posted
My first post and first dumb question. I'm a DS vet with apnea. I've been out of the service since '95, and I THINK I've only had apnea-related sleeping problems for about 7 years now. I was diagnosed with apnea at a sleep clinic (non-VA) and my doc recommended CPAP. I've been trying alternate methods to deal with it, but I think I've given up and will go with CPAP now. While researching apnea I stumbled across this thread about the apnea/Gulf War connection and "presumptive conditions."
Do I stand a chance of receiving compensation from the VA for my apnea/CPAP even though I don't have any records related to it in my service files? I've read the posts here several times and looked at other sites, but I'm still not clear if just being a Gulf War Vet + being diagnosed with apnea is enough for me to attempt this.
Posts: 5 | From: AL | Registered: Aug 2008
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Sleep apnea can develop years later. I recommend that you visit the VA about it and get it documented as soon as you can. Use of CPAP automatically qualifies you for a partial disability. It is presumed that if you develop sleep apnea within a certain period from your service in the Gulf that it is service connected.
posted
Thanks. Do you guys recommend doing the VA's online application - VONAAP (?), or actually going to a VA facility? We only have a clinic or whatever they call it in my town. The nearest VA hospital is 100 mi away.
Posts: 5 | From: AL | Registered: Aug 2008
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posted
I'm sure that eventually they will want to do a sleep study on you. You will have to go there overnight. You could call or visit the clinic and see what they recommend. I doubt that the clinic will be able to do the sleep study itself, but they may be able to assist with the paperwork and preliminary stuff.
Posts: 106 | Registered: Mar 2007
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posted
I just used the VA's VONAAP online application to submit my application for compensation. I've gathered up my DD-214 and civilian doctor's diagnosis of Sleep Apnea with a recommendation for CPAP. I'll get that mailed to my regional VA office and then start the wait process. Thanks to all for the info you provided at this site.
Posts: 5 | From: AL | Registered: Aug 2008
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posted
To get the SC for Sleep Apnea, please email me @ etihwr@gmail.com. After doing 4,000 claim for the state of Virginia, I have allot of experience with Sleep Apnea Claims. It will help if you have a Nexus letter. See below for what you need:
THE NEXUS LETTER: Nexus Letter and how to make it work for you. A claim for a Veterans Benefits Administration (VBA) disability compensation award must be based on irrefutable evidence. If the claim leaves any doubt in the mind of the ratings specialist who makes that award decision, you may be denied.
This is often the case when the veteran alleged that an injury or illness that occurred in service has worsened over the years. While the condition may have been relatively minor then, it's significantly disabling today.
To show that there exists a connection between his/her documented service event (exposure to CBR elements, wounding, illness) and a condition today (cancer, worsening of original injury, etc.) requires that the veteran present a favorable opinion of an expert who agrees with his/her thought process. This is known as a nexus letter. A simple definition of nexus is: Tie; bond; link; connection or interconnection.
When writing a nexus letter, a few points to remember are in order.
• The letter should be as brief as possible while stating facts • The author must be an expert. • This is most often a medical doctor who is board certified in the area of health that's at issue. • If cancer is the condition, an oncologist is preferred. • If an old injury to a bone is in question, an orthopedic surgeon is the obvious choice. • PTSD has become more controversial in recent years and it's accepted today that a clinical psychiatrist or psychologist is the gold standard for opinions related to the condition. • The expert who signs the nexus letter must have thoroughly reviewed all available and pertinent medical records (to include Service Medical Records) and state that fact in the letter. If the expert can't reasonably verify that all records were reviewed, the letter won't be of much value. • The nexus letter should be as detailed and complete as the circumstances dictate.
Although it may not always be an absolute requirement, it will lend a lot of weight if the writer of the nexus letter has recently examined the veteran.
The doctor who writes the letter does not have to use absolutes or conclusions in his or her statements. Opinions are made based on conjecture of observing facts and possibilities arising from those facts.
This means that the author isn't required to say that one thing definitely caused another only that it might have or is likely to have led from point A to point B.
The preferred language to describe an expert's opinion should express whether "it is more likely than not (i.e., probability greater than 50 percent), at least as likely as not (i.e., probability of 50 percent), or less likely than not (i.e., probability less than 50 percent) that (the condition) was incurred or aggravated during active service.
In practical terms, the nexus letter is a powerful tool for the veteran to use to establish a claim. Often the VA will recognize that the physician who writes your nexus letter is better trained, better experienced or spent more time examining you than a VA Compensation and Pension (C&P) examiner did. In many cases at the VARO level as well as the Veterans Board of Appeals and in higher courts, the expert opinion expressed in a nexus letter has been the deciding factor that wins a Veteran those well deserved benefits. Many physicians, both civilian and VA doctors, are reluctant to write such a letter. Sometimes, they are concerned that there are legal pitfalls that can arise from writing disability letters and they want to avoid such. While there probably are some legal issues to consider, I'm not aware of any physician ever suffering any repercussions from writing a truthful, factual nexus letter.
In my experience, the physician is most often simply too busy to write such letters or isn't sure of the proper statements to make. Keeping it simple is your best chance for the doctor signing the letter. It is also best to have your doctor write the letter on his letterhead.
If the veteran’s personal doctor won't write such a letter, the veteran will have to seek out a physician who specializes in Independent Medical Examinations or IME's. The doctor who is a specialist in Independent Medical Examination is usually thought to be above reproach as their living depends on their reputation as an impartial reporter of facts. They will often know the language that's needed very well and they spend a lot of time examining the patient and reviewing the records. The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. These IME opinions may cost from $600.00 to $1500.00 or more. There is no guarantee that the IME doctor will agree with the veteran’s thinking and if the report is not in agreement with the veteran, he/she will not get their money back.
Example of nexus letter;
DATE Reference: VETERAN’S NAME ADDRESS ETC.
To Whom It May Concern;
I am Dr. Quack. I am board certified to practice in my specialty. A CV is included.
Mr. John Doe is a patient under my care since DATE. His diagnosis is YOUR CONDITION, etc.
I have personally reviewed his medical history (NAME DOCUMENTS) and I've also reviewed his history of the (EVENT OR EVENTS YOU CLAIM ARE THE CAUSE OF YOUR CONDITION) while he served during his military service.
I am familiar with his history and have examined Mr. Doe often while he has been under my care. (SPECIFY LAB WORK, X-RAYS, ETC.)
Mr. John Doe has no other known risk factors that may have precipitated his current condition.
In my personal experience and in the medical literature it is known, ETC.
It is my opinion that it is more likely than not that Mr. John Doe's condition ETC.
SIGNED Dr. Quack, M.D.
Posts: 19 | From: Washington DC Metro Area | Registered: Dec 2007
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posted
etihwr, I sent you an email and a PM but haven't heard back from you. Since you have dealt with a lot of claims do you know if I (GW Vet) stand a chance of getting compensation for my apnea even though (as far as I know) it started many years after I left the Army?
Is Sleep Apnea considered a presumptive condition for Gulf War Vets? I'm reading everything I can on the subject, but the best I understand it is that "undiagnosed sleep disorders" are presumptive. Since I was diagnosed by a non-VA doc with sleep apnea I would think my condition would not fall under undiagnosed sleep disorders.
Posts: 5 | From: AL | Registered: Aug 2008
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posted
Looks like I'm sunk. I saw my non-VA sleep doc yesterday - I have an appointment for a sleepover with a CPAP next month. I wrote up a Nexus letter that I thought the doc would be comfortable signing while helping my case. When I brought up that I was a Gulf War Vet he gave me a "here we go again" look. He stated that a few vets had asked him about it, that the general population gets apnea and that he would not look at or sign my letter. He instead gave me a boilerplate letter that stated something along the lines of - I'm his patient, I have apnea, here's some info about apnea and there is no way of telling when someone first gets apnea.
I don't think this helps me at all. I'm going to go ahead with the process, but it looks like I don't have much of a shot to get this service connected. About the only thing I have going for me is that I don't fall into any of the classic conditions/causes for apnea - not overweight, never smoked, no family history, etc.
Posts: 5 | From: AL | Registered: Aug 2008
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posted
I wont to get on the rollcall for the sleeping disorder I too only get about 3 to 5 hours of sleep and this been going on sents 1991. I have been on all kinds of mebs but they dont work. And the va will not say that I have a sleeping disorder but they gave me the meds for this.So what do I do?
Posts: 9 | From: Oklahoma | Registered: Oct 2008
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To obtain an evaluation for sleep apnea (a condition in which you stop breathing when you sleep), you will need to have a sleep study performed. It's usually a two-night study in a hospital which monitors your breathing. Sleep apnea is not just a problem with getting enough sleep at night... It's a problem in which a person stops breathing in their sleep. It can be life-threatening.
You might ask to be evaluated for depression or PTSD in the mental health clinic. These kinds of conditions can cause problems in getting enough good sleep at night. I'd ask for a complete copy of my VA records (you are entitled to copies of your own records) and review them to see what has been documented by the doctors in them.
Many other members here have problems getting enough good sleep at night, so maybe someone else has a suggestion or two for you. Sometimes, we just have to try different meds and diets that restrict caffiene in order to help get adequate sleep and rest.
If you're looking for filing a claim for sleep disorder, you should probably also seek a VSO (Veterans Service Officer) to help you get the evaluations and documentation you need to build a claim.
[ October 19, 2008, 05:52 PM: Message edited by: Gale ]
-------------------- HONOR OUR VETERANS WITH BETTER CARE AND BENEFITS Posts: 3482 | Registered: Jul 2005
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posted
Just thought I would put in my name for the roll call.
I have both Obstructive and Central. I have worked up from the CPAP to the BiPAP because the central apneas were worse when using the CPAP. I still have problems with the BiPAP but not as much as with the CPAP.
I am SC for it. I had asked about it during one of my visits with the doc after the Gulf. They never followed up. That was enough for them to rate me as SC.
posted
I just wanted to add my name to the list and see if I can get some advice.
I retired in 2004, considered a Gulf War veteran, and was initially diagnosed with Parkinson's Disease and REM sleep disorder. These were granted service-connected. Over time, the PD has gotten worse, and so has the "sleep disorder". After visiting the Sleep Clinic in Durham, I was diagnosed with Sleep Apnea, and issued a CPAP machine. When I re-submitted this information to the VA, they stated that the "sleep disorder" and Sleep Apnea were two different things. The "sleep disorder" is a mental thing, where as the Sleep Apnea is a respitory thing. That's how they are broken down in the CFR 38. So they state I have to show how the Sleep Apnea is service-connected even though the Neurologist I saw sent me to the Sleep Clinic. So now, how do I go about proving this? I don't think anyone ever went to sick bay because they snored a lot. Any advice would be appreciated. Thanks.
Posts: 1 | From: North Carolina | Registered: Dec 2008
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posted
I have what I believe is sleep apnea for years now. I wake up choking, spitting and flailing, my wife has had enough. I have an appointment with the VA next month.
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