely award you a combined 100% scheduler rating.

 

Edited February 1, 2022 by pacmanx1

[Riplip]

37 minutes ago, pacmanx1 said:

Bottom line, you are going to need an IMO (INDEPENDENT MEDICAL OPINION). If you can get one from one of your VAMC doctors that would be great, but you are definitely going to need one. Some have paid out of pocket. I could never afford one and seem to find a way to get my VAMC doctors to write one. Even if they write a statement in your progress reports that will do but you are going to need it to overcome this decision. I used a CCP (COMMUNITY CARE PROVIDER) to fill out one of my DBQs and got service connected that way. It needs to say that your sleep apnea is as least likely as not (50/50 probability) caused by or the result of your service-connected disability and name that service-connected disability and give a good medical rationale (reason how they connect). The sleep specialist could do it also. Keep in mind to get the 50% rating you are going to have to be on the CPAP machine and using it as a medical necessity. 

Your disability shows that you are currently 90%. A Sleep Apnea award with a 50% rating would most likely award you a combined 100% scheduler rating.

 

 

37 minutes ago, pacmanx1 said:

Bottom line, you are going to need an IMO (INDEPENDENT MEDICAL OPINION). If you can get one from one of your VAMC doctors that would be great, but you are definitely going to need one. Some have paid out of pocket. I could never afford one and seem to find a way to get my VAMC doctors to write one. Even if they write a statement in your progress reports that will do but you are going to need it to overcome this decision. I used a CCP (COMMUNITY CARE PROVIDER) to fill out one of my DBQs and got service connected that way. It needs to say that your sleep apnea is as least likely as not (50/50 probability) caused by or the result of your service-connected disability and name that service-connected disability and give a good medical rationale (reason how they connect). The sleep specialist could do it also. Keep in mind to get the 50% rating you are going to have to be on the CPAP machine and using it as a medical necessity. 

Your disability shows that you are currently 90%. A Sleep Apnea award with a 50% rating would most likely award you a combined 100% scheduler rating.

 

Pacman I totally agree. I was planning on working on that this Friday with my appointment. They've never made a decision this fast so it caught me off guard. I plan to ask my sleep nurse to write in her notes and also see if my psychologist can write one as well. I hope they will. Oh and yes I am getting my CPAP this Friday. Thank you

[Buck52]

Don't trust ebenefits  you should wait and get the denial in the mail ...>there  lible to put anything on ebefits  try  ebenfits va. gov.

Was your C&P EXAM FAVORABLE ?  THE C&P Examiner can not put denied on his report. BUT THEY CAN FOOL YOU WHEN YOU THINK YOU GOT A GOOD dR AND THINGS SEEM TO BE GOING OK AND YOUR SURE YOU WILL BE APPROVE BY WHAT THE EXAMINER SAID TO YOU DURING THE EXAM  

AND YOUR SURE YOU WILL BE APPROVED  SOME TIMES THAT WORKS BACKWARDS BUT IF IT DOES THERE ARE WAYS TO WIN.

Appeal go get you a I private MO/IME  tell the dr what you need and why.

If your service connected for hearing loss  and they say your depression is due to your hearing loss   sometimes if your not 100% for depression and the symtomps   hearingloss can cause you to be 100% depressed  just need a quailfied  Dr to give his favorable  medical opinion, you also can be s.c. at 100% for other conditions  as long as you can connect to your military service   but there some conditions that wing off one another.  like sleep apnea  depression can case that   you maybe sc for S.A.?

[Carl the Engineer]

Buck,

He got denied before his C&P,

Yikes,

Hamslice