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VA Claims question...why would the VA order additional examinations (3rd and 4th opinion) from doctors after military and VA contracted Doctors already diagnosed a condition? Seems as if they are searching for a diagnosis they want rather than what's been diagnosed. For example, I have nearly severe sleep apnea (28 apneas per hour) and my CPAP which I use every night for an average of 5.5 hours, 4 hours or more, more than 80% of the time. I still average roughly 8 to 10 apnea events with the CPAP. I'm claiming an inability to concentrate (concentration issues), probably because, as one Dr. put it, I have had a proper nights sleep for over 10 years. Second example, why would the VA order X-Rays to rule out one herniated and several bulging discs that MRIs less than a year old have already concluded exist. I'm no a Dr but I'm pretty sure these injuries don't heal themselves nor does an X-Ray rule out what an MRI shows...thought it was the other way around. Does the VA intentionally set out to discredit the diagnosis of other doctors?
Posted in these groups: 
Department of Veterans Affairs (VA)
Department of Veterans Affairs (VA)
Posted >1 y ago
Responses: 5
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Regarding claims; Apnea, when you change physicians or first enter the VA they have to verify conditions because you may or will have a percentage of disability associated with it. Many sleep clinics fudge numbers. As for bulges and hyrniations, they can sometimes improve. Either way they need to assess your current status in support of your disability rating. Even when they treat, updates after a year for comparison if nothing else. As long as they are not impeding your care, I would say be patient. If they are then ask for immediate assessment. Thank you for your service.
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CPO (Join to see)
Thanks! I had a sleep study 2 years ago at Walter Reed, the diagnosis was swift. There is a very obvious difference in the way I feel now that I've been on the CPAP for almost 2 years. Even with the CPAP, I still fall in the mild apnea range of above 5 and less than 15. IRT the bulges and herniation, there is no change in the way my back feels except for when I aggravate it and it gets worse for a few days.
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CSM Darieus ZaGara
Sorry for your misfortune. The better the VA checks you the better your rating. Be patient so that you can get what you deserve.
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On the apnea thing, if the first doc or two are not Pulmonologists who specialize in sleep medicine, then the diagnosis can be in doubt. Don't know what's going on in the second case. With the apnea and disc thing combining for well over 50% disability, the VA is like any insurance company in that they're doing cheap things to try and limit their monetary exposure. One other thing about the apnea. From what you describe, whatever is going on is outside therapeutic parameters for which a specialist needs to take a deeper dive on. If you're getting 10, that's well above the target of 5 or less. Many times it's a matter of dialing you in or choosing the right type of equipment or configuring the equipment correctly. I get 0-1 events just with a fixed setting. My wife does much better with a variable response that tends to sense an event coming and pumps her up a bit to prevent most of them. It's and art and a science.
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CPO (Join to see)
Thank you, the study was done at Walter Reed and as far as I know the Dr. does specialize in sleep medicine. Whether he is a Pulmonologist or not, I'm not sure. My machine is supposed to self adjust and send information back to Respira (the provider). Respira's respiratory therapists are "supposed" to be taking the feedback from the machine and pushing updates. At least this was the explanation I got from the respiratory therapist at Respira.
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It might be your VA that does that, the one I go to never asked/told me to have additional examinations. Now I did have to do two sleep studies because the first one where you go in and they hook up so many wires you could talk to the ISS, I couldn't fall into a deep enough for them. The second one was a home test that they gave me a small machine to check my apnea, I was more comfortable and was able to get more sleep. Have you tried to get them to increases the air pressure ? I had to go back 3-4 times to have them up the pressure.
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