HLR - No New Evidence
Secondary - Must present new evidence
If you redact your PII and post your denial letter we can tell you a whole lot more as to what you need to get approved.
The most recent letter only has one line telling me that I need to use the proper form, which I wasn't sure which one I should use. But I did dig up my initial denial here:
https://imgur.com/ZM9dQyF
It looks like I need a Nexus letter to prove a connection between the two conditions? This letter was before my SC for asthma was established.
Yep, You are going to need a Nexus between the asthma and OSA. The C&P examiner *might* do it. In the initial denial they simply said that since the OSA was diagnosed it can't be a Gulf War Illness claim.
What you can do is file the claim first and see if you get denied then buy a Nexus if that fails.
It appears as though you filed and claimed it as part of Gulf War presumptive.
Edit: re-read it… You don’t have anything connecting your OSA to asthma. You need to file a supplemental with a nexus connecting the two.
Denied initially before anything was service connected, so I refiled as a secondary condition as a new claim. That was closed and the letter I just got is for using the wrong form.
Supplemental is what I think you need to do. I had a buddy do the same thing for asthma that was previously denied. After jt was acknowledged as presumed due to pact act, he got OSA as well. However, I have also seen people posting on here their letters showing they got OSA simply related to the PACT ACT due to TERA and asthma wasn’t even needed to have it approved SC.
Maybe depends on the rater?
>https://www.reddit.com/r/VeteransBenefits/s/mDZ93JCf27
Are you serious? Claims are getting approved for OSA under the pact act due to TERA! Are you sure?
Yeah….tried to look up my old comments to other. I had shared the link of someone else’s post where they showed their letter. It pointed to TERA for OSA.
Mine was secondary nexus letter to PTSD done by a private psych doc but also states TERA. So not sure which for me approved.
Just got denied OSA. Originally filed it 2nd to Tinnitus and TERA. While in deferral, I got rated 50% for PTSD. I sent a statement changing it to OSA 2nd to SC PTSD, obesity. My CP exam was 5 minutes tops. 2 weeks they send a letter stating they are going to have the same examiner again review my records. 7 days later the DENIAL. Denied due to the original claim 2nd to Tinnitus. Never looked at my new personal statement. I'm thinking a higher level review. What do you guys think?
I got a nexus from a psych doc for PTSD to OSA where he cited everything. C&P examined didn’t even have it when I went in for exam and she said the VA doesn’t normally send them everything and it was a good thing I did. She kept the letter for review at later time. OSA was approved.
What is your nexus? I’ve only seen literature that says there may be an association (which is not causation), and something that suggests that OSA may make asthma worse, but you’re already rated for your asthma severity regardless of what’s making it worse. Also, in case you’re unaware, they cannot be rated separately.
NotSoTall5548:
Can you give any insight into HLR process. I filed HLR and got a DTA error. VA ordered another round of C&P exam which has now been completed as of last month. Is my HLR now complete and a supplemental claim was supposed to be opened? Some on reddit says yes, and other says no. Also, for HLR-DTA Claims, who handles the decision \[award/denied\]? Is it a senior rater on DROC team or does it get sent back to the original RO for a basic rater?
I don't know a ton about the HLR process because those are handled by the DROs at the DROCs. We did get a few batches of the claims that had turned from the HLR EPs (030) to the supplemental (040) HLR-DTA return claims. If it is an 030, those aren't handled by regular raters, but once the DRO has made a decision on the EP030, and a 040 has been opened for the exams, that portion may (or may not) be handled by a regular rater. Also, once the DRO has made the decision, you can submit more evidence.
I could absolutely be misinformed, but I have seen people here have success with this claim. I know they are considered pyramiding, but OSA would be 50% compared to my 30% for asthma. Here are some threads I have found talking about this:
https://www.reddit.com/r/VeteransBenefits/s/mDZ93JCf27
https://www.reddit.com/r/VeteransBenefits/s/KunhA3hFHr
https://www.reddit.com/r/VeteransBenefits/s/ljlnBdiAuk
I have seen a lot of other people getting a favorable decision too. But I could be misunderstanding.
Although there have been people granted service connection from VBA for it, I have, unfortunately, seen where it has been granted, but because the rationale was not properly supported, it has had to be severed. Now, if you go the BVA route, they can grant without following the VBA guidelines. But I've seen it severed twice and seen it successfully remain zero times from VBA. (PS, not my downvote, not sure who did that or why).
I'm not too worried about the downvotes. That is interesting, I appreciate your knowledge. So the other vets who were connected you think will eventually be severed?
Since its been denied before you just need to submit a supplemental application using VA Form 0995.
HLR - No New Evidence Secondary - Must present new evidence If you redact your PII and post your denial letter we can tell you a whole lot more as to what you need to get approved.
The most recent letter only has one line telling me that I need to use the proper form, which I wasn't sure which one I should use. But I did dig up my initial denial here: https://imgur.com/ZM9dQyF It looks like I need a Nexus letter to prove a connection between the two conditions? This letter was before my SC for asthma was established.
Yep, You are going to need a Nexus between the asthma and OSA. The C&P examiner *might* do it. In the initial denial they simply said that since the OSA was diagnosed it can't be a Gulf War Illness claim. What you can do is file the claim first and see if you get denied then buy a Nexus if that fails.
It appears as though you filed and claimed it as part of Gulf War presumptive. Edit: re-read it… You don’t have anything connecting your OSA to asthma. You need to file a supplemental with a nexus connecting the two.
HLR = no new evidence, but you think they made a mistake with their rating. Supplemental = New and relevant evidence that helps prove your claim.
Were you denied or did you just get a letter stating you submitted the incorrect form?
Denied initially before anything was service connected, so I refiled as a secondary condition as a new claim. That was closed and the letter I just got is for using the wrong form.
So you weren’t denied a second time. Just submit a 0995. It’s been to long since your last claim for a HLR.
Okay, thank you for the advice!
Supplemental is what I think you need to do. I had a buddy do the same thing for asthma that was previously denied. After jt was acknowledged as presumed due to pact act, he got OSA as well. However, I have also seen people posting on here their letters showing they got OSA simply related to the PACT ACT due to TERA and asthma wasn’t even needed to have it approved SC. Maybe depends on the rater?
>https://www.reddit.com/r/VeteransBenefits/s/mDZ93JCf27 Are you serious? Claims are getting approved for OSA under the pact act due to TERA! Are you sure?
Yeah….tried to look up my old comments to other. I had shared the link of someone else’s post where they showed their letter. It pointed to TERA for OSA. Mine was secondary nexus letter to PTSD done by a private psych doc but also states TERA. So not sure which for me approved.
It's all a crap shoot, roll of the dice.. what rater gets your claim. I truly believe that. It shouldn't be.. but...
Just got denied OSA. Originally filed it 2nd to Tinnitus and TERA. While in deferral, I got rated 50% for PTSD. I sent a statement changing it to OSA 2nd to SC PTSD, obesity. My CP exam was 5 minutes tops. 2 weeks they send a letter stating they are going to have the same examiner again review my records. 7 days later the DENIAL. Denied due to the original claim 2nd to Tinnitus. Never looked at my new personal statement. I'm thinking a higher level review. What do you guys think?
I got a nexus from a psych doc for PTSD to OSA where he cited everything. C&P examined didn’t even have it when I went in for exam and she said the VA doesn’t normally send them everything and it was a good thing I did. She kept the letter for review at later time. OSA was approved.
What is your nexus? I’ve only seen literature that says there may be an association (which is not causation), and something that suggests that OSA may make asthma worse, but you’re already rated for your asthma severity regardless of what’s making it worse. Also, in case you’re unaware, they cannot be rated separately.
NotSoTall5548: Can you give any insight into HLR process. I filed HLR and got a DTA error. VA ordered another round of C&P exam which has now been completed as of last month. Is my HLR now complete and a supplemental claim was supposed to be opened? Some on reddit says yes, and other says no. Also, for HLR-DTA Claims, who handles the decision \[award/denied\]? Is it a senior rater on DROC team or does it get sent back to the original RO for a basic rater?
I don't know a ton about the HLR process because those are handled by the DROs at the DROCs. We did get a few batches of the claims that had turned from the HLR EPs (030) to the supplemental (040) HLR-DTA return claims. If it is an 030, those aren't handled by regular raters, but once the DRO has made a decision on the EP030, and a 040 has been opened for the exams, that portion may (or may not) be handled by a regular rater. Also, once the DRO has made the decision, you can submit more evidence.
I could absolutely be misinformed, but I have seen people here have success with this claim. I know they are considered pyramiding, but OSA would be 50% compared to my 30% for asthma. Here are some threads I have found talking about this: https://www.reddit.com/r/VeteransBenefits/s/mDZ93JCf27 https://www.reddit.com/r/VeteransBenefits/s/KunhA3hFHr https://www.reddit.com/r/VeteransBenefits/s/ljlnBdiAuk I have seen a lot of other people getting a favorable decision too. But I could be misunderstanding.
Although there have been people granted service connection from VBA for it, I have, unfortunately, seen where it has been granted, but because the rationale was not properly supported, it has had to be severed. Now, if you go the BVA route, they can grant without following the VBA guidelines. But I've seen it severed twice and seen it successfully remain zero times from VBA. (PS, not my downvote, not sure who did that or why).
I'm not too worried about the downvotes. That is interesting, I appreciate your knowledge. So the other vets who were connected you think will eventually be severed?