Sleep Apnea and Hypertension VA Disability Claims

Aug 24, 2023

Sleep Apnea and Hypertension VA Disability Claims

Veterans with service-connected Sleep Apnea who later develop Hypertension as a secondary condition may qualify to receive VA disability compensation for both. Learn the connection between these two disabilities, secondary service connection, how they’re rated, what types of evidence you may need, and tips for your VA disability claim during today’s edition of CCK LIVE!

VA Ratings for Hypertension: https://cck-law.com/types-of-va-disab…

VA Ratings for Sleep Apnea: https://cck-law.com/blog/how-does-va-…

Read About the Connection: https://cck-law.com/blog/va-disabilit…

Learn More About CCK Law: https://cck-law.com/why-hire-cck-for-…

0:00 Introduction
0:45 What is Hypertension? How is it Rated by VA?
3:45 What is Sleep Apnea? What Are the Types of Sleep Apnea?
5:39 How is Sleep Apnea Diagnosed? What About C\u0026P Exams for Sleep Apnea?
7:50 The Relationship Between Sleep Apnea and Hypertension
9:30 Obtaining Secondary Service Connection
11:50 Proving Your Hypertension is Related to Your Sleep Apnea: Nexus
12:30 Types of Evidence to Support Your VA Claim
14:40 Important Takeaways

Feel free to ask questions, give us feedback, or request new veterans’ law topics below! And don’t forget to SUBSCRIBE so you won’t miss future videos. Visit our website at cck-law.com.

Content

15.406 -> Welcome everyone to another edition of CCK Live. My name is

20.226 -> Michael Lostritto. I'm an attorney here at the firm and today

23.586 -> we're going to be discussing Hypertension and sleep apnea

26.626 -> and how those two conditions are connected and interrelated

30.546 -> with us today. We have attorneys Amy Odom and also

34.306 -> Caitlyn Dena and so why don't we jump right in Amy? Why don't

39.666 -> we get started with you? Could you give us a little bit of

42.866 -> information as to what is Hypertension? What is the

46.386 -> medical community think Hypertension is what is VA

49.506 -> think Hypertension is and can you describe that a little bit

51.986 -> for us? Sure Mike So Hypertension means high blood

56.306 -> pressure and blood pressure is the pressure of the blood

59.666 -> pushing up against the walls of your arteries. It's measured

62.706 -> using two numbers, systolic blood pressure and dias blood

67.106 -> pressure. systolic blood pressure is the pressure in

70.226 -> your arteries when the heart beats and Dias blood pressure

74.306 -> is. Pressure in your arteries between heartbeats generally a

79.246 -> normal blood pressure level is less than 120 systolic and

83.566 -> eighty dias. The American Heart Association recognizes

89.406 -> Hypertension at systolic pressure of 130 or higher and

95.006 -> dias pressure of eighty or higher, But VA does not

100.286 -> recognize Hypertension as a disabling condition until.

106.226 -> Systolic pressure is to 160 or higher and or dias pressure is

113.106 -> ninety or higher, and it'll rate the disability based on

118.386 -> systolic and dias pressure. The big thing about Hypertension is

124.306 -> that it presents a greater risk for heart problems and stroke

127.746 -> if it's left untreated. So that's a great point. Amy. So I

132.946 -> think what I hear you saying, is that a veteran may. Think or

136.406 -> they're they're treating private doctor may say they

138.806 -> have high blood pressure, but in VA's eyes that might not

142.486 -> actually be the case in order for it to be service connected

145.206 -> and rated is that correct. Yes, unless your Hypertension blood

150.966 -> pressure is at least ninety dias or 160 systolic. VA will

158.566 -> not recognize it as a current disability. Yeah, and that

163.446 -> that's that's a great point. I know I've seen Veterans. In my

166.666 -> practice, I'm sure we all have where they you know. they have

171.466 -> high blood pressure, according to their doctor, and they can't

174.426 -> understand why VA doesn't recognize that the reason

177.866 -> really is because you know the regulations state that that's

181.706 -> not the standard. It's a little bit different of a standard for

185.306 -> VA to consider it a disabling condition. So yeah, that's a

189.386 -> critical difference and a good point now the American Heart

192.666 -> Association's definition of. Dias or higher that's

200.326 -> relatively new in the past few years, So maybe in the near

204.326 -> future, VA's regulations will catch up with medicine. But

208.326 -> until that happens, you're kind of out of luck unless you have

212.966 -> these particular blood pressure readings. Thanks Amy. So

219.206 -> Kaitlyn turning to you, the second condition that we're

221.206 -> talking about today is is sleep apnea. So maybe you can talk to

227.046 -> us a little bit about you know what is sleep apnea Are there

230.086 -> different types of sleep apnea? What are those different types?

232.406 -> Can you can you talk to us a little bit about that sure so

235.926 -> sleep apnea is a potentially serious sleep disorder where a

239.766 -> person's breathing is repeatedly interrupted during

242.566 -> the course of their sleep. There's three main types of

245.446 -> sleep apnea. The first and most common is obstructive sleep

249.126 -> apnea, which occurs when the throat muscles intermittently

253.286 -> relax. And block your airway while you're asleep. the second

257.606 -> is central sleep apnea, which occurs when your brain does not

260.806 -> send the proper signals to the muscles that control that

263.846 -> breathing and the third type is complex or mixed sleep apnea,

268.406 -> which basically means that you have symptoms of both

270.806 -> obstructive sleep apnea and central sleep apnea. Yeah and

275.766 -> II think it's important to know that. despite there being three

279.526 -> different main types of sleep apnea, they all kind of have

283.286 -> very similar signs and symptoms and Veterans really. Because

288.546 -> often times they're they're lay people right, they're they

290.706 -> don't have medical knowledge. They're not expected

292.706 -> necessarily to know which condition they have or which

295.106 -> type they have and claim that specifically, but you know all

299.986 -> all of the signs and symptoms are more or less the same and

302.866 -> somewhat overlap. so some common symptoms include you

306.706 -> know bowed snoring gasping for air during sleep, you know

310.946 -> awakening with a dry mouth. having a morning headache

314.626 -> insomnia that might result from sleep apnea, You know

318.226 -> difficult. Difficult concentration or having

321.326 -> difficulty concentrating I should say these are all kind

324.286 -> of symptoms and things that you know a veteran might experience

328.686 -> that would relate to anyone of those three types of sleep

331.726 -> apnea. Kaitlyn that you that you just talked about. so so

335.966 -> Amy turning back to you. How is sleep apnea diagnosed well,

340.366 -> generally a veteran will seek treatment for the symptoms that

344.286 -> you just mentioned like the snoring. Usually somebody in

347.406 -> the house is complaining about how loud the snoring is or.

351.766 -> Somebody's witnessing these moments in the night where the

355.446 -> veteran is gasping for air and so the veteran will seek

360.006 -> treatment for these particular symptoms. The doctors will.

367.066 -> Will will consider sleep apnea as a possible explanation for

374.206 -> the symptoms and send the veteran for a sleep study,

377.646 -> which is usually overnight and you know, doctors monitor the

384.206 -> veterans Sleep and oxygen levels during sleep and based

389.246 -> on that study, the doctor will diagnose sleep apnea or

394.686 -> something else. But for VA purposes, it's really important

399.246 -> that you actually have the sleep study done just a doctor

403.486 -> saying well, this veteran has these symptoms of snoring and

406.686 -> choking and gasping and headaches, and so it sounds

409.326 -> like sleep apnea isn't going to be sufficient for the VA.

411.886 -> They're going to require that there has been an actually a

414.686 -> conservatory sleep study sleep study done. Yeah. That's a good

421.006 -> point. You know. I see that a lot of our veterans they they

425.006 -> may obviously not know what happens during their sleep, but

427.726 -> they might have a spouse or a family member or a friend. Even

431.086 -> that would you know right? A statement in support of their

433.546 -> claim, but without the diagnosis without a sleep

436.506 -> study, it's going to be difficult and in many cases for

439.946 -> veterans to actually get the condition service connected. so

443.146 -> that is something that's that's a really critical piece here in

446.906 -> terms of rating, the condition one service connection has been

450.586 -> established for sleep apnea. You know there are various

452.986 -> ratings depending on the severity of the condition they

455.306 -> range from a 0% to a thirty to a fifty all the way up to a

460.026 -> 100% rating again based on the severity. Of the condition,

462.806 -> according to the applicable regulation. Kaitlyn Turning

466.966 -> turning back to you again here now that we've kind of talked

470.886 -> about the two conditions generally speaking Hypertension

473.606 -> and sleep apnea. Can you talk to us a little bit about the

476.966 -> relationship between those conditions? You know how they

480.486 -> impact the other. you know, are there any you know, trends or

484.646 -> medical evidence that shows that there's a relationship

486.886 -> between Hypertension and sleep apnea. Sure, so research by the

491.206 -> American Heart Association and others has shown or has

494.886 -> suggested at least that obstructive sleep apnea is

498.326 -> highly relevant to patients with Hypertension it. That

501.926 -> translates to an estimated of 50% of patients with

505.366 -> Hypertension also having obstructive sleep apnea, and

509.286 -> that condition represents one of the most prevalent secondary

513.046 -> contributors to Hypertension. Another study has also found

516.726 -> that people with untreated sleep apnea were 2.6 more time.

521.206 -> excuse me 2.6 times more likely to experience cardiovascular

525.366 -> complications, which included Hypertension, researchers

529.846 -> believe that when breathing is restricted oxygen levels in the

533.206 -> body decreased and that causes an increase in blood flow and

536.966 -> this. Blood flows places additional pressure on the

540.966 -> blood vessels walls ultimately, causing higher than normal

544.406 -> blood pressure levels, and overall, there appears to be a

547.926 -> causal relationship between sleep apnea and the development

550.966 -> of Hypertension or at least the research suggests that there is

555.766 -> yeah and that that kind of leads into the next point here.

559.206 -> if there's medical research that shows that you know

562.566 -> Hypertension or rather sleep apnea can impact or cause.

567.186 -> Maybe Hypertension in some way is there an ability for

570.066 -> veterans to seek compensation service connection for their

573.106 -> Hypertension based on sleep apnea and so here we're looking

578.146 -> at you know what's known as secondary service connection

580.466 -> for Hypertension based on sleep apnea. Both sleep apnea and

584.146 -> hypertension may be granted service connection. You know

587.586 -> independently if a veteran can prove that the condition began

590.626 -> in or was caused by something that happened during service.

593.906 -> So you know, advocates and VA typically calls that direct

597.346 -> service connection something happened in. That directly

600.886 -> leads to or causes in layman's terms, the condition sleep

606.166 -> apnea Hypertension, but there's another avenue available to

608.806 -> veterans and it speaks to that relationship that you were just

611.846 -> discussing and so that is what's known as secondary

615.846 -> service connection so secondary service connection is is

621.366 -> essentially if a veteran has a condition that's service

624.566 -> connected and that service connected condition causes or

628.966 -> contributes to causing or aggravating another condition,

632.166 -> then that secondary. Condition can be service connected in its

637.346 -> own right based on that that primary or first condition that

641.426 -> was service connected. so for our purposes here, it is

647.586 -> possible to get Hypertension service connected secondarily

651.586 -> to a veteran's already service connected sleep apnea, and so

654.866 -> with secondary service connection, the medical nexus

659.346 -> opinion that you know a private physician or you know an

663.986 -> expert. Offers or maybe even a VA examiner offers it has to

667.706 -> link the veteran's secondary disability. In this case, the

670.906 -> Hypertension to the veterans already service connected sleep

674.426 -> apnea. So that really is a critical point here because of

680.346 -> the relationship Kaitlyn that you discussed and even if a

683.546 -> veteran may not be able to prove that their Hypertension

688.266 -> on, it's own directly was related to something that

690.906 -> occurred in service. There's another path here. There's

694.106 -> another avenue for veterans to consider for veterans advocates

697.386 -> to consider. So with with that in mind, Amy turning back to

704.666 -> you. How does. One prove that you know Hypertension is

709.726 -> actually secondary to sleep apnea. How do we how do we

713.486 -> apply these concepts to you know, make it more concrete you

717.726 -> know and actually proving the claim. Well, you have to have a

721.326 -> medical nexus opinion like you mentioned Mike. It's not enough

725.406 -> to just have a diagnosis of Hypertension, even one that

728.126 -> meets VA's criteria and sleep apnea confirmed by sleep study.

734.526 -> You also have to have medical evidence linking the two

738.606 -> conditions. And that, in most cases is going to need to be in

742.546 -> the form of a medical nexus opinion by a competent medical

746.306 -> professional who can say that based on your history, your

750.546 -> specific history, the sleep apnea has caused or aggravated

755.506 -> the Hypertension.

759.166 -> And so Kaitlyn, when we're thinking about you know

763.026 -> practically how we submit this evidence or the types of

765.346 -> evidence that we want to submit and what goes into that. can

768.226 -> you talk to us a little bit about you know how a veteran

771.826 -> would want to go about doing that what they would want to

773.986 -> keep in mind the types of evidence that they'd want to

776.146 -> submit Yes. So, as Amy said, you know you need a competent

781.266 -> medical nexus opinion. so one thing that you can do is that

785.266 -> if your doctor you know does believe that there's a

788.146 -> relationship between your sleep apnea and your Hypertension he

791.986 -> or she could. Provide an opinion that states it is at

794.606 -> least as likely as not that the Hypertension is caused by the

798.126 -> sleep apnea. You can also submit medical relevant medical

802.526 -> records that might show you know associations between the

806.126 -> two condition. You can submit medical articles that talk

809.246 -> about the relationship between the two conditions and you can

812.526 -> also submit lay evidence now Veterans as lay persons, you

816.526 -> know can't render an opinion of themselves, but they can talk

820.606 -> about their experiences with. The two conditions that could

823.946 -> inform that kind of opinion. Yeah, that that that's that's

829.506 -> an excellent point and you know another point that I that I've

832.866 -> seen here representing Veterans is if a veteran has AA

837.746 -> compensation and pension examination for the

839.586 -> Hypertension or really any condition. But in this context,

842.466 -> Hypertension, the examiner may very well on service connection

847.586 -> on a direct basis or maybe even a presumptive basis, but often

851.346 -> times what I see is, they don't consider secondary service

854.546 -> connection as a theory and so they're not offering an

857.346 -> opinion. On that and so Veterans if that, if that is,

860.486 -> in fact the case in a particular veteran's case, they

862.806 -> should push back on that. They should make sure that you know

867.266 -> a VA examiner is considering that theory and any evidence

870.626 -> related to that theory is considered and you know the

873.826 -> failure to do so should be something that maybe a veteran

877.506 -> looks to appeal or asks for a new examination to consider

880.946 -> that evidence and and those theories of service connection

884.386 -> right. Mike I think the important takeaway here is that

886.866 -> in most cases you're going to have to have that medical

889.986 -> opinion either by a VA examiner or your own doctor saying that

893.906 -> there's a link but this other evidence. Like the medical

897.146 -> records and the medical articles can provide a good way

901.946 -> to prove to the VA that you should get that opinion and

906.586 -> might provide if if you get a bad opinion from a VA examiner

910.586 -> or I should say a negative opinion. the medical articles

914.106 -> and the medical records might contradict the examiner

919.546 -> rationale for the unfavorable opinion and provide a basis for

924.906 -> appeal. Yeah. Well, I think that actually does it for this

932.226 -> edition of CCK Live. Thank you for joining us as always and

938.306 -> for more information on the topics mentioned. in this

941.026 -> video, please visit our blog or check out our other videos on

945.506 -> YouTube. Also, please don't forget to follow us on social

948.626 -> media but thanks for tuning in and we'll see you next time.

Source: https://www.youtube.com/watch?v=VZ4ElncILdk