IMO was very Comprehensive but OSA Supplemental Still Denied

[GulfWarVet1990]

Good afternoon, I just received the denial letter from VA for OSA supplemental claim (added new evidence).  Even with a very comprehensive IMO from Dr. Anaise, OSA diagnosis and CPAP prescription VA denied.  I am SC for Chronic Sinusitis (10%), Tinnutis (10%), Allergic Rhinitis (0%), and PTSD (50%), the IMO included these conditions linking to OSA.  No go, the VA still noted the VES Examiners write up was more persuasive.  Also as usual, they state no evidence of OSA while in service. 

The supplemental denial letter also indicated a DBQ review on June 3, 2022 which did not require my attendance.  Just disappointing how the VA keep taking the cheap route hiring the lowest bid contractor (my perception anyway).  I question the validity of the VES examiners credentials, the examiner who reviewed my file and completed the DBQ for the supplemental claim had no credentials for the specialty.  

As stated, Dr. Anaise wrote an excellent IMO and several on this forum have hired his services, so I have confidence in his work.  The denial letter was a disappointment however, I do not plan to give up.  I was denied twice for cancer and wanted to give up but my VSO convinced me to pursue and I eventually I was granted sc with retro.  

Has anyone ever experience a supplemental claim for OSA and after appealing to BVA won your case. BVA is the route we are taking, I just cringe at the delay and amount a days before my case may be considered.  Positive words of encouragement and advice are welcome. Thank you. 

 

 

 

[El Train]

You could file a complaint with your local VARO and contest the VES examiners credentials and exam.  This probably will trigger another C&P with a different examiner.  I've done this in the past.  It worked out for me.  I guess you have nothing to lose by filing an HLR, but they'll probably rubber stamp the VES examiner.  But you never know.

I believe Dr. Anaise is also a lawyer.  You may want to contact him again to see if he can represent you.  I imagine he might take interest since his exam is being dismissed.

[Whodat]

Here we go again. All of this hooblah about nexus letter, now vets are financially struggling as is, paying all of their money to get a nexus just to get shot down. 

I just received a pm from a member stating that legacy appeals are extended for another 3 years. I have not found anything on that but if it is true, then think about how long AMA claims will take. 

Nexus or not, VA is doing to take advantage of people that have sacrificed their lives for their country. 

[Whodat]

https://www.federalregister.gov/documents/2022/09/21/2022-20271/extension-of-program-of-comprehensive-assistance-for-family-caregivers-eligibility-for-legacy

[Stayfocus]

2 hours ago, GulfWarVet1990 said:

Good afternoon, I just received the denial letter from VA for OSA supplemental claim (added new evidence).  Even with a very comprehensive IMO from Dr. Anaise, OSA diagnosis and CPAP prescription VA denied.  I am SC for Chronic Sinusitis (10%), Tinnutis (10%), Allergic Rhinitis (0%), and PTSD (50%), the IMO included these conditions linking to OSA.  No go, the VA still noted the VES Examiners write up was more persuasive.  Also as usual, they state no evidence of OSA while in service. 

The supplemental denial letter also indicated a DBQ review on June 3, 2022 which did not require my attendance.  Just disappointing how the VA keep taking the cheap route hiring the lowest bid contractor (my perception anyway).  I question the validity of the VES examiners credentials, the examiner who reviewed my file and completed the DBQ for the supplemental claim had no credentials for the specialty.  

As stated, Dr. Anaise wrote an excellent IMO and several on this forum have hired his services, so I have confidence in his work.  The denial letter was a disappointment however, I do not plan to give up.  I was denied twice for cancer and wanted to give up but my VSO convinced me to pursue and I eventually I was granted sc with retro.  

Has anyone ever experience a supplemental claim for OSA and after appealing to BVA won your case. BVA is the route we are taking, I just cringe at the delay and amount a days before my case may be considered.  Positive words of encouragement and advice are welcome. Thank you. 

 

 

 

Just curious, did the imo state in detail that he reviewed your Cfile, and all SMR?

Edited September 27, 2022 by Stayfocus
Miss spelled

[Stayfocus]

2 hours ago, GulfWarVet1990 said:

Good afternoon, I just received the denial letter from VA for OSA supplemental claim (added new evidence).  Even with a very comprehensive IMO from Dr. Anaise, OSA diagnosis and CPAP prescription VA denied.  I am SC for Chronic Sinusitis (10%), Tinnutis (10%), Allergic Rhinitis (0%), and PTSD (50%), the IMO included these conditions linking to OSA.  No go, the VA still noted the VES Examiners write up was more persuasive.  Also as usual, they state no evidence of OSA while in service. 

The supplemental denial letter also indicated a DBQ review on June 3, 2022 which did not require my attendance.  Just disappointing how the VA keep taking the cheap route hiring the lowest bid contractor (my perception anyway).  I question the validity of the VES examiners credentials, the examiner who reviewed my file and completed the DBQ for the supplemental claim had no credentials for the specialty.  

As stated, Dr. Anaise wrote an excellent IMO and several on this forum have hired his services, so I have confidence in his work.  The denial letter was a disappointment however, I do not plan to give up.  I was denied twice for cancer and wanted to give up but my VSO convinced me to pursue and I eventually I was granted sc with retro.  

Has anyone ever experience a supplemental claim for OSA and after appealing to BVA won your case. BVA is the route we are taking, I just cringe at the delay and amount a days before my case may be considered.  Positive words of encouragement and advice are welcome. Thank you.