JKWilliamsSr Posted March 31, 2022 Share Posted March 31, 2022 11 minutes ago, GulfWarVet1990 said: Thanks JKWilliams Sr. - sounds like I need to get another IMO to overrule the VA examiners decision. I would have to agree with you taking the BVA route, I had a complex case re: cancer, final took it all the way to the BVA and won. If I may ask. What evidence did you submit for your claim for sleep apnea. Did you submit any medical evidence other than your diagnosis? pctinc2001 1 Link to comment Share on other sites More sharing options...
GulfWarVet1990 Posted March 31, 2022 Author Share Posted March 31, 2022 1 hour ago, JKWilliamsSr said: If I may ask. What evidence did you submit for your claim for sleep apnea. Did you submit any medical evidence other than your diagnosis? I submitted my sleep test results, diagnosis from sleep doctor and an IMO/nexus letter from a Psych D. Link to comment Share on other sites More sharing options...
JKWilliamsSr Posted March 31, 2022 Share Posted March 31, 2022 (edited) 5 minutes ago, GulfWarVet1990 said: I submitted my sleep test results, diagnosis from sleep doctor and an IMO/nexus letter from a Psych D. That should be enough. With that evidence you should not need another nexus letter providing the correct wording is in there. The decision letter should explain it. Since you had a positive nexus letter the VA is required to state the reasons they gave their examiner more weight than yours. Which is probably a laughable reason. My guess is the VA examiner is a NP or a PA. I have never had an actual VA examiner that was an MD. Edited March 31, 2022 by JKWilliamsSr Vync 1 Link to comment Share on other sites More sharing options...
GulfWarVet1990 Posted March 31, 2022 Author Share Posted March 31, 2022 10 minutes ago, JKWilliamsSr said: That should be enough. With that evidence you should not need another nexus letter providing the correct wording is in there. The decision letter should explain it. Since you had a positive nexus letter the VA is required to state the reasons they gave their examiner more weight than yours. Which is probably a laughable reason. My guess is the VA examiner is a NP or a PA. I have never had an actual VA examiner that was an MD. you are correct, she was a NP. Link to comment Share on other sites More sharing options...
JKWilliamsSr Posted March 31, 2022 Share Posted March 31, 2022 9 hours ago, GulfWarVet1990 said: you are correct, she was a NP. As long as your nexus letter states that it is "more likely than not" that your sleep apnea was caused by your PTSD you should not have a problem winning the appeal. Another thing that is important is that your doctor cited medical studies when making his opinion. I am not certain if it is required but it does seem to go a long way in making a credible opinion. In my BVA appeal the judge cited studies my doctor put in my IMO. Based on the evidence you have IMO you should appeal directly to the BVA. I would do the direct review without evidence submission. That is the fastest appeal route. If you decide to get another IMO then you would go the direct review with evidence submission. What makes this longer is you have 90 days to submit any evidence so you are not in the queue to have your your appeal submitted to a judged until that time elapses. Then of course there is the hearing route which is the longest route by far. The reason I feel you should avoid the HLR route is because I believe it is a farce. It looks good on paper but that is all it does. This is from personal experience with several HLR's. They all get denied with a rubber stamp. On each of my HLR's I pointed where the errors were citing the CFR and appropriate case law. I was still denied and on top of that the senior rater did not address a single argument I made. What I did was waste my time going the HLR route. The time frame for HLR's is 4-5 months. I know of people that have waited a year or more for an HLR. An appeal to the BVA will take longer but the success will likely be better. My understanding is the direct review WITHOUT evidence submission is around 12 months. I am sure it could be longer but my understanding that is the timeframe. So when you look at it this way you are only adding about 7 months or so to your wait where after an HLR denial you would still have to appeal to the BVA and that total would be 17+ months. Link to comment Share on other sites More sharing options...
Moderator pacmanx1 Posted March 31, 2022 Moderator Share Posted March 31, 2022 (edited) 39 minutes ago, JKWilliamsSr said: As long as your nexus letter states that it is "more likely than not" that your sleep apnea was caused by your PTSD you should not have a problem winning the appeal. Here we go again with semantics, your comment is misleading and puts a greater unnecessary burden/pressure on veterans and medical providers. A nexus statement does not need to state “MORE LIKELY THAN NOT” it simply needs to state “AT LEAST LIKELY AS NOT (50/50 probability)” caused by or the result of the veteran’s service-connected disability. By advising veterans they need a more likely than not statement is also placing a greater burden/pressure on the medical provider that may not be willing to provide that strong of a statement and not necessary to win service-connection. I know you are going to say that I am playing with words, but your advice can discourage a veteran and his/her medical provider. I feel that we have to try to correct bad or wrong information going out. Why place unnecessary hardship on veterans when we can correct it now. Edited March 31, 2022 by pacmanx1 Vync 1 Link to comment Share on other sites More sharing options...
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