IS THIS MEDICAL NEXUS LETTER GOOD ENOUGH?????????

[pctinc2001]

I attended my BVA hearing earlier this month. My judge appeared to be very helpful and advised me on what to do. I am attempting to get my sleep apnea claim service connected on the aggravation side. I had a neurologist review my records and provide me with a medical Nexus. Can those with the knowledge read and provide me with feedback???????   Thanks

nexus.pdf

[Dustoff1970]

pctinc2001 Your doctor's credentials are spot on (great) and his nexus opinion statement is good but could be even better.  For instance he could have provided more detail in the ways, method, mechanics of how your service connected medical condition actually causes and/or aggravates your weight gain and OSA.  As an example I am providing two copy and paste links about OSA caused and aggravated by in my case PTSD.

The first link is my actual winning claim and OSA Appeal from BVA that granted me OSA due to PTSD and PTSD meds even though I was overweight by 30lbs.  This BVA grant for me was in December 2021.  You will note that I paraphrase in my appeal what Dr. David Anaise said his nexus opinion statement stating that my OSA was as likely as not greater than 50% chance that my OSA was due to my long term PTSD and PTSD meds.  In his actual 12 to 15 page opinion he goes into great detail of how PTSD causes and aggravates OSA and also includes  many pages of other medical reference research studies and treatises to support his nexus opinion.

I am also posting a link to one of his nexus opinions for another vet that the vet's OSA was caused and/or aggravated by his service connected condition.

The BVA said that the VA C&P examiner's negative opinion against me for my OSA claim was very inadequate as compared to Dr. Anaise's credentials and detailed explanation.  I have read many BVA decisions granting overweight vets their OSA due to PTSD or other medical conditions and usually the BVA finds the C&P examiner and/or VARO rater's negative opinion against the vet to be defective in not providing a detailed rationale or explanation why they ruled against the vet and/or ignored or discounted the vet's strong medical evidence and his doctor's nexus opinion if any.

The fact you were treated in service for your sleep problems will be also of very great help.  Be sure to keep copies of your service medical records for yourself and send important copies of those records along with other evidence with your claim to the BVA

Keep in mind that even with strong medical evidence and good doctor's nexus opinions the VARO will very often deny vets claims by lying and saying no evidence or no records therefore requiring an appeal as I had to do to win claim/BVa appeal based upon the very same evidence submitted with the initial claim.  Good luck on your appeal with BVA.

I could not upload copy of my actual OSA appeal statement due to wrong format.

My comment is not legal advice as I am not a lawyer, paralegal or VSO.

 

 

Private Doctor Anaise nexus letter for vet.ipb.pdf

Edited June 14, 2022 by Dustoff 11 (see edit history)

[broncovet]

I would have liked to see, at least 3 more things:

1.  A medical rationale as to "why" he made said opinion, such as a 2015 study done at harvard university confirmed a connection between OSA and PTSD (for example, dont use my example). 

2.  Saying that a CPAP use is "medically necessary" (reasons are good here, too). 

3.  Dr. Anise CV.  

     However, Dr. Anise has a good reputation, so he likely knows much, much more about this than I do, so I would go for it.    For example Dr. A may well be aware that such a statement (number 2) is no longer necessary.