sleep apnea va claim denied

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. This guide will outline the basics of sleep apnea, how the VA disability rating works for this condition, and how qualifying veterans can prove direct service connection as well as sleep apnea as a secondary service connected condition to PTSD. 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. Click Go Elite Now below to get started today and a member of our team will be in touch within minutes. As youve seen, claims for obstructive sleep apnea can be trickyyet important to pursue if youre suffering from this disability, so you can get the benefits you deserve and care you need. According to the VA, 1 in 5 veterans has obstructive sleep apnea. Lay Statements are important! OSA is a common denial veterans receive when pursuing a VA claim, but it doesnt have to beif you understand the condition and what your claim must include in order to be successful. Since 2009, the number of veterans claims for sleep apnea has increased by over 150%, according to USA Today. Your Sleep Apnea VA Rating A Guide to Getting a - VA Claims Insider Get a Free Case Evaluation, The Link between Sleep Apnea and Hypertension, VA Disability Ratings for Insomnia and Sleep Disturbances, Sleep Apnea Secondary Connection to PTSD VA Disability, Other Medical Conditions Sleep Apnea is Connected With, VA Proposes Changes to Sleep Apnea Ratings, Common Sleep Apnea and Sleep Problems Symptoms in Veterans, VA CPAP Machines for Sleep Apnea Treatment, Establishing Service Connection For Sleep Apnea, C&P Exam for Sleep Apnea and Sleep Studies. How to Get a 100 Percent VA Rating (if deserved)! For the most part, if you're a disabled veteran with a sleep apnea claim, the 50% sleep apnea rating is your best-case scenario. This includes having a sleep study done, a buddy letter from your spouse, and medical records from your doctor about your symptoms. Is it difficult to stay awake performing tasks like driving, reading or watching TV? He was denied support connectio nitrogen for sleep apneas by the BVA, despite extensive proof of treatment for sleep apnea away 2007 - 2014, at VE medical facilities. The doctortold her that the genioglossus muscle the muscle that connects the tongue to the jawbone was substantially weakened and causing her tongue to fall backward while sleeping, blocking the airway. Evidence. VA Sleep Apnea claim denied I recently received word back from the VA that my sleep apnea claim was denied. I was however granted 10% for Asthma, as they said I would have gotten 30% if I had meds, which I did, and did submit that as evidence. One common scenario is when a veteran tries to claim sleep apnea as a primary condition when there was no diagnosis during active-duty service. The major causes appear to be sleep deprivation and chronic stress. Before or in addition to CPAP therapy, lifestyle changes such as diet, exercise, and stress reduction may be recommended. The second part can be satisfied with your existing service-connected disability rated at 0 percent or higher. Hypersomnolence (i.e., excessive daytime sleepiness), Mental anxiety and/or depression related to combat, Use of alcohol, sedatives, certain medications or tranquilizers. Sleep Apnea and How it Affects Your VA Disability Rating He was diagnosed with sleep apnea in 2007, after his military service. However, VA has not identified literature to support inclusion of sleep apnea as a presumption at this time. 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). Seattle, WA: 506 2nd Ave,Suite 1400,Seattle, WA 98104. 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)so you can increase your rating faster! 203, San Jose, CA 95134 This can occur from ten times to hundreds of times per night. 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. * The 5 Reasons that 76% of VA Sleep Apnea claims are denied - and how to fix the problem in YOUR case. Regulation Update: VA Ratings for Kidney Disease and Renal Dysfunction. His eBook, the9 Secrets Strategies for Winning Your VA Disability Claimhas been downloaded more than 300,000 times in the past three years and is the #1 rated free VA disability claims guide for veterans. We answer your questions about VA claims for sleep apnea compensation. In April 2004, he wastreated after his military service ended for fatigue and insomnia. Having a doctor connect your sleep apnea to your secondary service-connected disability will greatly improve your chances of winning a sleep apnea VA rating. People with sleep apnea are four times more likely to have depression than people without a sleeping disorder. www.va.gov Essential Keys to Winning Your Sleep Apnea VA Benefits Claim The VA has been moving a lot of claims through this process. Record Before the Agency ("R.") at 4-12. A statement from the doctor, and some additional medical evidence regarding those facts, was enough to win the case for sleep apnea, and it is now (at least for this veteran) a service connected condition. Yes, sleep apnea can be service-connectedand will need to be service-connected in order for you to get a disability rating for sleep apnea. In our experience, if you did NOT have a sleep study while on active duty and you did not get a medical diagnosis of sleep apnea in the military, you should only attempt to service-connect your sleep apnea VA claim SECONDARY to another service-connected disability. Were here for disabled veterans exploring eligibility for increased VA disability benefits and who wish to learn more about that process. Contact Us In this guide, we'll explore how to get a VA Rating for Insomnia even if youve already filed or been denied benefits in the past. PDF UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS No. 18-0495 When he got to the BVA the following evidence was in his C-File: A VA C&P exam concluding that sleep apnea was less likely than not related to military service. Obstructive sleep apnea (OSA) is the most common type of sleep apnea. Sleep apnea treatment depends on the type and severity of the condition. Sleep apnea can make it hard for your brain to regulate blood flows in your arteries and in the brain itself. Portland, OR: 650 N. E. Holladay Street, Suite 1600, Portland, OR, 97232 As of December 1st, 2022 the VA disability rate benefit amounts are as follows: 0 percent disability rating: $0.00 per month. No proof of service connection (missing a nexus letter), #4 Lack of active-duty documentation and medical evidence, #5 Filing for direct service connection vs secondary service-connection (secondary to an already service-connected disability). Philadelphia, PA: 1 International Plaza, Suite 550, Philadelphia, PA, 19113 Hear from fellow Veterans just like you, with many of our Business Development Representatives having gone through our programs. For a limited time, you can book a free, no-obligation VA Claim Discovery Call with one of our experts. The private physician noted post-deployment symptomatology of sleep apnea, and opined that the Veterans Sleep Apnea was, at least as likely as not, related to the Veterans tours of duty in Iraq. Which primary disabilities make the best claims for secondary service connection of sleep apnea? Physicians will treat sleep apnea depending on the type and severity of the condition. Pittsburgh, PA: 201 Penn Center Boulevard, Suite 400, Pittsburgh, PA, 15235 Save my name, email, and website in this browser for the next time I comment. Believe it or not, buddy statements can be helpful in proving sleep apnea claims if you can find vets who you served with and heard you snoring, or can talk about the issues that led to the sleep apnea. Even if youve had a sleep study before, its important to get one done within the 12 months prior to your VA claim. Its FREE to get started, so click Go Elite Now below to complete our 3-step intake process. These machines create airway pressure to help the individual breathe throughout the night. Top 5 Questions about Sleep Apnea VA Claims - Disability Denials Since that time, we have provided compassionate If you continue to use this site we will assume that you are happy with it. We can helpreach out so we can show you how. Think about it this way: if you are diagnosed with severe hearing loss, then to win your hearing loss claim, you arent going to waste your time telling the VA about your knee injuries. Sleep apnea and secondary service connection. Since 2016, VA Claims Insider has helped thousands of Veterans just like you get the VA rating and compensation they deserve in less time. Her husband told her she would snore loudly and wake up in the night often stopping breathing. Lesson learned:Lay Evidence is the Bullet, and Medical Evidence is the rifle. Signup to never miss a beat with special offers, blog updates, exclusive trainings, and more delivered right to your inbox! No current medical diagnosis (within the last 12 months), or improper diagnosis, #3. There isnt a single rating for sleep apnea, but a range of ratings depending on the severity of your condition (as is true for other disability ratings). Making the Sausage: Heres what you need to know about new VA Claims regulations. 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). 30 percent disability rating: $508.05 per month. I submitted a supplemental claim adding some articles and VA reviews showing correlation with PTSD. Top 5 Reasons for Obstructive Sleep Apnea Claim Denials - VA Claims Insider It was this evidence the lay observation of symptoms and limitations of sleep apnea from time of service to diagnosis which made the veterans private medical opinion so powerful inVA sleep apnea claim #2. If you need a lawyer, fill out a contact form at the law firm of Attig Steel: https://www.attigsteel.com/contact-us/. 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. He was denied service connection for sleep apnea by the BVA, despite extensive evidence of treatment for sleep apnea from 2007 2014, at VA medical facilities. If you want to learn how to implement these strategies to get the VA benefits you deserve, click here to speak with a VA claim expert for free. VA Sleep Apnea Claim - Deniedagain : r/Veterans - Reddit The Higher-Level Review for OSA - VA Claims Insider claim of entitlement to service connection for sleep apnea. 40 percent disability rating: $731.86 per month. Youll need to make the call on direct service connection versus secondary service connection. As a veteran, youre four times more likely than other Americans to develop sleep apnea. Sleep apnea often is thought of as a mild annoyance, but it is a significant condition that can lead to health issues ranging from hypertension, stroke and heart attack to depression, anxiety and headaches. This will confirm a medical diagnosis and current symptoms, especially if theyve become more severe over time. Diagnosing Sleep Apnea Typically the re-evaluation period is anywhere from two to five years after your initial examination. REM (Rapid Eye Movement) sleep is also sometimes known as deep sleep. Obstructive Sleep Apnea: aka,OSA, is a type of sleep apnea that occurs when your airway is blocked or obstructed. The condition is given a serious VA disability rating . Get the real info veterans need to file successfully for sleep apnea disability benefits. To learn more about how this works, check out my book: Put it to Rest: Your VA Sleep Apnea Claim. Many veterans receive wrongful denials when they apply for service connection for sleep apnea. 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. If youre stuck, frustrated, underrated, and currently rated between 0%-90%, VA Claims Insider Elite is for you! Its this simple: without a bullet, a rifle is powerless. Because sleep apnea affects how your body takes in oxygen, it can be linked to strokes. Learn what youve been missingso you can FINALLY get the disability rating and compensation you deserve! They denied my Sleep Apnea when I originally applied for disability on the grounds that there was no complaints or history of sleep apnea in my military records. Your sleep apnea rating will compensate you based on your conditions severity. VA Disability for Sleep Apnea: Proving Service Connection Finally, a 100% rating is available when sleep apnea is so severe that it involves organ damage. 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. Reasons Why The VA May Deny Your Sleep Apnea Claim 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. If you need a lawyer, fill out a contact form at the law firm of Attig Steel: https://www.attigsteel.com/contact-us/. 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 . Sometimes the VA will schedule re-examinations to determine if there has been an improvement with a veterans sleep apnea has improved. New Rule allows Presumptive Service Connection for Veterans particulate matter (burn pit) claims. Learn how your comment data is processed. Broadly, its defined as the occurrence of five or more breathing-related events per hour, measured by polysomnography (sleep study). This is called a split-night sleep study. Washington, D.C.: 1776 I Street, NW, 9th Floor, Washington, D.C 20006 * 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. These Veterans Sleep Apnea Appeals Stats Will Shock You! 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. 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. A Guide to VA Ratings for Sleep Apnea - Hill & Ponton, P.A. In this article, well help you understand the top 5 reasons OSA claims are deniedand even better, what to do about it if youve received a denial for your OSA claim. 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. According to the VBA , there were over 282,300 service-connected sleep apnea claims that were awarded in 2017. In order to prove a secondary service connection, youll need three things: PTSD doesnt have to be the main cause of your sleep apnea, but it does have to be connected. Making the Sausage: Heres what you need to know about new VA Claims regulations. How hard is it to get VA disability for sleep apnea? Medical evidence and documented medical records from a VAC&P exam will be necessary for the process of filing your claim and could even reveal other secondary conditions. One common scenario is when a veteran tries to claim sleep apnea as a primary condition when there was no diagnosis during active-duty service. As a part of the VAs duty to assist veterans in obtaining evidence to help prove their claim, the VA has a duty to assist veterans in scheduling the examination for a sleep study and helping them realize the VA disability claim that they are entitled to. 3 Steps to Veteran Disability Benefits for Sleep Apnea, 6 Tips for Your C&P Exam for Sleep Apnea Secondary to PTSD, 3 Ways to Get a VA Rating for Insomnia (The Insiders Guide). Example: How a Sleep Apnea Diagnosis Drives the VA Sleep Apnea claim. Copyright 2023 VA Claims Insider, LLC. Sleep Apnea as secondary to PTSD Denied - Denial Letters - VA The VA will usually order a sleep study to be performed in order to confirm a current diagnosis of sleep apnea. What happens during a C&P exam for sleep apnea? I applied for sleep apnea secondary PTSD about a year ago. VA claim for sleep apnea denied? Follow the steps below to remedy the above-listed typical reasons for denial, and youll be much closer to a winning claim! Do I need a nexus letter for 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. So she went back to her doctor she knew the diagnosis drives the Sleep Apnea Claim to understand HER diagnosis better. In this case, there must be a medical nexus to link the sleep apnea to their already service-connected disability. We know the pain of feeling stuck, frustrated, and alone, and we want to make this process as easy and painless as possible for you. EXCELLENT INFO SIR AND I WILL USE IT IN MY CLAIM!!!!! PTSD is well-known for causing sleep deprivation, chronic stress, and an increase in body mass or obesity due to prescribed medications. To understand HOW the diagnosis drives a veterans VA Sleep Apnea Claim, we have to first understand the 3 different types of Sleep Apnea, * Damage to the lungs themselves can lead to OSA. How to Get a VA Rating for Sleep Apnea Secondary to Anxiety (The Insiders Guide), Can I Get a VA Rating for Sleep Apnea Secondary to Depression? In VA sleep apnea claims, medical opinion evidence is the rifle, and lay evidence is the bullet. All Rights Reserved. The hard copy, if you would like to get that, is also the second editionyou can get the hard copy by clicking here. He regularly writes about issues that are important to veterans and their families. Not surprisingly, the VA Regional Office denied the claim in June 2008. Also see our post on receiving a VA rating for sleep apnea secondary to PTSD. 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. High Blood Pressure Secondary to Obstructive Sleep Apnea: What Veterans Should Know Are you suffering from obstructive sleep apnea syndrome and hypertension? The third part can be satisfied with a nexus Letter from a qualified medical professional, as noted above. 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. Travis Studdard is an attorney who focuses on representing veterans in VA disability compensation claims. Here are some of the most common symptoms of central and obstructive sleep apnea: Morning headache Having a dry mouth when you wake up Loud snoring Periods in which you stop breathing when you sleep Difficulty staying asleep Trouble paying attention while awake Irritability Daytime sleepiness Sexual dysfunction 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. Type II Diabetes & Sleep Apnea No proof of service connection (missing a nexus letter) They are putting the cart before the horse. The resulting reduction in sleep quality and in the bodys supply of oxygen can have serious consequences on health and quality of life. NOW ITS YOUR TURN. 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. Sleep apnea is a sleep disorder in which breathing is repeatedly interrupted during the course of sleep. Its this simple. yet assertive representation for our clients. Since sleep apnea can correlate with conditions like heart disease and obesity, its important to seek treatment options. Todays post is about 2 veterans at the BVA, both with very similar VA sleep apnea claims. Loved ones like family or close friends could also be a good help in sharing how your sleep has changed. Unfortunately, VA does not always apply the law correctly. (In one study, 69.2% of veterans were assessed as being at high risk for OSA.). Ask your private doctor for a referral to a sleep specialist in your area (a good option if you have private health insurance). Bringing someone with you to the appointment may also be useful. 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. #2: It crosses the uvula that dangling thing in the back of your throat. Youd focus on the things that caused nerve damage that led to the central sleep apnea, brain trauma, or brain chemistry, for example. No current sleep study within the last 12 months, #2. 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. The Office of the Inspector General found that 1.3 million veterans enrolled in VA Healthcare have a sleep apnea diagnosis. or particulate exposure in burn pits, for example), blocks the air path at the point where the lungs move oxygen into the blood stream. * 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. Denied Disability Claim for Sleep Apnea | Stateside Legal 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. If youre dealing with sleep apnea as a secondary condition to PTSD, you arent alone! The same goes for depression and anxietyor any of the 33 mental health conditions rated by the VAwhich can be highly disruptive to sleep. Check out the VA Sleep Apnea Field Manual. A VA claim for sleep apnea can be denied for many reasons. * Sleep Apnea is NOT a disease of the obese: just about any neurological condition, or any interference (physical or neurological) with the body's airway can - and will - cause some form of sleep apnea over time * 3 out of every 4 Veterans who file a claim for Sleep Apnea are denied by the VA Regional Office or the Board of Veterans Appeals. In our experience, most VA disability claims are won or lost based on medical evidence. Did the VA Benefit of the Doubt Rule just disappear? While some individuals with breathing disorders may show improvement from lifestyle changes, breathing assistance devices such as CPAP machines (Continuous Positive Airway Pressure), BiPap machines, etc. Turns out, SSG Jones was raped in the Army a very violent rape by a Senior NCO in her unit. I had a sleep study completed and the study indicated that I had obstructed sleep apnea and required a CPAP. 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 most trusted name in education-based resources for Veterans. Some doctors may have you fill out a questionnaire about your sleep habits. Conditions like COPD (due to asbestos. If your Obstructive Sleep Apnea was caused by damage to your throat focus on the in-service events that caused that damage. 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. The "Bridge Claim": How to use Obesity to Service Connect Obstructive Just be mindful that a sleep apnea diagnosis isnt all about neck girth and obesity. By focusing on what CAUSED the airway obstruction, you are forcingthe VA to focus on the in-service event and the nexus. The nature of the diagnosis of sleep apnea narrows the in-service events that we focus on for nexus purposes. 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. Its FREE to get started, so click Go Elite Now below to complete our 3-step intake process. Want More Help with Your Sleep Apnea VA Claim? 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.. First of all, lets explore a little about this common disability in veterans, so you understand the condition and why its important you pursue your claim and get the benefits you deserve. A 2023 Guide to VA Disability Rates & Pay Schedules, Individual Unemployability Rating Calculator, List of Blue Water Navy Ships Exposed to Agent Orange (Interactive Vietnam Map), Social Security Disability Benefits Guide, sleep apnea as a secondary service connected condition to PTSD, Calculate Your Potential Compensation Now. Anxiety and depression can interfere with sleep patterns. The denial of disability claims for unconfirmed, undiagnosed sleep apnea is a regular occurrence for the VA. NOW ITS YOUR TURN. Deland, FL: 1607 South State Road 15A Suite 12 Deland, FL 32720, Satellite Offices In order to help you with your secondary claim, we have put together this Insiders Guide! What is the current VA rating for sleep apnea? By doing so, you necessarily figure out which in-service events are most important to tie to it for purposes of establishing the element of nexus in a service connection claim. What Drives YOUR VA Sleep Apnea Claim? - Veterans Law Blog Brian Reese here, Air Force service-disabled Veteran and Founder @ VA Claims Insider. 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.
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