NARSUM Appeal

[ajenkins]

I'm currently going through a MEB for hypersomnia. So far, this process has been a complete mess. My profile was written for sleep apnea, and I wasn't able to get it corrected until after my C&P exams were completed. Therefore my NARSUM states that I was filing for Hypersomnia and VA compensation for obstructive sleep apnea. The claim hypersomnia was substantiated but not the obstructive sleep apnea (as I was diagnosed with CENTRAL sleep apnea and hypersomnia). My NARSUM also states that CPAP didn't help my condition. However, it was never fitted for a CPAP although my PCM and my first study suggested it.

My question is should I appeal to get the central apnea included in my VA rating? I figure sleep apnea is sleep apnea regardless of the type especially since I was fitted for a oral device (not CPAP).

Another issue I have is that my PCM notes during my frequent appointments claim that I was suffering from problems falling asleep and staying asleep. However, my problem has always been staying awake despite 10-12 hours of sleep a day.

Also after my profile was corrected for the correct medical condition, my initial condition of chronic plantar fasciitis was updated to state my function limitations to be: "no sit ups, ruck, pushups, side straddle hop or high-impact activities. No contact sports or combatives training. MAY PERFORM ALT WALK for APFT." (This updated profile was not included in my NARSUM.) This condition seems that it should be unfitting for military service (found to be fit). Also, the NARSUM doesn't state any of my appointments to a referred podiatrist within the last 1.5 yrs only the appointments prior to my last PCS.

 

[scoutCC]

I would disagree with the NARSUM, there seems to be significant enough issues with the data to confuse the PEB. Sleep apnea is sleep apnea for rating purposes, and really, sleep apnea and hypersomnia are the same thing. However I think it needs to be made clear that everything is related to the central question of you cannot get proper sleep and that the nature of your condition makes it impossible to treat properly. Clear up things like that a CPAP wasn't attempted, as you don't have OSA and that its not a simple matter of needing more sleeping hours, its that no amount of sleeping hours can fix the fundamental fact that your sleep is never restful.

The chronic plantar fasciitis does not appear to be below retention standards according to what you wrote. As a general rule, taking an alternative APFT event is fine. Rather than focusing on correcting the appointment question, I'd focus on answering the question of how it interferes with your MOS. I suppose you're partially getting there with the no ruck profile, but the way its written is pretty generic. You want to provide some concrete example of a job task, and not just PT, that you cannot do properly, reliably, and/or safely.