Tips By: Ben Krause                      Here’s a con­tin­u­ance of my own lit­tle story for ser­vice con­nec­tion for the fol­low­ing: Sleep Apnea sec­ondary to Sinusi­tis and Aller­gic Rhini­tis. I was denied for these con­di­tions right after my sep­a­ra­tion from ser­vice, in 2001.                           A lit­tle back­ground. I had a sleep study in ser­vice con­ducted by the Fargo VA. The VA had the records of a sleep study and was noti­fied as such. Yet, dur­ing my eval­u­a­tion, the VA did not request its own files and sub­se­quently denied my con­di­tion. I had brief episodes of apnea but did not require a machine. They also denied ser­vice con­nec­tion for the other con­di­tions despite at least 12 instances within my ser­vice records requir­ing treat­ment. The effects of sinusi­tis were later con­firmed in 2009 via an MRI as were the polyps from aller­gic rhini­tis. The next year I was given a CPAP machine.                         Rub­ber, meet Road. In 2010, I put the whole claim together with a lit­tle doc­u­men­ta­tion help from law school and “The Lit­tle Book on Legal Writ­ing.”   I called the Fargo VA for the actual sleep study from 1998. While on the phone, the FOIA guy at the VA faxed the records to me after a lit­tle con­vinc­ing (that was the morn­ing of my recent VA exam­i­na­tion – don’t wait to the last sec­ond like I did). The records ver­i­fied my apnea. I was also able to find Con­gres­sional Reports about the con­di­tions of the dor­mi­to­ries we lived in while at tech school – there were issues of asbestos and leak­ing sewage along with out­dated HVAC sys­tems blow­ing par­ti­cles around. I imme­di­ately came down with sinusi­tis and pneu­mo­nia after arrival. I included this doc­u­men­ta­tion in the event that I come down with cer­tain can­cers down the road.                        Armed with the report, my med­ical records and a typed sum­mary, I went to the exam. The first appoint­ment was with an Ear Nose and Throat doc­tor. He said the VA already con­ceded ser­vice con­nec­tion but he needed to find out how many episodes I have every year. I handed him my doc­u­men­ta­tion. While he did not read over the doc­u­men­ta­tion in full, he most likely referred to it after the meet­ing while fill­ing out his exam notes. This is key, espe­cially if the exam­iner did not take good notes while in the meet­ing or for­got some key point that you men­tion. The sum­mary you hand him may be the dif­fer­ence between a 10 or 30 per­cent.                         My sec­ond eval­u­a­tion was for sleep apnea. I showed the doc­tor my cur­rent diag­no­sis along with the for­mer diag­no­sis while I was in ser­vice. She took the time to read over my sum­mary, which explained how the VA missed my ear­lier diag­no­sis. Since I had the old sleep study exam with me, she was able to clearly tell that I had sleep apnea while in ser­vice. Because of the way my doc­u­men­ta­tion was set out, she told me on the spot that she was going to tell the VA I had sleep apnea in 1998. This could result in a deci­sion for retroac­tive pay if I can prove VA com­mit­ted a Clear and Unmis­tak­able Error dur­ing their 2001 denial.     Tip By: Joe   If something develops, take a picture with a camera or a phone with a camera.  Show it to the examiner and send in a hard copy of the photo large and gruesome enough for the examiner to clearly see it.  Hopefully before lunch.  For something like sleep apnea, make digital recording of how you sleep.  Edit the recording to highlight the problem as well as sending in the unedited video and audio.   Tip By: Patrick When you visit a civilian medical institution ask them to fax a copy to your VAMC.  They will then digitize them and they are added to your permanent VA medical file.

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