My OSA was awarded service connection the first time through. I began displaying symptoms at 19 years old, just a year and a half after enlisting (35 years old now). I went to my military doc at 19 to complain about excessive snoring and daytime sleepiness. At the same time my blood pressure had spiked and I had put on some weight. He refered me to an ENT (an old Lt. Col) who told me that OSA was an "old man's disease" and that he wouldn't even consider a sleep study for me. Over the next 3 years in the service I continued to complain about snoring, my BP stayed high, and my weight steadily increased. I did 4 years and got out. About 3 years after separation I had a sleep study. My AHI was 59! I tried CPAP for a few months but it made things worse. I'd wake up in the middle of the night in a dead panic and would rip the mask off of my face. Sometimes I'd throw the entire CPAP unit across the room. Because of the failed CPAP trial I had surgery... uvula and tonsils removed, septoplasty, and turbinate resection. That worked great for about 4 years but then the problems returned. About 10 years after separation I was without health insurance and found myself in a VA clinic for the first time... I needed a refill on my BP meds. During the intake appointment at the VA I slam dunked the PTSD screen (which explained the panic / tearing apart the CPAP in the middle of the night). The PTSD revelation was an eye opener. I finally had a way to explain the things that I hadn't been able to put to words for so long. Once I came to terms with my PTSD diagnosis I began a service connection claim. I also filed a claim for my OSA. Luckily, I had a full copy of my service medical records. I did my own detective work, charting every instance in which my snoring/sleep problems were noted by a doctor. I also graphed my weight and BP from my physical at the MEPS to my last medical appointment prior to separation. When I saw the C&P doctor regarding my OSA claim he was quick to rule out service connection because there was no in-service diagnosis or outstanding event to show what casued it. I then laid out my charts and graphs. He spent the next 20 to 30 minutes poring over my medical record and eventually came to the same conclusion that I had.... something happened around the time I was 19 that brought on OSA. He theorized that I had some sort of chemical or environmental exposure that created a metabolic shift. One possible cause, according to him, may have been from one of the many immunizations I received. Between deployments to the Middle East and being on a team that was always a phone call away from going to Africa (those damn embassies were constantly being evacuated in the late 90s!) I had been immunized for just about everything imaginable. I thought the immunization/exposure metabolic shift theory was a little quacky, but the rating board took his recommendation without a fight and awarded 50% for OSA. My PTSD claim was awarded 30%. So, my advice to you is to do some homework before hand. It sounds like you have a solid case. Write it all out, chart it, graph it, timeline it, do whatever you need to do to sell it to the C&P doctor. Contrary to popular belief, C&P docs aren't there to find ways to deny claims, but they don't go out of their way to support them either. If you do the detective work for him, and present it in a clear manner, you make it that much easier for him to submit a medical opinion in your favor.
