Secondary conditions

Jim,

I have applied for sleep apnea secondary (OSA) to hypothyroidism in Jun 2011. I retired in Jan 2001 and was diagnosed with (OSA) eight months later. There is no mention of (OSA) in my SMR, however there are symptoms after thyroid removal in 1996. I gained 30 LBS one year after thyroid ablation and documented fatigue and throat closing sensation in my previous SMR. I know OSA is not a presumptive condition and will not be considered so if diagnosed within 1 yeat of retirement, however I have read in appeals cases it is considered probative on behalf of the veteran if it is diagnosed within 1 year. I am currently service-connected for hypothyroidism and have continuous use of C-pap to date. My current endroconologist provided a nexus letter and hypothyroidism and OSA are linked to each other. I feel this should be approved, however I also know the VA is not predictable. What do you think? Thanks for your time.

Reply:

I'll assume that you filed for the thyroid problem that occurred while you were on active duty. The OSA should easily be connected as a secondary condition to that if VA follows the trail of your symptoms. The diagnosis within a year of ETS helps. The most helpful evidence will be the nexus letter. If correctly phrased, that should seal the deal for you. Correct phrasing means that there is a passage that reads "it is more likely than not". Without that phrase, your chances of winning are significantly less than with it. Having said that, VA seems to arbitrarily deny most OSA claims these days so as you go along, expect that you will have to appeal. Please read http://www.vawatchdog.org/how-to-appeal.html, http://www.vawatchdog.org/obstructive-sleep-apnea-osa.html, http://www.vawatchdog.org/How_To_Hire_A_Lawyer.html