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

[Rivet62]

3 hours ago, Hamslice said:

He got denied before his C&P,

Yikes,

But it could be that VA is rating him for something else instead. So, they deny one and get him rated for some other diagnostic code after his C&P.

[Rivet62]

10 hours ago, Riplip said:

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 replied to Hamslice about this, but it's better to reply directly to you.  It could be that VA is rating you differently instead. So, they deny one and get you rated for OSA as secondary to some other diagnostic code, or after your C&P.

As for C&P exams, if you're expecting one and you're worried you haven't heard anything yet then I would call 1-800-827-1000 to find out who is scheduling your C&P exams then call them. I had to literally call MSLA (the folks doing my C&Ps) once a week to see if I was scheduled for a C&P because they had the wrong address and phone number for me. Somehow, they ended up with contact information that had changed over a year ago. I couldn't seem to change it with them. So I just kept calling to check.  I didn't have this problem with QTC.

I first became aware of the problem when a C&P examiner called me!  He said, did you know you had an exam with me this afternoon at 4:30? I said NO I did not.  He asked when I could be there. I was at work. I said 30 minutes. He waited and I got my C&P exam done.

Edited February 2, 2022 by Rivet62

[Rivet62]

17 hours ago, Riplip said:

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

I did some research on my Central Sleep Apnea and found that your overweight condition is one of the recognized causes of Obstructive Sleep Apnea (OSA).

There was a discussion here on Hadit about a successful claim that was won by adding credible, authoritative medical articles to the claim.

[Riplip]

13 hours ago, Buck52 said:

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.?

I never had a C&P exam. My wife called them because I can't use phones due to hearing loss. They said they would call on Saturday 1/22 between 6 and 7:30 if they needed too ask questions and we would have to be together for me to verify that she is my wife speaking for me. She even said the person stated that he doesn't think anyone would call but he then back peddled like he said too much when she asked how he knew that. They never called so I assumed they didn't need to exam me for anything. Fast forward a week later and the claim has been denied. That's where I stand at this point. My follow-up and to receive my C-Pap is this Friday. It just seems it got denied before they gave me a chance to get the paperwork in. Last couple claims to 2-4 months. I'm going to try for the IMO and see if I can reopen the claim after I get it. I even stated when filing the claim that is wasn't fully developed and I was getting more info. I just wanted to get the thing started. We will see I guess. Always something different every time. Keeping us on our feet I guess LOL

[Rivet62]

54 minutes ago, Riplip said:

That's where I stand at this point.

It sounds like VA is connecting some dots in the claim. You can't see their work in progress. Think of it like a big Tetris game. They rearrange some diagnostic codes and replace those with others more fitting.  They deny one and grant some other in its place. Or, they have a diagnostic code that more aptly applies than the one you claimed. As for me and mine, their Tetris rearranging opened me up for more future secondary claims. Had I stayed in the old diagnostic code then my future claims would have been limited.  As my conditions worsen I can see 100%P&T in my future and even SMC because of their diagnostic code changes.  So take heart, and give it a little more time for the outcomes on VA.gov or look for benefits letters on eBenefits.

If you see a tangle occurring with respect to possible C&P exam scheduling then you need to call whoever is administering the scheduling (MSLA or QTC or whatever the third party is that is scheduling and notifying you of C&P appointments. I had to check with MSLA on a weekly basis to see if C&Ps were scheduled, because their contact info for me was outdated and my updates were not sticking in their records, so each agent referred to the old contact info.

It could be that VA doesn't need a C&P after all, because they have connected enough dots such that they don't need it.

Edited February 2, 2022 by Rivet62

[pacmanx1]

It seems that according to the VA, you currently do not have any service-connected disabilities that could cause Sleep Apnea. Something interesting is that the VA will/would service connect Sleep Apnea secondary to PTSD but not Major Depression Disorder. 

Depression and obstructive sleep apnea - PubMed (nih.gov)