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The Office of the Inspector General found that 1.3 million veterans enrolled in VA Healthcare have a sleep apnea diagnosis. I applied for sleep apnea secondary PTSD about a year ago. If you have symptoms of OSA, consider obtaining a sleep study, also known as polysomnography. Sleep Disturbances in Veterans: the Hurricane Threatening the Veterans Brian Reese here, Air Force service-disabled Veteran and Founder @ VA Claims Insider. 76% were Denied or Remanded for more evidence. You can also check out our 2022 Facebook live video on the Top 5 Causes for OSA Denials and How to Fix Them! Research shows a strong correlation between deployments and sleep disorders, and sleep apnea is extremely common among veterans. If your obstructive sleep apnea VA claim, or other sleep apnea claim, was originally denied, you may be able to appeal the rating and receive VA disability compensation. Check out our post on sleep apnea secondary connection with PTSD here! Was your obstructive sleep apnea (OSA) VA claim denied? Since 2016, VA Claims Insider has helped thousands of Veterans just like you get the VA rating and compensation they deserve in less time. The VA has found sustained improvement in your ability to function under the ordinary conditions of life. For all about getting a VA rating for sleep apnea, see our post Your Sleep Apnea VA Rating A Guide to Getting a VA Disability Rating for Sleep Apnea. Its this simple. Is Sleep Apnea Could Be a Service-Connected VA Disability? Sleep apnea is extremely common among veterans, as the disorder is frequently caused or exacerbated by time in service. Brooklyn, NY: 300 Cadman Plaza West, One Pierrepont Plaza, 12th Floor, Brooklyn, NY, 11201 The Veteran appealed, and had his first Board hearing (a remand for further development) in December 2009. What really makes your VA Sleep Apnea claim race through the VA disability claim system is this one thing: Your response, I imagine, might be something like this: To understand HOW the diagnosis drives a veterans VA Sleep Apnea Claim, we have to first understand the 3 different types of Sleep Apnea: obstructive, central, and complex. This would mean you had a sleep study conducted while on active duty and received a medical diagnosis of sleep apnea as a result of the study. If youve filed your VA disability claim and have been denied or have received a low ratingor youre unsure how to get startedreach out to us! Learn what youve been missing so you can FINALLY get the disability rating and compensation youve earned for your service. You will need medical evidence that shows what type of sleep apnea you have (obstructive, central or mixed), how severe it is and if you can show how it was caused by your service in . VETERANS VOICE: Sleep apnea claims often denied - The Leaf-Chronicle If you continue to use this site we will assume that you are happy with it. Sleep Apnea is a potentially serious sleep disorder in which a persons breathing is repeatedly interrupted, or ceases, during the course of a nights sleep. The hard copy, if you would like to get that, is also the second editionyou can get the hard copy by clicking here. This study will serve as medical evidence for the veterans case and can help to prove the medical condition or medical conditions that go into a total rating. Though the path from your nose to your lungs is a short one, there are a lot of parts of your body that air has to pass through. However, in February 2022, VA proposed changes that would reclassify sleep apnea ratings to 0 percent, 10 percent, 30 percent, or 50 percent, with 100 percent for sleep apnea seeming even harder to qualify for. Top 5 Reasons for Obstructive Sleep Apnea Claim Denials - VA Claims Insider Thousands of other Veterans in our Community are here for you. Service connection on a secondary basis requires evidence of aggravation or causation.This requires that the secondary disability be shown to be proximately due to or proximately aggravated by another service-connected disability. Asymptomatic sleep apnea would not be compensated under the tentative regulation. See our tips on how to obtain a credible nexus letter, Both sinusitis and rhinitis are linked to sleep apnea, Emerging research indicates a strong association between PTSD and sleep apnea, You Deserve It: The Definitive Guide to Getting the Veteran Benefits Youve Earned, 9 Secrets Strategies for Winning Your VA Disability Claim, Disrupted breathing in which a persons respiration can become labored or even stop for up to a minute at a time, Limited attention span or difficulty thinking clearly, Snoring, including snoring that is especially loud and involves gasping, choking, or snorting that may cause a person to briefly wake up, #1. Weve supported more than 15,000 veterans to win their claims. Sleep apnea is proven to significantly reduce a persons quality of life (in one study, the reduction in quality of life was equivalent to that observed with diabetes or hypertension). Typically the re-evaluation period is anywhere from two to five years after your initial examination. Conditions like COPD (due to asbestos. Sleep apnea can be aggravated by PTSD (secondary to PTSD), also an extremely common disorder for veterans. In an April 2014 report, a VA examiner opined that Ms. Walsh's sleep apnea was "likely due to her Signup to never miss a beat with special offers, blog updates, exclusive trainings, and more delivered right to your inbox! Even if youve had a sleep study before, its important to get one done within the 12 months prior to your VA claim. I do not response to Individual claim and legal questions, although I do catalog them for post / video ideas. Signup to never miss a beat with special offers, blog updates, exclusive trainings, and more delivered right to your inbox! While an OSA disability claim secondary to sinusitis/rhinitis is an easier path, veterans who are service-connected for PTSD (or other mental health conditions) are eligible for secondary service connection for their sleep apnea, and its possible to achieve an OSA disability claim secondary to PTSD with the right strategy and credible medical evidence. Since this condition is nearly epidemic among veterans, its important to learn what it takes to get a VA disability for sleep apnea, as well as how the condition may affect you. The violence of the rape caused a lot of damage to her jaw, back and neck muscles, including breaking her jaw. There are cases in which your VA rating for sleep apnea would not be re-evaluated. Being honest and thorough is important so everything can be properly documented. Under the current rating schedule, VA issues ratings at 0, 30, 50, 100 percent for sleep apnea even if treatments are somewhat effective in dealing with the condition. The signs and symptoms of these three types of sleep apnea tend to overlap, sometimes making it difficult to determine which type a person has. If I had a nickel for every time I heard someone say the following statement about a VA Sleep Apnea claim, I might be able to buy a damn nice race car: The VA denied sleep apnea in my claimthey said it was because I had no sleep study in service, the veteran says. The polysomnography study records your brain waves, the oxygen levels in your blood, your heart rate and breathing, and eye and leg movements, among other criteria. VA Secondary Conditions to Sleep Apnea - CCK Law Take advantage of a FREE VA Claim Discovery Call with an experienced Team Member. A 50% rating would be given if treatment was ineffective or you were unable to use therapies due to another condition. This field is for validation purposes and should be left unchanged. Since 2016, VA Claims Insider has helped thousands of Veterans just like you get the VA rating and compensation they deserve in less time. By focusing on what CAUSED the airway obstruction, you are forcingthe VA to focus on the in-service event and the nexus. How to Use one VA Lay Display to Win Your Disabled Claims Ask your private doctor for a referral to a sleep specialist in your area (a good option if you have private health insurance). Learn how your comment data is processed. Check out the VA Sleep Apnea Field Manual. In order to help you with your secondary claim, we have put together this Insiders Guide! Brian Reeseis a VA benefits expert, author of the #1 Amazon Bestseller You Deserve It: The Definitive Guide to Getting the Veteran Benefits Youve Earned, andfounder of VA Claims InsiderThe Most Trusted Name in Education-Based Resources for Veterans.. Although the VA diagnosed me with sleep apnea, they stated that they did not have enough evidence to tie my diagnosis with events I experienced during my deployment. In fact, even if the Veteran inVA sleep apnea claim #2 had not had a private medical opinion, that lay evidence would have completely undercut the VA C&P examin that claimbecause that VA C&P opinion did NOT consider the lay statements of the ongoing and chronic symptoms of sleep apnea from discharge to diagnosis. The DBQ allows an examiner at a C&P exam to check boxes next to descriptions that best express how your sleep apnea is affecting you. How to File a Claim on VA.gov (step-by-step)! Here are a few examples of how sleep apnea could be impacting your life, which youll want to clearly state and demonstrate in your C&P exam and in your claim: We recommend a nexus letter from a medical professional to connect your condition to your military service (or secondary to a service-connected disability) in order to improve your chances of receiving a rating for sleep apnea as a secondary condition. Lets look a little deeper at OSA for a minute Obstructive Sleep Apnea is by far the most common type of Sleep Apnea that affects veterans. Lay Statements are important! Top 5 Questions about Sleep Apnea VA Claims - Disability Denials A sleep apnea VA rating can be reduced by the VA. 30 percent disability rating: $508.05 per month. * How to use Medical & Lay Evidence in your Sleep Apnea Claim, * The 39 Conditions KNOWN to cause, aggravate, or be caused by Sleep Apnea, * The 4 Most Common VA Sleep Apnea scenarios and how to prove service connection in each. Sleep apnea treatment depends on the type and severity of the condition. If you have sleep apnea and sinusitis/rhinitis, your next step would be to get a doctors medical opinion supporting that your service-connected sinusitis/rhinitis caused or aggravates your sleep apnea. You may already be able to see how understanding the roots of your Sleep Apnea diagnosis can DRIVE your sleep apnea claim. Weve supported more than 15,000 veterans to win their claims and increase their ratings. These sleep disturbances can occur from tens to hundreds of times per night. A provided a NEXUS statement that stated the apnea was more than 52% likely to be the cause. this was in Sept last year, fast forward to now, and as i suspected my sleep apnea was denied connection to my PTSD. A doctors diagnosis will be one of the keys to getting a sleep apnea VA rating. In order to establish direct service connection for sleep apnea, a claimant must show that they have: A veteran can also establish service connection for sleep apnea on asecondarybasis. In this blog post, we will discuss how. What happens during a C&P exam for sleep apnea? The most common reason for denial of secondary claims is not establishing a strong enough connection between the service-connected disability and the sleep apnea. It can also work in reverse: sleep apnea can lead to other disabilities. Even veterans who had a sleep study in the military are denied service connection for sleep apnea by the VA. Like you, they are left scratching their head wondering why. Im not going to talk about it much here because Im not seeing it in VA claims and appeals just yet. * The 5Reasons that 76% of VA Sleep Apnea claims are denied and how to fix the problem in YOUR case. Lets take a look at 2 VA Sleep ApneaClaims. Now, it wasnt just the mere existence of lay evidence of sleep apnea symptomatology from service discharge to diagnosis that made the difference. New Rule allows Presumptive Service Connection for Veterans particulate matter (burn pit) claims. This means you do NOT currently have the VA disability rating and compensation YOU deserve, and you could be missing out on thousands of dollars of tax-free compensation and benefits each month. Denied Disability Claim for Sleep Apnea December 28, 2015 Jim, I retired in 2011 with 22 active duty yrs of service. After first reading these examples, the obvious answer is that the private examiners opinion in VA sleep apnea claim #2 was what made the difference. I submitted a supplemental claim adding some articles and VA reviews showing correlation with PTSD. These sleep disturbances can occur from tens to hundreds of times per night. The BVA is saying that there was no lay evidence (or medical evidence for that matter) from service to diagnosis of the veterans sleep apnea. Sleep Apnea denial - Veterans Benefits Network As a fellow disabled Veteran this is shameful and Im on a mission to change it. 1.3 million veterans enrolled in VA Healthcare have a sleep apnea diagnosis, With over 50 conditions that can be medically linked to sleep apnea. Cleveland, OH: 600 Superior Ave. East, Fifth Third Building, Suite 1300, Cleveland, OH, 44114 In April 2004, he wastreated after his military service ended for fatigue and insomnia. The sleep study, while a critically important piece of evidence, is not DRIVING your VA sleep apnea claim. #2: It crosses the uvula that dangling thing in the back of your throat. If your initial rating decision letter says that future examinations are scheduled, or you dont have a 100% permanent and total rating, then your disability rating is not considered permanent or static by the VA. At that time, the VA may schedule a re-examination to verify if your sleep apnea symptoms still exist, and if theyve changed. If youre claiming sleep apnea as a secondary condition, make sure you already have a medical diagnosis before you make your claim. Its FREE to get started, so click Go Elite Now below to complete our 3-step intake process. VA is currently reviewing the other disabilities reviewed by NASEM in the 2020 report for consideration for potential presumptive service connection. All of these can contribute to sleep apnea. Essential Keys to Winning Your Sleep Apnea VA Benefits Claim The most common symptoms include: There are a multitude of potential causes of sleep apnea in adults, but in veterans specifically, the causes could include: To confirm a diagnosis of sleep apnea, a sleep study must be given to show that you are experiencing breathing problems, and other sleep disorders and health problems have been ruled out. Sleep Apnea Secondary Connection to PTSD VA Disability Youll need to make the call on direct service connection versus secondary service connection. If treatment for sleep apnea provides only limited alleviation, you will only receive ten percent of your maximum compensation, even if a CPAP machine is required. Some of the most common symptoms of sleep apnea include: People who suffer from sleep apnea are often unaware of the breathing disturbances, finding out about them from a bed partner or roommate. Its likely your doctor will need to order a sleep study to determine if you have sleep apnea. Since 2009, veterans' claims for sleep apnea have increased 150%, more than 94% of these coming from veterans of Gulf War I or the Iraq and Afghanistan wars. The same goes for depression and anxietyor any of the 33 mental health conditions rated by the VAwhich can be highly disruptive to sleep. Click Go Elite Now below to get started today and a member of our team will be in touch within minutes. sleep apnea secondary connection with PTSD, Denied for Benefits? Veteran Service-Connected Sleep Apnea Claims on the Rise An increasing number of sleep apnea claims are cropping up among younger veterans. 11:30 Why this obstructive sleep apnea claim was denied Sleep disordered breathing, as well as the myriad of symptoms linked with it (such as sleepiness and fatigue), can all exacerbate the relationship between sleep apnea and PTSD. Since you have already received a denial then you would have to submit a supplemental claim with new evidence and new ARGUMENTS. VA claim for sleep apnea denied? This includes having a sleep study done, a buddy letter from your spouse, and medical records from your doctor about your symptoms. * SSG Jones got out of the Army never had a sleep study done in the military after serving 2 tours in Iraq and 1 in Afghanistan. VA Claims insider is an education-based coaching/consulting company. A sleep study is critical to confirming whether you meet the clinical diagnostic criteria for sleep apnea. Beyond the PTSD criterion symptoms of insomnia and nightmares, 40% to 98% of veterans with PTSD also have a co- occurring sleep disturbance such as obstructive sleep apnea (OSA), periodic leg movement disorder, sleep terrors, or nocturnal anxiety attacks. She has also spent several years working with the Department of Veterans Affairs audiology programs in Salt Lake City, UT and Pocatello, ID. Phoenix, AZ: One Renaissance Tower, Two North Central Avenue, 18th & 19th Floor, Phoenix, AZ 85004 A current disability (medical diagnosis in medical records), An in-service event, injury, disease, or aggravation; and, evidence of chronicity and continuity in your service treatment records and private treatment records, or, A medical diagnosis of sleep apnea confirmed by a sleep study in VA medical records or private records (sleep study in past 12 months), Medical nexus evidence establishing a connection between. You DESERVE a HIGHER VA rating.WE CAN HELP. The independent opinion of a private medical professional can also influence the C&P examiners medical opinion, as well as the VA rating officials final disability decision. Spouse; Family Members; Friends; Colleagues; Other Service . Dear Veteran, Heres the brutal truth about VA disability claims: According to our data, 8/10 (80%) of veterans reading this message right now are underrated by the VA. Sleep Apnea and How it Affects Your VA Disability Rating I submitted my claim and tried to Link my Sleep Apnea to my PTSD. Proposed rating must be based on entire medical history, Must show there has been improvement in veterans functionality, If you have a rating that has remained the same for over five years (stabilized), If you have a total disability rating, meaning 100 percent rating. Traumatic brain injury and physical pain are also conditions that affect many veterans and can lead to sleep apnea. In VA sleep apnea claims, medical opinion evidence is the rifle, and lay evidence is the bullet. Its free to join and we dont win unless you win.). Conditions like COPD (due to asbestos or particulate exposure in burn pits, for example), blocks the air path at the point where the lungs move oxygen into the blood stream. The veteran in VA sleep apnea claim #2 had exactly that. Take advantage of a FREE VA Claim Discovery Call with an experienced Team Member. Build Your Sleep Apnea Claim RightField Manual Package. Discuss your sleep issues with your primary care VA doctor and ask for a referral to a sleep specialist at the VA. It is essential that you document symptoms and evidence to submit. When youre granted a sleep apnea VA rating, you may also be assigned a re-evaluation period (unless the condition is classified as static). Sleep apnea is rated under 38 CFR 4.97, diagnostic code 6847 Sleep Apnea Syndromes (Obstructive, Central Mixed). How to Claim Sleep Apnea Secondary to PTSD - Rep for Vets I had a sleep study completed and the study indicated that I had obstructed sleep apnea and required a CPAP. Many veterans are diagnosed with obstructive sleep apnea, and thereforewith an effective claim that includes the right evidenceshould be eligible for a sleep apnea VA rating. For veterans who have already been diagnosed with sleep apnea without a sleep study by the VA, the veteran may have to undergo a sleep study done by the VA in order to confirm the diagnosis for benefit purposes. In our experience, OSA denials are almost always due to one or more of these five gaps: #1. By subscribing to the Veterans Law Blog you get a free copy of the eBook version along with many more training manuals and instructional videos. If you use a CPAP machine to address your sleep apnea, youre likely to be rated at least at 50 percent. This is especially relevant for veterans diagnosed with sleep apnea long after leaving the military. The most trusted name in education-based resources for Veterans. How does this help you in YOUR VA Sleep Apnea Claims? What is the current VA rating for sleep apnea? The most common VA rating for sleep apnea is 50 percent. During an evaluation for sleep apnea, a doctor may ask some of the following questions: During the exam, the doctor may also take into consideration your weight, neck circumference, or blood pressure (all which could put you at higher risk for sleep apnea). A disability with a secondary service connection is a condition that was caused or made worse by an already existing service-connected condition. In our opinion, the only time a veteran should pursue direct service connection for sleep apnea is if you had a sleep study performed while on active duty, which confirmed the presence of a sleep apnea condition (medically diagnosed) during active-duty service. A credible nexus letter fulfills one of the requirements for secondary service connection for sleep apnea: medical nexus evidence establishing a connection between the service-connected disability and the current disability (sleep apnea). Evidence. Typically, sleep apnea symptoms are at their worst during REM Sleep due to the bodys naturally-occurring reduced muscle tone in the bodys airway. If youre experiencing any of the symptoms listed above, and suspect your sleep apnea arose from your time on active duty (or was or aggravated by a currently service-connected disability), you should consider seeking a diagnosis and pursuing compensation for this disability. Your final VA Disability Rating for Insomnia depends upon the Top 5 Reasons for Obstructive Sleep Apnea Claim Denials (Plus OSA Service Connection Tips), Steps and Strategies: How to Prove Service Connection for Sleep Apnea, Step #1: Get a NEW Sleep Study (within the past 12 months), Step #2: Obtain a medical diagnosis of sleep apnea from a sleep specialist, Step #3: Get a nexus letter for sleep apnea from a credible independent medical professional, Lack of Medical Evidence is the #1 Reason VA Claims are Denied, Step #4: Consider secondary service connection instead of direct service connection, Secondary Service Connection Requirements. These include: As youre gathering medical evidence to file your VA claim for sleep apnea, remember that just having a CPAP alone doesnt meet the VAs requirements for service connection. There are many different symptoms that go, Sleep apnea is a common medical condition that can be caused by many different factors, including conditions like Posttraumatic Stress Disorder (PTSD). This is rare, because most veterans dont realize they have sleep apnea until after theyve left military service. yet assertive representation for our clients. Making the Sausage: Heres what you need to know about new VA Claims regulations. High Blood Pressure Secondary to Obstructive Sleep Apnea: What Veterans Should Know Are you suffering from obstructive sleep apnea syndrome and hypertension? These would include situations in which: According to 38 CFR 3.105(e), a rating reduction (for any condition) may only take place in cases where: The VA is also required to issue a veteran notice of a proposed reduction and give you 60 days to submit evidence and 30 days to request a hearing (unless the reduction would not change your compensation). See our article Burn Pit Presumptive Conditions. PDF UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS No. 18-0495 All Rights Reserved. Both anxiety and depression can also be linked to sleep apnea. A Continuous Positive Airway Pressure (CPAP) machine helps treat sleep apnea by delivering a stream of air into your airways through a mask and a tube. When the jaw was reset, it was done in such a way that caused the genioglossus muscle to weaken substantially although it happened over time. Sleep apnea and secondary service connection. During a C&P exam for sleep apnea, you will be asked questions about your condition and how it affects your day-to-day life. Learn what youve been missing so you can FINALLY get the disability rating and compensation youve earned for your service. Know your diagnosis, and you know what in-service events are most important to tie to it for purposes of establishing the element of nexus in a service connection claim. A study conducted by the VA Healthcare System for San Diego and National Center for PTSD found that between 40 percent and 98 percent (!) Our process takes the guesswork out of filing a VA disability claim and supports you every step of the way in building a fully-developed claim (FDC). 203, San Jose, CA 95134 Membership gives you your very own veteran coach to walk you through the VA claim process from start to end, and access to proprietary resources. * Any damage to your nose, face, mouth, throat, neck, chest, or diaphragm can cause the airway to be obstructed, or the airflow to be limited. You must have a medical statement from a doctor detailing how your sleep apnea is service-connected. A VA C&P exam concluding that sleep apnea was "less likely than not" related to military service. If accepted into our ELITE membership program, youll get free up-front access and permission to use $13,119 worth of proprietary VA claim resources, including access to our network of independent medical professionals for medical examinations, disability evaluations, and credible Medical Nexus Letters, which could help you get a HIGHER VA rating in LESS time. These machines create airway pressure to help the individual breathe throughout the night. The constant interruption of breathing can lead to reduced sleep quality, short-term memory loss, irritability and even mood disorders, as well as major metabolic diseases such as diabetes and heart disease. Research has shown that combat veterans with post-traumatic stress disorder, also known asPTSD, may be at higher risk for sleep apnea than the general population. We share our top tips and a step-by-step guide to a successful claim for obstructive sleep apnea! book: Put it to Rest: Your VA Sleep Apnea Claim. Columbus, OH: 100 E. Campus View Boulevard, Suite #250, Columbus, OH, 43235 Your email address will not be published. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This site uses Akismet to reduce spam. This book is a must-read: I wrote it after talking to several doctors, hundreds of veterans who were denied sleep apnea in their VA disability claim, and after reading hundreds if not thousands of BVA and Court Decisions about Sleep Apnea. of veterans with PTSD also have a co-occuring sleep disturbance, including obstructive sleep apnea (OSA). Why? Houston, TX: 2925 Richmond Ave, 12th Floor, Houston, TX 77098 Do I need a nexus letter for sleep apnea? Although all of these symptoms contribute to the interaction betweensleep apnea and PTSD, the main culprits seem to be sleep deprivation and chronic stress. Regulation Update: VA Ratings for Kidney Disease and Renal Dysfunction. Here is just a sampling of the problems that can obstruct the airway (notice how FEW of them have to do with obesity): * Deviated Septum (damage to the piece of cartilage that separates your nostrils), * Swelling in your nose due to allergic or other conditions, * Your tongue can fall back and obstruct the airway, * Reduction in the opening in the throat, or a narrowing of the side walls of your throat, * Damage to your vocal chords can restrict your airway. Did the VA Benefit of the Doubt Rule just disappear? PTSD is well-known for causing sleep deprivation, chronic stress, and an increase in body mass or obesity due to prescribed medications. Heres the brutal truth about VA disability claims: We use cookies to ensure that we give you the best experience on our website. Anxiety and depression can interfere with sleep patterns. I already have 70% for PTSD. Check out our Philips CPAP Recall page here! When he got to the BVA, the following evidence was in his C-File: Statements from the Veterans wife describing the sleep apnea symptomatologysince the Veteran returned from Iraq until his 2007 diagnosis.

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