Claim For Sleep Apnea in VA Disability Claims (General) Forum

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Claim For Sleep Apnea

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Gunny1995

Claim For Sleep Apnea

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Rookie VBNer

Posts: 2

Jan 4 08 3:46 PM

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Ooh-Rah:

In November of 2006 I filed a claim for sleep apnea. After 2 tests were done I was issued a CPAP machine for the diagnosis. My claim however was disapproved due to no proof of connection thru Marines. I was in from Jan 1976 to May 1990 (then put on medical hold for 4 years and 11 months) and received a permanent disability claim for 40 percent seizures and 50 percent migraines (combined 90 but the math comes to 70 percent employable). I am working to obtain a claim for sleep apnea in case something should happen to me in my sleep (besides my snoring). I want to appeal but not sure how to write it up or show evidence. Will a statement from my wife of 28 years do any good? Anyone out there have any suggestions? I have 10 months to go to appeal.

Stay Safe and thanks for all you do
Tom

cruiser

#1

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Posts: 17453

Jan 4 08 4:24 PM

Gunny1995 wrote:
Anyone out there have any suggestions?

First of all, welcome.

Now as to your question, not really unless you provide some additional info. What is your basis for associating this condition with military service? What evidence do you have to support that? What evidence have you already provided to VA and what was the reasoning for not accepting the veracity of that evidence?

As to whether or not a statement from your wife will help, it might; it all depends. If you were not diagnosed with sleep apnea in service only a doctor can provide the link, or nexus, between your military service and your sleep apnea. A lay person such as you or your wife cannot do this. About all your wife can do is to provide a statement about what she knows about whatever it is in service that forms the basis for your claim. For example, she can say that she observed this or that, but she can't say that it was sleep apnea nor can she say that it has any relationship to your sleep apnea. The doc must do this.

So if you can provide the answers to the above questions maybe I, or someone, can direct you further as to the best way to proceed.

Cruiser

leenoga

#2

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Posts: 302

Jan 4 08 6:52 PM

Not to butt in...

Lee wiggles in sideways ...

I had migraines for years in the Navy..and they figured out 21 years later I had sleep apnea which lowered my oxygen and gave me a "hypoxia" headache upon awakening. These morning headaches which were show stoppers were diagnosed as migraines when in fact they were due to lack of oxygen from SLEEP APNEA.

So.....

Maybe there is a correlation between your migraines which you are SC for...and your apnea.

Another thought for you..if your on a CPAP now and your headaches stop....that is some evidence right there your headaches are from sleep apnea.

Your sleep Doctor may be the ticket to make this correlation as well as your primary Doc...

Something to look into...

USN, 9 years [E-5]-Hospital Corpsman 1975-1984
80% IU, P & T - Awarded 2006 / 6 month process
SSDI - Awarded 2007 / 18 month battle won at OTR level

TPGUSMC

#3

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Posts: 3357

Jan 4 08 7:27 PM

From one Gunny to another......welcome! You have gotten some good advice. Please follow through via your primary care doctor to see if their is a nexus.

mprise

#4

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Posts: 4098

Jan 4 08 9:00 PM

USN RETIRED

Gunny, welcome to the VBN

Mary

cheefw03

#5

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Posts: 806

Jan 5 08 4:49 AM

Bottom line is, as the expert has already pointed out, on the doc can make the nexus. Do you have any complaints in your SMRs, of tirdness, sleepiness etc....? What brought about your need for a sleep test? As far as the lay statements go they can and do help in the case of a weak nexus. Buddy letters from guys who felt like killing you for snoring during field trips, or vactions in the sandbox etc... along with those of your wife cause she had to sleep with three pillows over her head or she was constantly shaking you cause she thought you were dead due to gasping for breath etc....... great advise above.... go see your doc. Most sleep doc's don't like commenting on when sleep apnea began. They just simply want to say you gotit now. Your primary care doc is the best bet cause he has been treating you over the past months or years and knows how to look at things in your SMR's a little better. JMHO.

bigalnv

#6

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Posts: 6146

Jan 5 08 9:25 AM

Gunny

Big Al

Be who you are and say what you feel,
because those that matter, don't mind,
and those that mind don't matter.

ms57

#7

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Posts: 1153

Jan 6 08 10:21 AM

lee are you rated for sleep apnea i have had migraines for 20+yrs and i also would wake up with headaches i mention this to my neuro doc and he said to take my verapamil at night it has helped but i still need the cpap. mike

leenoga

#8

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Posts: 302

Jan 7 08 7:12 PM

Nah, I was diagnosed with sleep apnea after I won the 80%/IU P&T, decided to let the rest go...and not chase an apnea rating.

I have severe apnea and I did not really have the obvious symptoms. I complained of morning headaches for years and the primary did nothing. I changed primary Doc's and she ordered a sleep study. I passed the sleep test which was a baby version...

Then one night I woke up and was paralyzed, fully cognitive and could not inhale....when I passed out [thought I was dying] I sat upright, gasped and was freaked out. The sleep Doctor did not believe on the baby screener test I could be normal so he ordered the big one where there is like 25 wires and paste...that was the test that showed how bad I had apnea.

USN, 9 years [E-5]-Hospital Corpsman 1975-1984
80% IU, P & T - Awarded 2006 / 6 month process
SSDI - Awarded 2007 / 18 month battle won at OTR level

Gunny1995

Sleep Apnea Comments

#9

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Rookie VBNer

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Jan 18 08 2:48 PM

Thanks Cruiser:

By your way of explaining all this I actually now understand why, and how, the VA can say no to the claim. It's making sense to me now. I have also found out from my wife (its amazing what our spouses can teach us when we listen) that the apnea started as far as she can remember when i began taking my seizure meds...Tegretol XR. 600mg in the am and 600 mg in the pm. Can this be a side effect like the ringing in the ears? And where do you suggest I look? And thanks again in advance..Semper Fi

Gunny1995

sea2fish

#10

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Posts: 1646

Jan 24 08 7:16 AM

Thanks Everyone for you insights

My sleep test is month, as I have no stomach and migraines. My doc is concerned I have apnea. I burp in my sleep as a result of my condition, she said when a burp gets stuck you do have 02 starvation. I do not sleep very well period. VA gives me Teazapam, it is not helping. I'll see what the test reveals. Going to be interesting

sea2fish

90% SC IU P&T

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cruiser

#11

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Posts: 17453

Jan 24 08 8:49 AM

Gunny1995 wrote:
the apnea started as far as she can remember when i began taking my seizure meds...Tegretol XR. 600mg in the am and 600 mg in the pm. Can this be a side effect like the ringing in the ears? And where do you suggest I look?

You need to ask your doctor. I don't know if sleep apnea is a known complication of seizure meds or not; however, even if the evidence supports this you still will need to have a doctor say that this is true in your situation. Every VA decision in something like this is based on the medical facts and opinions pertaining to you, not how this affects the general population. Run this by your doc and if he/she can say that there is at least a 50/50 chance of a relationship, ask he he/she will put this in a written statement. Then re-file the claim with VA requesting service connection for sleep apnea secondary to the seizure medication.

Cruiser

lvacjoub

#12

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Posts: 1414

Jan 25 08 3:37 PM

It might help to bring your wife with you when you ask the doc about seizure meds causing apnea - that way she can tell the doc what she observed back when you first started using the drug/drugs.
I suspect she can explain about snoring, snorting & holding your breath - all of which seems to be a sign of OSA.
This is a good example of a lay person having witnessed something that can help a medical profession make a dx.

quietpro

Denied service connection

#13

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Posts: 129

Jan 27 08 8:07 PM

Hello, everyone. I'm new to this site but wanted to say hello. My name is Ron and I've been retired from the Air Force for a little over a year now. I served 20.5 yrs, mostly at Hurlburt Field, FL, and spent 15 yrs working various capacities in special operations.

Anyone have any advice in appealing an unfavorable rating decision? My C&P doc "opined" that I had a pre-existing condition that wasn't aggravated during military service. So far, I have located a complaint about fatigue in my medical records that I made back in '94. Also, I have buddy statements from my family that state they had never witnessed any snoring or fatigue prior to my entry into service and my friends' statements show how the condition progressed through the years. I'm also linking declining job performance and slowed promotion as symptoms/signs that the condition was worsening although it had not been diagnosed. Any thoughts, folks?

Thanks for any advice,
Ron

cruiser

#14

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Posts: 17453

Jan 27 08 10:11 PM

quietpro wrote:
Any thoughts, folks?

Welcome to the site. As a former VA Rating Specialist and DRO I will answer your inquiry from that perspective. The person who decides your claim is not a doctor and is not allowed to make medical decisions. And the question as to whether or not any of the symptoms that you mention in service were actually symptoms of sleep apnea is a medical question that a lay person, which includes not only you but also the decision maker at VA, cannot answer.

What this means is that unless you can provide an opinion from a doctor that rebuts the opinion that VA already has, they cannot change the decision. At best they could request another opinion, but I doubt they would do that. What you need to do is to show the evidence that you have gathered to another doctor and ask for an opinion, and submit that opinion to VA along with the evidence that you mentioned.

Please don't take this the wrong way but when I left VA two years ago claims similar to yours were becoming quite plentiful. Sleep apnea is being diagnosed right and left these days (seems like half the people I know have a CPAP at home) and just about every one of them that is a veteran is doing exactly what you are doing in an effort to get it service connected. I can't tell you how many statements I had to read from a spouse about her husband snoring in service.

Given that you have only been out of service for a very short period of time you probably have a good chance of prevailing if you can get the medical opinion from a doctor; however, my point is that the person looking at your claim has probably seen several others just like it and will likely say to himself "Oh no, here we go again". Just wanted to give you a heads up on that, but like I said, if you can get a doc to give you an opinion you should be OK. Good luck.

Cruiser

pilot

OSA

#15

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Posts: 138

Jan 28 08 5:54 PM

This is a really interesting topic to me.
I am RVN era vet.

I filed in mid-2006 for other things and listed my Medical Care Providers as requested.
For my family doctor, I listed "Sleep Problems" as one thing that he was treating me for.
In reality, at that point in time, I had just given up and was prepared to go to sleeping pills to get some quality sleep.
He referred me for a sleep study and guess what? OSA with a CPAP and supplemental O2 generator. Life is better now.

Anyhow, the VA processes my claim and denies "Sleep Apnea claimed as Sleeping Problems" due to lack of Service Connection in my medical records. I certainly understand that!

Based on the info I learned here (Thanks Guys and Gals), I contacted my ex-wife from the RVN era. She provided a detailed and lucid statement about my apnea symptoms and how they developed, especially after my first RVN tour and before my second one. She is not exactly "my best friend", but she was very detailed and accurate in her statement.
I contacted a "buddy" who was with me from basic training all the way through seperation from the military. He provided an excructingly detailed (5 pages) history of the apnea symptoms and how they progressed from "zero" in basic training through my first RVN tour and into the following years.
This was all followed by a statement from my current wife (Love her dearly) of 33 years. Once again she details the symptoms from the time we got toghether till now including the improvement since I recieved my CPAP and O2 generator.

All of this was tied together with a clear statement (letter) from my attending Physican that he had reviewed my SMR and all the other info available and it is "more likley than not" that my OSA had it's nexus during my military service.

Now, I did not go back to my "Sleep Doc" simply because he and I have a "disagreement" about life in general and the study was almost 1.5 years ago and will probably need to be re-done anyway.

I have simply asked for service connection for SA.

I would be really satisfied if VA just provided the CPAP (and O2 generator), even without the monthly check.

I give VA big "kudos" for "inferiring" the claim for SA and thank them for that!

Gonna be a year of so, but looking forward to see how this develops.

"Cross your T's" and "Dot your I's" and provide "probative medical evidence" is the lesson I have learned here!

Edited 1 time by pilot Jan 29 08 7:52 AM.

fenderstrat72

#16

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Posts: 174

Jan 29 08 10:04 PM

I would like to ask a question about sleep apnea as well. I just recently retired after 26 yrs in the USAF, actually my retirement date is 1 Mar 08, I am on terminal leave until then. I was diagnosed with sleep apnea in the fall of 2005 and have been on a CPAP ever since. My question is this, is it easier to prove claims that for issues that were diagnosed while the member was on active duty and is already in their medical records? So I guess what I am asking is this, is the likelihood of being SC for sleep apnea better because it was diagnosed while I was on active duty?

Retired USAF
80% Service Connected

quietpro

Medical "opinions"

#17

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Posts: 129

Feb 4 08 9:30 AM

"Please don't take this the wrong way but when I left VA two years ago claims similar to yours were becoming quite plentiful."

Cruiser,

Yes, I understand that. Unfortunately, many of us just simply weren't diagnosed or treated properly by the military health care system. I had even asked for a sleep study and was assured by my primary care physician that a referral would be put in. However, it never was and in my state of mind back then (just struggling to get through the days), I just didn't push it.

Here are some other details in my case and I would appreciate your thoughts. I have at least two (I found a second one) mentions of fatigue/malaise in my medical records from when I believe this all started occurring. I was simultaneously being treated for chronic headache (which was and still is my major concern). In the course of that treatment, an ENT recommended uvuloplasty with turbinate reduction because he felt that I likely had a sleep disorder that was causing my fatigue and likely the headaches. I agreed to have the surgery but only saw improvement in my nasal congestion. As a matter of fact, my symptoms became worse after the surgery (I started falling asleep at work and while stopped at stop lights).
My sleep doc seems reluctant to make any DEFINITIVE claims and I honestly don't blame him. Coming from my background, I know the differences between using the words probable and possible. He has written that the shift work I was subjected to during one of my assignments "could have potentially worsened underlying sleep apnea and made it more evident." He also writes, "He (meaning me) also believes that his condition has worsened after the UPPP, which is also possible."
Of course, neither of those state anything definitively but it would be impossible for him to do so with any credibility because he didn't know me back then. So, with that lackluster statement from the doc, my buddy statements from friends that acknowledge my steady decline, and my two complaints of fatigue from 10 & 12 years ago, would the DRO be inclined to rule in my favor? Keep in mind that I'm disputing the C&P examiners opinion that my condition was pre-existing and not aggravated during service. Even if the condition were pre-existing (which I dispute), it seems even MORE ludicrous to suggest it wasn't aggravated since I had the surgery 14 yrs. after entry.
Please understand that I'm not attempting to simply argue. It just seems so obvious to me but maybe I'm not expressing myself well enough. If you see something in my explanation that makes you think I'm off base, please share.

Thanks again!
Ron

dj3756

Exactly

#18

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Posts: 59

Feb 5 08 9:49 AM

This is the reason why I've never claimed Sleep Apnea. I know I had it while in the service [my old roommates can attest to that] but, I never saw anyone for the condition, I just put up with being cussed out!

Dee says: If your not going to like the answer then, don't ask the question.

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Sleep Apnea

#19

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Posts: 684

Feb 5 08 1:20 PM

I, too, filed for Sleep Apnea in 2007..... but, as Cruiser said, you must have a MD's statement that establishes a NEXUS between the illiness/condition and your military service. THATS A PROBLEM FOR ME. Why.... or, how will an MD make such a statement ? Also, the MD must list some research that was done that correlates a connection between your military service. To my knowledge, there are no such research studies.

Gunsmith65

#20

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Posts: 166

Feb 5 08 4:07 PM

It is hard to get the connection made. Even if you have SA noted in your SMR. I had to appeal mine. The words Sleep Apnea were noted in my records and they still had difficulty rating as SC. It is hard so make sure you have your duckies in a row before you submit. I eventually had the indepth study done (all the wires and so forth) and it took awhile. I get the feeling they are watching SA claims hard.

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