Sleep Apnea And The Va

Is surgery the only option for treating sleep apnea or snoring

I do predominantly the line share of sleep apnea surgery in our department. I collaborate closely with the pulmonologists, who are the sleep medicine s. Those are the s that help diagnose and treat sleep apnea, as well. If those patients fail their, their medical or their conservative therapy, that's typically when they get sent to see me for surgical considerations to, to look at potential cures for their apnea. It's not uncommon for me to see a lot of patients for, who come in for snoring complaints and, you know, are wondering whether or not they have sleep apnea. So sleep apnea is condition where you actually stop breathing at night.

Snoring is somewhere on that spectrum, towards the more mild, you know, milder end of that spectrum. But, you know, really the only way to determine if you have sleep apnea, the gold standard of testing, is really getting a sleep study. And that's an overnight, monitored study where patients, you know, sleep in a room that's similar to a hotel room but they're being monitored and they're hooked up, you know, for sound so to speak with different monitors and cables on them. And that's really our best test to diagnose sleep apnea. The treatment for sleep apnea is typically a nonsurgical therapy; something called CPAP,

which stands for Continuous Positive Airway Pressure. And it's the patients that don't tolerate their CPAP who end up seeing me for surgical considerations. And there's a number of reasons why patients may not tolerate their CPAP. But there are some surgeries that can be helpful in patients who are not tolerant of their medical therapy. And I offer a variety of surgeries including nasal surgery, a variety of palatal surgeries for the kind of tonsil and soft pallet region and then also a variety of tonguebased procedures, as well. But we typically see a patient back after their procedure in about three weeks to recheck everything, make sure that they're healing okay.

After that, I normally recheck a sleep study in about three months after their surgery, just to give everything a chance to heal and to scar. And we, you know, make further recommendations based on the result of their followup sleep study after their surgery. We're exploring the, a new technology now which is actually a nerve stimulator for sleep apnea. It's an implantable device, very similar to a pacemaker that goes into the patient's chest. And there's an electrode that will actually stimulate the nerve that goes to the tongue to provide the tongue with a little bit of more tone when they're sleeping at night, and thereby eliminating their sleep apnea.

Compensation 101 How did I get this rating

If you've receiveda rating with multiple disabilitiesand wondered how VA got the combined percentage,the following information and example can help youunderstand. VA uses a concept calledthe quot;Whole Person Theoryquot; to determine Veteran'scombined disability rating. This method ensures thata disability rating can never be greater than 100,since a person cannot be

more than 100% able bodied. The disability isdetermined by using the quot;Combined Rating Tablequot;located at 38 CFR 4.25. To use the rating table,you need to start with the highest disabilitypercentage, and from there, arrange them in orderof severity, highest to lowest. For example, if there aretwo disabilities evaluated 50 and 30 percent disabling,the highest degree

or most severe disability in this example 50% will be foundin the left column. Then, the otherless severe disability in this example 30% will be found in the top row. The figures appearingin the space where the left columnand top row intersect will represent the combinedvalue of both disabilities. This combined value willthen be converted

to the nearest numberdivisible by 10. Remember, combined valuesending in 5 or higher, will be adjusted upward to the nearest number divisible by 10. Combined values endingin 4 or lower, will be rounded down to the nearest divisible by 10. The rounding is only doneat the very end after all the disabilitieshave been combined. Let's begin withJoe Veteran as an example.

Joe has been ratedfor the following disabilities in order of severity: 30% PostTraumatic Stress Disorder (PTSD), 20% Diabetes Mellitus,10% Peripheral Neuropathy. Joe has a combined rating of 50%. This combined rating wasderived by the following method. Start with the greatestdisability and then combine them using Table 1in 38 CFR 4.25.

First take the 30% ratingand find it in the left column. Then take the nexthighest disability which is 20% from the top row. The figures appearingin the space where the column and row intersect will represent the combined value of the two. The value is 44. Use this value for theleft row and then find

VA Disability Compensation 100 Disability

(soft music) Hi there, Matthew Hillhere with Carol Ponton from Hill and Ponton, and we're here to talk today about getting 100% service connection for VA benefits. We get clients asking us all the time what's in it for them,

why get to 100, and why is it so hard to get to 100%é First of all, there's two ways to get to 100%. The first way is to have either one rating or combined ratings that equal 100%. And as we've seen in our vet scene, the VA doesn't do one plus two

equals three math. They've got a strangeway of combining things. And the closer you get to 100%, the harder it is to get 100%. There's a whole chart, combination chart, in the VA regulationsthat we won't get into, but suffice it to say that it's really, really hard to get acombined rating of 100%.

Well I think thatthe best way to explain it is if the VA finds you 40% disabled, then they figure you only have 60% of your body left. So the next time they give disability, it's, say it's 20%, instead of adding 20 with 40, they go well it's 20% of the 60% left,

which is 12%, which gives you 52%, not 60. As you can see, each time it gets harder and harder to get to 100, and that's why they have the other way to get 100% which is called total disability due to unemployability. Or unemployability or IU.

Right, and that's forpeople that aren't working and that they have a combination of disabilities that would equal 70%. They have to have on that equals at least 40 out of that, and a lot of times it's much easier for a veteran to get 100% through the unemployability

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