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

[Vync]

@broncovetI remember the days when we could request de novo review which guaranteed it was reviewed by someone else. Now, it's just supplemental, HLR, or BVA. Of course Berta would have stated CUE can be filed at any time, but based on my results in filing CUEs, half the time the VA gets those right and the other half they spend trying to figure out if you submitted on the correct form (which there is none for CUE). Gotta love it... 

 

[Gulfvet45]

I did an appeal on this time and again. The problem is that the VA examiner does not account for the medication you are taking for the treatment of your PTSD that is known to cause the weight gain might be something your other opinion accounted for.  The RO also needs to account for the the general council opinion on obesity Bing the linchpin between the service connected condition and the secondary condition of sleep apnea.

read this link and appeal to the Board as most of these claims are won at the board and or the courts and not the RO level.

https://ngwrc.org/updates.htm 

[Dustoff1970]

Very well said and correct GulfVet45. Many many BVA decisions I have read support your statement and my own appeals.  Cheers

[GulfWarVet1990]

On 4/7/2022 at 12:58 PM, Gulfvet45 said:

I did an appeal on this time and again. The problem is that the VA examiner does not account for the medication you are taking for the treatment of your PTSD that is known to cause the weight gain might be something your other opinion accounted for.  The RO also needs to account for the the general council opinion on obesity Bing the linchpin between the service connected condition and the secondary condition of sleep apnea.

read this link and appeal to the Board as most of these claims are won at the board and or the courts and not the RO level.

https://ngwrc.org/updates.htm 

Hi Gulfvet45, thank you for the information, I received my letter today, the VA sided with the VA examiner "the medical opinion was more persuasive than you private physician's opinion." Please note I submitted an IMO from a PsyD specialist re: OSA/PTSD. 

The also noted "the VA examiner's opinion provided more weight".

What is the best approach or appeal route to win my claim? And what additional evidence will I need to do so. Thank you.

 

 

 

[Dustoff1970]

Gulfwarvet 1990 I won a recent OSA Sleep Apnea with CPAP appeal from the BVA due to several factors such as

1. A great deal of favorable medical and non medical evidence I provided in claim and appeal to support my claim that my OSA was secondary to my long term Vietnam PTSD and PTSD medications including providing recent research medical studies, treatise, reports, etc. from prestigious places such as Mayo Clinic, Walter Reed, Cleveland, others, showing a strong association cause and effect of OSA due to PTSD in combat vets. 

Many BVA decisions have granted vets OSA due to PTSD based on this evidence alone and with and without a doctor's nexus opinion. I have read these decisions and BVA often says the VA examiner's negative opinion was inadequate or defective.

And like me many of these vets have been overweight for many years.  They also presented successful arguments with studies that their weight gain was due to long term use of PTSD strong medications

2. VA Doctors and nurses notes on diagnosis of my OSA at the VA Sleep Clinic that stated my long term PTSD and PTSD medications contributed to my OSA and it's severity including on Axis III.

3.  A 2019 22 page nexus opinion statement from Dr. David Anaise stating my OSA is due to my PTSD and VA service connected Agent Orange Heart IHD/CAD Ischemic Disease.  He gives a detailed explanation rationale for his opinion along with other medical references to support his MO.  He states truthfully he has reviewed my Army, VA and private medical records from 1970 to 2019.

A key statement he made was that all Obstructive Sleep Apneas have mixed components of central and obstructive apneas and that it is the brain misfunction sending signals to the other areas that cause this disorder due to PTSD mental effects.  This is a Non quote and a only a close paraphrase by me. 

He included his long established credentials of a 30 year MD surgeon and expert on veterans disability claims including book author on same subject. Many BVA favorable decisions for the vets have cited him by name or initials.

Here is an example of outright deliberate lying BS put out by the administrators of another  location (not this forum). 

"If you have OSA vs Central sleep apnea the link to PTSD is shaky at best. Any opinions are likely going to be challenged by the VBA requesting a c&p and they'll likely give better supporting evidence than anything you pay out of pocket to get".

What they never tell the vet is he or she stands a very good chance of winning their claim on appeal to the BVA who in my case also said the VA examiner's negative opinion was "inadequate" and on appeal of another issue the BVA said the same examiner's negative opinion was "defective".

Do not give up hope and be discouraged by other  misinformation from anyone.  I know their motives for such BS.

"The Federal Circuit in Hensley v. West, in considering the use of treatise evidence to support the medical-nexus requirement of a well-grounded claim, stated:  "A veteran with a competent medical diagnosis of a current disorder may invoke an accepted medical treatise in order to establish the required nexus; in an appropriate case it should not be necessary to obtain the services of medical personnel to show how the treatise applies to his case."  Hensley, 212 F.3d at 1265 (citing Wallin, supra).  The Federal Circuit then held that on remand that treatise evidence "should be evaluated to see if it supports a nexus. . . sufficient to meet the low threshold of the well[-]grounded claim requirement." Ibid."

 My comment is not legal advice as I am not an attorney, paralegal or VSO.

 

Edited April 14, 2022 by Dustoff 11

[GulfWarVet1990]

Thanks Dustoff11 - I am going to move onward and appeal. Dr. Todd Finnerty wrote my IMO, he did not have much to go on viewing my records, no evidence of sleep apnea in my medical records but a recent diagnosis and sleep test results from a non-VA physician. He is willing to write a rebuttal, as of date have not received a copy of my C&P exam.