OSA rating should have happened when I retired


Hi Jim, Thank you for your service and to all of us Veterans. I was awarded a 90% (Severe Anxiety, Migraine, Hypertension, shoulder and lower back & many others) rating when I retired.  Three years after retirement, I had an ischemic stroke and subsequently T2D. When going thru the C&P Exam, I didn't know what OSA was, but was diagnosed this year. Recently applied and denied for OSA, but my VA Doc and external MD wrote letters indicating I’ve had a history of OSA was awarded 50% increased to 100% P&T.   As I was reviewing my initial C&P report when claiming OSA, I noticed the Radiologist’s report stating I have significant blockage in a carotid artery and recommended MD intervention. All medical care has been by VA MDs – not once did anybody say or put in my record they did, nor have they try to deny this - even after my follow-on care with VA. Also, in that report C&P exam it shows I shared I had snored very loudly.

My contention is: I’ve had OSA while on active duty and my rating and effective date should have been 100% when I retired, not this year. I’ve worked with the local DAV office and they’re great. They seem to think I could be at risk for a deeper review if I claim that my OSA was secondary to any of my documented service-connected ailments. Also, they indicated the VBA C&P MDs don’t discuss their findings with VHA MDs… meaning they would have not let my VA doc know that I had blocked carotid. They indicated I would need to go the Tort Claim route for that. Please let me know your thoughts on both challenges. Thank again!

Jim's Reply:

It's hard for me to accurately comment without seeing your complex record but I can tell you that a condition is rated only after you file a claim. That the condition may or may not have been present on active duty isn't particularly important, when you file the claim is when the effective date is set.

Whether or not you were informed of a blockage in an artery is hard to predict when and why you'd be informed of that. Blockages of arteries to different degrees aren't unusual and if the vessel isn't demonstrating any clinical problems, it may not be necessary to talk about all findings when you have other more significant health issues.