Just found out today Denied Sleep Apnea Secondary to PTSD - Disappointed

[Dustoff1970]

Either wording will work just fine in my experience and is best. Also when the doctor says due to or caused by has also worked

Edited March 31, 2022 by Dustoff 11

[JKWilliamsSr]

1 hour ago, pacmanx1 said:

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. 

Semantics?....SMH.   Different post and my response in that manner was about a specific choice words in where I was just clarifying something and in any case I was not wrong in that post. 

I am not above admitting I am wrong and this particular issue I was.  I took the wording I used from my own IMO where my doctor put "more likely than not".   "At least as likely as not" is the minimum standard and is all a vet needs in the IMO.  You are correct.  

[pacmanx1]

Really not trying to say that I am right, and you are wrong, just trying to help the veteran.

Your post was correct just a little misleading. As stated, it would just make it a little harder. It is bad enough to try and get some doctors/physicians to get involved but try to make them understand that it is just possible at least 50/50 probability would do. 

[deedub75]

The IMO that you have could be inadequate if all the bases aren't covered. 

1. It has to state that the veterans pertinent medical records were reviewed.

2. The IMO at a minimum needs to say "at least as likely as not." 

3. Rationale on the medical opinion needs to be in there. Just can't give a medical opinion with rationale. 

4. The doctor's credentials must be listed as well. 

The only one time I needed an IMO, I asked my personal orthopedic surgeon if he'd support me because a VA NP kept saying that an abnormal gait could not cause knee and back issues. My orthopedic surgeon said that was just plain wrong. I wrote the IMO for him and just had him sign it, and the claims were finally granted. 

 

[JKWilliamsSr]

1 hour ago, pacmanx1 said:

Really not trying to say that I am right, and you are wrong, just trying to help the veteran.

Your post was correct just a little misleading. As stated, it would just make it a little harder. It is bad enough to try and get some doctors/physicians to get involved but try to make them understand that it is just possible at least 50/50 probability would do. 

I understand.  My actual intent was to provide the minimum necessary.   That is why we are all here.  To point out mistakes to make it easier to understand.  Fighting the VA is hard enough.

[Vync]

@GulfWarVet1990Sounds like your VA examiner never took a college-level psychology course. Did your IMO describe how psychological issues can manifest themselves physically? Looks like the VARO failed to consider relative equipoise.

I have noticed in my own claims and from reading posts from others, in many cases VARO staff tends to side with the VA examiner too often. It's like they are supposedly being told that they cannot make a medical decision, so just take the VA examiner's opinion over that of a non-VA opinion. I had this happen a couple of years ago after filing a heart attack claim. The VA NP opined against SC despite having a strong IMO from a non-VA specialist. The person who worked my supplemental simply took their examiner's word and even failed to notice that they opined on a condition I never claimed and was not even related to my heart. That's why it is very important to get a copy of the VA's C&P findings and review them for stupid mistakes like this. Of course, I filed an HLR and asserted CUE by opining on the wrong decision. The DRO saw my non-VA specialist was very thorough, acknowledged the error, and granted SC.

It looks like BVA cases are now taking much longer than ever before unless a vet has a reason to justify advancement on the docket. From recent posts by other vets, they are still working appeals from 2018. Mine was submitted a year ago and I still do not have a docket number, so I estimate it will be reviewed in 2024 or later. BVA closes the door to new evidence just like HLR and get into a potentially very long line.

My supplementals and HLR each took about 4 to 5 months, but that was pre-covid. For my heart claim, I opted to go supplemental first in hopes they would get it right in just a few months. After submitting several CUE claims, one was granted at the supplemental level, another granted at the HLR level, and another denied at HLR because someone failed to read my evidence and is currently in the appeal line at the BVA. That just shows that you can get a mixed bag of results regardless of which path you choose.

Edited March 31, 2022 by Vync
Added info about review/appeals