Secondary condition rated higher than primary?

[Rivet62]

I have a situation that I am approaching that would have my future claim of a secondary condition rated higher than the primary condition. Is this typical?

I think I could have a claim for my Central Sleep Apnea because I require a BiPAP (a CPAP). VA rates this as 50%.

My disc degenerative disease in my cervical spine is the cause due to compressed nerves in the neck (I'm pretty sure).  I'm unsure of what the neck DDD would be rated for, 20% maybe for limited range of motion maybe. Upper extremity radiculopathy is well under way from compressed nerves in the neck.

I think I would like to file a claim for C-spine DDD together, with Central Sleep Apnea as a secondary at 50% while the primary might be rated as 20%.

Is this reasonable to do?  Are there instances where a secondary condition is rated higher than the primary?

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Edited February 2, 2022 by Rivet62

[brokensoldier244th]

In traumatic spinal cord injuries, yes, but if its not affecting regular inspiration it is going to be a harder sell. That's all I'm saying. I HAVE a spinal injury- and OSA. Ive read most of this stuff, too, and it had no impact on my rating because my regular breathing is not impaired. If a breath test indicates weakness in the diaphragm or other breathing apparatus then he should be fine.

 My OSA was secondarily connected due to BMI brought on by an underactive thyroid, demonstrable chronic pain, and sedative medications that cause relaxation of the physical breathing apparatus. Another avenue to consider.

 

[Rivet62]

10 minutes ago, pacmanx1 said:

An IMO with a good medical rationale would greatly help your claim. Your doctor can medically explain how your C-spine could cause breathing problems and apnea.

I can steer this somewhat with my providers in MyHealth eVet messaging, moving along the path toward diagnosis perhaps with a neurologist referral, but I can't rely on my doctors to make the statement needed. This is an important claim for me that can easily lead to 100%P&T and even SMC, so I will strongly consider your advice for an IMO since so much is on the line.

[Rivet62]

29 minutes ago, brokensoldier244th said:

If a breath test indicates weakness in the diaphragm

That would describe Obstructive Sleep Apnea. In my case, my brain is not sending signals to breathe due to compromised nerves in the C-Spine. This type of sleep apnea is called Central Sleep Apnea. I have "severe" Central Sleep Apnea. There is also a combined sleep apnea where both Central and Obstructive are mixed.

Do you remember Christopher Reeves? The old Superman?  He fell off his horse and injured his neck, and from that point on he was a paraplegic and had to have a respirator to breathe?  Remember? Well, my neck is not nearly as bad but it's the same premise that has me on a BiPAP.

Edited February 2, 2022 by Rivet62

[Rivet62]

1 hour ago, shrekthetank1 said:

It does happen all the time.  It depends on what the secondary condition is and how bad it is.  

The VA does not say well since you have 20% for said condition, then we are only going to give you 30% of the 50% that the rating says you should get.  

If you are connected to a Secondary condtion the Va rates it as a seperate condition as long as it does not pyramid.  So it will have it's own rating that has nothing to do with what it is secondary too.  

Thanks Shrek. 

[Rivet62]

1 hour ago, brokensoldier244th said:

connecting OSA to neck disc compression unless the discs that are compressed affect regular breathing.

I'm not OSA. I am CSA. Yes, disc compression affects regular breathing.

[ArNG11]

Rivet the big thing here is going to be to get a medical opinion that relates your neck injury to CSA or OSA not sure,  I know they are different forms of sleep apnea, that affect different pathways of the sleep cycle, in any case, VA doctors will sometimes write a nexus but at times it can be like pulling teeth from a sleeping lion.   Not to say you shouldn't try, it definitely has its merits.  Would it be possible to save a bit for an IME/IMO, if you had both, the VA docs opinion and an independent medical opinion, the VA would have a dandy of a time trying to say no.  just my two cents.