A couple of VA disability questions

I'm looking for a little advice on a couple of things:

1) I have sleep apnea and I've been trying to get it connected as a secondary to PTSD. I was turned down the first time, appealed it and was turned down again. I got the nexus letter from my Dr when I tried the appeal but it was still turned down. What are some other steps that I can take to get this approved? Would a letter from myself and from my wife do the trick? Or is there anything else I can do?

2) I have RLS and want to get it service connected. From my research, I can see three things to try and use to go the secondary route. I have allergic rhinitis that I take zyrtec and afrin for. Is sleep apnea a better route if I can get it service connected, or is going secondary to PTSD a better idea? Just curious which way would likely have more success.

Thanks for any help and input.

So, my .02 cents only here, but it is based on my experience working cases for Soldiers transitioning from AD for the last 8 years. Couple of (not very) quick questions:
1. How long did you serve, and where, and how long have you been out? This is important if you’ve ever had or discussed previous sleep related issues while on AD. For example, I didn’t actually do my sleep study and claim until nearly 15 months after I retired. But, there were two previous attempts at tests, and complaints made while I was still on AD (scheduling conflicts and deployments got in the way)…which of course showed that I sought treatment while on AD.
2. When were you diagnosed with sleep apnea? If this was years after you retired…it makes it a lot harder to tie it to your military time...not that it can’t be done, just takes longer…and as you’ve discovered, expect to get denied. During the initial sleep study and/or meeting with BH, did you discuss traumatizing events? Flashbacks? Nightmares, etc? No need to answer on this forum, but if you didn’t…you probably should (if it is applicable).
3. Are you prescribed a CPAP? May seem like a stupid question, but you can be diagnosed with sleep apnea but not prescribed a CPAP. A CPAP can be a 50% rating (though I’ve also seen a 30%). No CPAP can be a 0% or 10%.

I doubt a letter from your wife will help you though more documentation from a BH source (if you’re going to one) and documentation from your Pulmonologist or Sleep Clinician definitely will.

As for the Restless Leg Syndrome (if that’s what you’re asking about), I’m not sure how you would get that service connected, but if you do…I don’t know of anyone getting compensated for it. The Allergic Rhinitis issue is tough to get compensated for because you have to show that there’s a 50% or more blockage (unless it’s recently changed, I haven’t looked up the VASRD lately.

If your sole aim is get your ratings raised and you came into my office, my first question would be: What are your ratings now? And as a follow up, do you know what your actual number is? i.e. 85.1 is 90%...but so is 94. There are numerous calculators out there if you no longer have your ratings decision letter. Always start with your highest rating and work down. There’s an old saying adage that says it’s harder to go from 90% to 100%, than it is to go from 50% to 90%.
My second question would be: What are you currently being compensated for? Sometimes it’s easier to change a 10% to a 20%...of course it takes time and doctors appointments to establish that your condition has worsened.

Thank you for your response. So, I did 17 1/2 years before accepting retirement under TERA. During my time I was stationed mostly state wide with several deployments to the middle east. I went to my PCM with sleep apnea symptoms while on AD and had a sleep study done, but was told I didn't have sleep apnea. I was diagnosed with sleep apnea several years after retirement. I was prescribed a CPAP. The reason I asked about a letter from myself or my wife was because during some of my research, it was said that a "buddy" letter or letter from spouse would help.

As far as the RLS, when I was diagnosed with it, my Dr mentioned that the antihistamines that I take because of allergic rhinitis (service connected 10%) can make it worse. During research for that, I saw that it could be related to PTSD, or could be due to sleep apnea. Also as a note, I get a good bit of my info from the Brian Reese videos and blogs. I get it from other places also, but this is usually my starting point.

Again, thanks for you input.

Okay, good start point, so I’m not overly familiar with TERA (I’ll dig into any effects it may have) other than it affects your total retirement pay, but as I understand it you’re still considered “retired,” which is good. Means you’re also eligible for CRDP and/or CRSC. What is your current VA rating? And as a follow up….do you know what your current “number” is? For example, when I first retired I was at 80%...but my number was actually 78% and change (if memory serves). When I filed for my sleep apnea my overall rating moved to 90%, although my total equaled about 93% I believe.

Regarding the CPAP, the reason why I believe a letter from your spouse will not help is that you’re already diagnosed with sleep apnea. The only way it “might” (again, only my opinion) is if she can state that the sleep issues began while you were on AD, or immediately following a specific deployment. Of greater concern is your comment that you were tested while on AD and told you did not have sleep apnea (because now that’s in your records). I’m assuming you had a follow-on test after retirement. Was it long afterwards? Just curious, the shorter the gap the better many times.

It appears the RLS can be service connected, the question would be how would it be rated? As I mentioned above, I don’t know of anyone that has gotten compensated for it, but the consensus online is that it could be 10% or higher (as much as 30%) depending on the severity. I would assume you would need nerve testing, and again, much harder to prove service connection if it’s been many years since you’ve retired.

I’m not familiar with the Brian Reese videos/blogs but will do a little research on them as well. I always tell Veterans to be wary of all these “organizations” promising to get you higher ratings. Most of them are only concerned about getting paid…and they get paid by processing paperwork (you can do on your own) and then taking a percentage of what you’ve earned. It’s a very lucrative cottage industry. Have you discussed your case with a VSO?

This might help. Good info here for everyone. Disability ratings.

https://www.ecfr.gov/current/title-3...ubpart-B#4.111

Find a good VSO, they are not miracle workers, BUT the good ones know the regs and can be a life saver! IMHO they are humans and as such are not created equal. I looked, got frustrated as all get out, bitched, moaned, and complained until I finally got off my butt (at the prodding of a few here including the two on this thread trying to help you) and did something about it. I absolutely DESPISE the fact so many try to scam this program. It's not one sided! I see scammers on both sides. Health care, especially government ran healthcare for veterans should not be this complicated.

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Originally Posted by n2ratfishin

... Health care, especially government ran healthcare for veterans should not be this complicated.

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Boy! Ain't that the truth. My next hurdle will be learning the ins and outs of medicare. I've got a few years yet, but it's closing in on me.

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Originally Posted by 1stindoor

Boy! Ain't that the truth. My next hurdle will be learning the ins and outs of medicare. I've got a few years yet, but it's closing in on me.

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You can download a book that helps, or you can go by the local SS Office and pick one up.

https://www.medicare.gov/forms-help-...s/go-paperless

When you think you are out of options, then take the time to write to your Senators and your Rep in the house about this issue. They will initiate a "Congressional Inquiry" that IMMEDIATELY gets the attention of the VA. I did this for my father who was getting the run around from the VA and within a week the problem was solved to the satisfaction of my father.

I received a personal phone call from the head of the VA in Arkansas offering his apology and his personal cell phone number if we ran into any problems. An hour after than we had a couple of calls from the local VA setting up the necessary appointments.

While Congressional Inquiries can work...often they are the nuclear option. The issue here is that the VA has already determined that the sleep apnea is not service connected. This is probably largely due to the fact that he was previously tested while on AD and it was determined that he did not have sleep apnea.

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Originally Posted by 1stindoor

Okay, good start point, so I’m not overly familiar with TERA (I’ll dig into any effects it may have) other than it affects your total retirement pay, but as I understand it you’re still considered “retired,” which is good. Means you’re also eligible for CRDP and/or CRSC. What is your current VA rating? And as a follow up….do you know what your current “number” is? For example, when I first retired I was at 80%...but my number was actually 78% and change (if memory serves). When I filed for my sleep apnea my overall rating moved to 90%, although my total equaled about 93% I believe.

Regarding the CPAP, the reason why I believe a letter from your spouse will not help is that you’re already diagnosed with sleep apnea. The only way it “might” (again, only my opinion) is if she can state that the sleep issues began while you were on AD, or immediately following a specific deployment. Of greater concern is your comment that you were tested while on AD and told you did not have sleep apnea (because now that’s in your records). I’m assuming you had a follow-on test after retirement. Was it long afterwards? Just curious, the shorter the gap the better many times.

It appears the RLS can be service connected, the question would be how would it be rated? As I mentioned above, I don’t know of anyone that has gotten compensated for it, but the consensus online is that it could be 10% or higher (as much as 30%) depending on the severity. I would assume you would need nerve testing, and again, much harder to prove service connection if it’s been many years since you’ve retired.

I’m not familiar with the Brian Reese videos/blogs but will do a little research on them as well. I always tell Veterans to be wary of all these “organizations” promising to get you higher ratings. Most of them are only concerned about getting paid…and they get paid by processing paperwork (you can do on your own) and then taking a percentage of what you’ve earned. It’s a very lucrative cottage industry. Have you discussed your case with a VSO?

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Sorry for the delay in replying. Retiring under TERA (The Early Retirement Authority) is no different than a normal retirement other than a small percentage reduction in retirement. I receive roughly 43% retirement pay instead of 50%. Everything else is the same.

My initial rating after retiring was 20%, and I assumed that was it for the rest of my life. I was out for about six years when a friend finally convinced me to see a VSO. When I finally got the opportunity to go through the process again, I got a bump to 80% (77). I'm pretty sure I went about the sleep apnea claim the wrong way. My Dr was about to send me for a sleep study when I talked her out of it. I told her I would let the VA pay for the test to be done so that I could save a little bit of money. That seemed to have been a mistake since it was a royal pain getting CPAP supplies paid for by my insurance. But all is well now as far as that goes. It was six years after retiring that I was diagnosed with sleep apnea. I was just hoping there was something I could do to better my odds of getting connected as a secondary to something else. Hoping maybe the VA would pay for my supplies.

Dang dude, I hardly ever meet someone who got approved for TERA. I applied when it first came out and was denied because my AFSC was deemed critical. I dropped my papers at 19 and served 20 years and 15 days. Not that I was counting or anything LOL. All I could think of after retiring and earning real money was "why did I stay so long". These days I realize the real money isn't the percentage. The real money is in the healthcare savings.

You're exactly right. I've told people the retirement money is nice, but not having to worry about healthcare is the best thing.

I guess I was lucky, my AFSC was considered overmanned at the time. Also, I was #19 AF wide that put in for retirement on the first day applications were available for submission. Not that I was standing by at 0000 hrs or anything. :smile: Apparently I wasn't the only cat ready to hit that button.

RETUSAF14. Sorry my late response as well. It never hurts to keep trying. At this point it's mostly just paperwork and submitting, you have the rest of your life to try and get it service-connected. Don't know if having the VA cover supplies is actually cost effective, since I would think you're still filing off of your Tricare for Retirees, which is what I'm doing as well. What I will tell you though is having the service-connection and accompanying 50% rating will definitely push you over 80% to 90% or maybe even 100%. Which, truthfully, after getting 80% for years, will nearly be "life-changing," in your disposable income category. If I were you...I would keep at it.

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Originally Posted by 1stindoor

RETUSAF14. Sorry my late response as well. It never hurts to keep trying. At this point it's mostly just paperwork and submitting, you have the rest of your life to try and get it service-connected. Don't know if having the VA cover supplies is actually cost effective, since I would think you're still filing off of your Tricare for Retirees, which is what I'm doing as well. What I will tell you though is having the service-connection and accompanying 50% rating will definitely push you over 80% to 90% or maybe even 100%. Which, truthfully, after getting 80% for years, will nearly be "life-changing," in your disposable income category. If I were you...I would keep at it.

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Thanks. I'm definitely going to keep trying. It's just aggravating is all.

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Originally Posted by RetUSAF14

Thanks. I'm definitely going to keep trying. It's just aggravating is all.

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It took me almost 10 years , NEVER give up, ITs worth it :thumb up2::salute: