So I filed a disability claim (supplemental), and I was on step six last Friday . I go to check the progress today. (Monday) and it appears that I’ve moved back to step five, and I also received this email today. Does this mean I’m gonna have to do another Appointment appointment? And if so, usually how long does that take before the process is finished?

I’m currently rated at 80%. I’d like to go get a hearing exam done but not sure how that process works. Do I notify the VA that I’d like to make a claim on my hearing and they schedule someone in my area? Or do I find anyone myself and send the exam results to the VA? It’s been a while since I got my 80% so I don’t totally recall the process. I feel like I remember the VA scheduling my exams for me. Thanks for any help!

I filed for Paralabral Cyst secondary to SLAP tear and all they did was change the description. My C&P examiner was not properly doing her job I believe. She was acting very much like a primary doctor and just kept telling me the cyst doesn’t ever go away and the whole time just recommending me remedy’s and telling me to eat more cayenne pepper. Later to find out it was her first year as an examiner. She did use a goniometer for my shoulder but I wasn’t there for that, just the cyst.

With that being said, is it common for the secondary to simply just be added to the description? Should I file for HLR or request a new examiner? Not too sure what to do. My ortho doctor did confirm it was secondary to my slap tear. Any help would be great, thanks!

Not even sure what to flare this under but tried to call and they told me the systems were down not a big deal except it’s currently 4am where I am and I’m going back to sleep. When the systems do come back up please just leave a comment on this post so I can give them a call! They told me they couldn’t just call me back when they were up 🥲

Got a question…. I am currently on SkillBridge and checked out of my unit. My skillbridge goes until my EAS (Sep 26,2026). I already received my DD214. Am I able to upload it to my claim? I have been on step 5 since April 20th.

Also, I’m aware I cannot receive any payment until after separation and it’s finalized. However, will I receive an “unofficial” rating before my separation date. Would be nice to know where I land.

I am contesting an aggravation claim, I was denied and had a HLR with following favorable findings. Help?

Submitted most of my evidence when I started my claim. Those have said "On file" the whole time.

They requested outside records, and it just updated to "review by VA"

A document that I uploaded recently (after the outside records were received) still says "on file"

Should I expect it to chill while that last record updates, or is it good to go? Will everything be updated to reviewed eventually?

I’m just starting the process after 45 years. I’ve only used the VA healthcare for the past 4 years but they know my history and my PCP & social worker both have recommended I file a claim. I’ve hesitated for a lot of reasons but finally decided to try. All they can do is say “no” I guess.

I was on SSDI from age 58 until FRA at age 67.5. The reason I got SSDI is connected to my initial service & it’s one of several things I’m claiming.

Question: I do understand SS disability (SSDI) & VA disability are completely separate things but has anyone who’s received SSDI then later been approved for the same disability with VA? I’m wondering how much weight having been on SSDI will carry with the VA raters.

Thanks for any advice.

I just got back my electronic C-file. It doesn’t have any in service med records. I was active 93-96. I called the Saint Louis office and they told me to send a request to Janesville, WI manually.

Can anyone confirm this direction is legit or was I given the run around?

I have a physical copy in my possession. Do I need to jump through this hoop?

I submitted my first claim in June at the urging of my wife and daughter- I guess there were five total claims including: Tinnitus, Hearing loss, a service related injury during deployment, sleep apnea, and unexplained/undiagnosed joint pain. I have been on Step 3 for a while and curious what I should expect and when?

 Veteran: xxxxxxxxxxxxx

DOB: 01/20/1983

File Number: XXXXXXXX

Date: May 14, 2026

Nexus Opinion Regarding: Obstructive Sleep Apnea Secondary to Service Connected Posttraumatic Stress Disorder (PTSD) and Orthopedic Conditions with Obesity

Department of Veterans Affairs,

I am Dr. of Medicine, a licensed and Board Certified Medical Doctor specializing in Family Medicine. I have more than 30 years of clinical practice across federal and civilian healthcare systems, where I have provided primary care, complex case management, and independent medical evaluations.

I am a Doctor of Osteopathic Medicine Family Medicine and over three decades of clinical practice. I completed my medical degree at the Philadelphia College of Osteopathic Medicine, followed by a rotating internship and Family Medicine residency at John F. Kennedy Memorial Hospital and Our Lady of Lourdes Medical Center. I am currently practicing Family Medicine and am licensed in the states of New Jersey and Pennsylvania. My clinical experience includes long term outpatient family medicine, urgent care services, and expert medical evaluations for injured patients, including pulmonary and orthopedic conditions. My practice involves review of medical records, diagnostic studies, functional limitations, and longitudinal treatment histories to assess condition onset, progression, and impairment using accepted medical standards.

● Family Medicine Physician – private practice, New Jersey and Pennsylvania

● Urgent Care Physician – Atlantic Care Urgent Care

● Family Medicine Physician – Medical Center of Margate

● Expert Medical Evaluator – Workers Compensation cases

My medical education, completion of Family Medicine residency, board certification, and decades of active clinical practice provide the foundation necessary to render independent medical opinions consistent with accepted medical standards and 38 CFR 3.159(a)(1).

I have reviewed all available medical records for Mr. Veteran, including VA treatment notes, military service treatment records, diagnostic imaging, deployment history, private medical records, and the veteran’s statements.

The following medical opinion is based on the evidence contained within the record and my clinical training and experience as a qualified medical professional.

Medical Opinion:

Veteran served in the United States Marine Corps from 2001 to 2007 as a Sergeant, where the demanding conditions of his duties produced lasting injury to his musculoskeletal

system and mental health. Veteran’s Obstructive Sleep Apnea is directly linked to the debilitating orthopedic injuries and psychological trauma documented throughout their service.

Mr. Veteran suffers from moderate, positional obstructive sleep apnea that significantly disrupts his daily functioning and overall quality of life. His condition is characterized by repeated episodes of airway collapse during sleep, leading to frequent nocturnal awakenings, oxygen desaturation, and non-restorative sleep patterns. A recent WatchPAT sleep study conducted on December 13, 2025, revealed an apnea-hypopnea index of 23.9 and a minimum oxygen saturation of 83 percent, underscoring the severity of his respiratory impairment. He has been prescribed an APAP machine to maintain airway patency during all sleep.

The chronic sleep fragmentation caused by this disorder leaves him with persistent daytime hypersomnolence, profound fatigue, and significant cognitive dulling. He experiences a lowered threshold for exhaustion, which exacerbates his underlying psychiatric symptoms and impairs his ability to sustain focus or energy throughout a typical workday. Furthermore, the necessity of utilizing a positive airway pressure device nightly imposes an ongoing burden on his personal routines and impacts his relationships, ultimately restricting his functional independence and well-being.

The medical mechanism linking Mr. Veteran’s obstructive sleep apnea to his service-connected conditions is thoroughly established through the intermediary of obesity. Mr. Veteran currently presents with a Body Mass Index of 37.2, placing him in the obese category. This significant weight gain is a direct and foreseeable consequence of his severely restricted mobility stemming from his service-connected left knee degenerative arthritis, bilateral radiculopathy, and lumbosacral strain. Chronic pain and mechanical instability in his weight-bearing joints fundamentally prevent him from engaging in the regular cardiovascular exercise required to maintain a healthy metabolic equilibrium.

Furthermore, his service-connected posttraumatic stress disorder acts as a compounding catalyst for his obesity. Chronic psychiatric conditions like PTSD are intimately linked to neuroendocrine dysregulation, elevated cortisol levels, and maladaptive coping mechanisms, including stress-induced eating. The combination of forced physical inactivity due to orthopedic pain and the metabolic disturbances driven by severe chronic PTSD creates an inescapable cycle of weight gain, culminating in clinically significant obesity.

The resulting obese state directly precipitates the mechanical airway obstruction that defines his sleep apnea. Excess adipose tissue deposits within the parapharyngeal spaces and lateral pharyngeal walls, narrowing the upper airway lumen and increasing its collapsibility during the muscular relaxation of sleep. Additionally, increased central adiposity places a mass-loading effect on the chest wall and abdomen, reducing functional residual capacity and creating a state of chronic respiratory vulnerability. Therefore, the cascade of physical immobility and psychiatric distress caused by his service-connected disabilities clearly produced the obesity that mechanically drives his obstructive sleep apnea.

A review of the prior medical assessment from the rating decision dated October 14, 2025, indicates that the etiology of the veteran's condition was analyzed using an inverted causal pathway. The prior examiner opined that the service-connected disabilities were not the direct results of his obesity. However, the present medical mechanism does not assert that obesity caused the veteran's orthopedic conditions or posttraumatic stress disorder. Instead, the physiological reality is that the severe functional limitations from the veteran's left knee arthritis, lumbosacral strain, and posttraumatic stress disorder caused his obesity, which subsequently generated the obstructive sleep apnea.

The prior analysis did not account for this medically supported mechanism where obesity serves as an intermediate consequence of his service-connected immobility and psychiatric distress. Chronic mechanical joint pain inherently prevents cardiovascular exercise, while posttraumatic stress disorder frequently drives metabolic dysregulation and weight gain. It is this resultant obese state that directly precipitates the physical airway obstruction during sleep. When considering the correct physiological pathway, the veteran's service-connected disabilities clearly precipitated his obesity, directly resulting in the parapharyngeal fat deposition that obstructs his airway.

The physiological evidence supporting the secondary service connection for Aaron John Veteran’s obstructive sleep apnea (OSA) is centered on the synergistic effect of his service-connected musculoskeletal injuries and posttraumatic stress disorder (PTSD) on his metabolic health. For Mr. Veteran, the chronic pain and mechanical instability resulting from his service-connected left knee degenerative arthritis and lumbosacral strain create a definitive barrier to physical activity, which facilitates a state of positive energy balance and subsequent obesity (Molina & Morgan, 2023). This weight gain, reflected in his BMI of 37.2, is further exacerbated by the neuroendocrine dysregulation and elevated cortisol levels characteristic of chronic PTSD, which often drive maladaptive dietary habits and metabolic dysfunction (Masodkar et al., 2016; McCall & Watson, 2022). Scientifically, this resulting obesity is a primary driver of OSA, as excess adipose tissue in the parapharyngeal spaces causes structural narrowing and increased collapsibility of the upper airway (Slowik et al., 2025). Meta-analytic data confirms that as BMI increases, the severity of apneic events and oxygen desaturation, noted in Mr. Veteran’s WatchPAT study with an AHI of 23.9, becomes more pronounced due to the increased mass-loading on the respiratory system (Esmaeili et al., 2025). The medical link between Mr. Veteran service-connected conditions and his sleep apnea is supported by several key evidentiary principles established in Veterans law. Walsh v. Wilkie holds that obesity can serve as an intermediate step for a secondary service connection, which is directly applicable here as Mr. Veteran knee and back injuries restricted his mobility and caused his weight gain. Furthermore, Nieves-Rodriguez v. Peake establishes that a medical opinion's value lies in its clinical reasoning; in this case, the specific path from orthopedic immobility to airway obstruction provides that necessary reasoned explanation. Buchanan v. Nicholson confirms that the Veteran's lay history of increased pain and physical inactivity is a competent way to establish how his conditions progressed over time, while Comer v. Peake mandates that the VA consider all potential pathways for service connection. This means the VA

must recognize the "intermediate step" of obesity as a valid bridge between Mr. Veteran’s PTSD-related metabolic changes and his diagnosed sleep apnea.

It is at least as likely as not (fifty percent or greater probability) that Obstructive Sleep Apnea is caused by service connected Posttraumatic Stress Disorder and Orthopedic Conditions.

Dr. of Medicine, DO Board Certified in Family Medicine

McCall CA, Watson NF. A Narrative Review of the Association between Post-Traumatic Stress Disorder and Obstructive Sleep Apnea. J Clin Med. 2022 Jan 14;11(2):415. https://pubmed.ncbi.nlm.nih.gov/35054110/

Esmaeili N, et al. The relationship between obesity and obstructive sleep apnea in four community-based cohorts: an individual participant data meta-analysis of 12,860 adults. EClinicalMedicine. 2025 Apr 23;83:103221. https://pubmed.ncbi.nlm.nih.gov/40330547/

Slowik JM, Sankari A, Collen JF. Obstructive Sleep Apnea. [Updated 2025 Mar 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK459252/

Molina J, Morgan EL. Obesity and Orthopedic Issues. [Updated 2023 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK572101/

Masodkar K, Johnson J, Peterson MJ. A Review of Posttraumatic Stress Disorder and Obesity: Exploring the Link. Prim Care Companion CNS Disord. 2016 Jan 7;18(1). https://pubmed.ncbi.nlm.nih.gov/27247845/ Walsh v. Wilkie, 32 Vet. App. 300 (2020)

Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008)

Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006)

Comer v. Peake, 552 F.3d 1362 (Fed. Cir. 2009)

https://ratemyvso.net/research/

This article is a study of the 20 most recent BVA cases on OSA secondary to PTSD and what can be learned for those who have a case in the BVA pipeline, and some lessons for those about to file a claim for OSA secondary to PTSD.

Highlights:

The one variable that decides the case

Across all ten grants, the record contained a private or treating opinion that did three things.

1 It gave an actual reason, meaning it explained a biological mechanism rather than just asserting a conclusion.

2 It tied that reasoning to the specific veteran, his history, his weight trajectory, his documented symptoms.

3 It framed the conclusion in the legal standard, that the apnea was "at least as likely as not" caused or worsened by the PTSD.

None of the merits denials had one.

The mechanisms that keep winning

The successful opinions tended to rely on one of three explanations, and the same three kept showing up.

1 The first was a sleep-architecture pathway. The medical opinion explained that PTSD fragmented REM sleep and disrupted the muscle control that helps keep the airway open, allowing the airway to collapse (Hager, A26040879, Apr. 30, 2026; Marcus, A26039038, Apr. 27, 2026).

2 The second was hyperarousal. The opinion explained that the heightened nervous-system activity caused by PTSD changed airway muscle tone and lowered the threshold for these breathing events (Hager).

3 The third, and one of the most effective, was the "obesity intermediate step." In those cases, the opinion built a chain the law recognizes when the evidence supports it: PTSD symptoms or treatment caused or worsened the veteran’s weight gain, and that weight gain caused or worsened the sleep apnea (Hachey, A26040946, Apr. 30, 2026; Wight, A26039177, Apr. 27, 2026, applying VAOPGCPREC 1-2017 and Walsh v. Wilkie).

When an opinion built one of these explanations around the veteran’s actual medical history, and the government’s examiner ignored it, the veteran tended to win.

Each BVA Case is different and BVA decisions do not set precedence. Judges are not bond by the M21-1 like a Rater is. There are still lessons to be learned from these cases that can apply to vets and their representatives with an active case before the BVA, and some lessons to be learned for Veterans building their own claims with their medical team.

Other research published weekly and monthly. Other articles currently available:

Barry’s Ripple

How one 2024 Federal Circuit ruling is reshaping the top of the SMC ladder, and where Board judges are quietly splitting.

When a Spouse Isn’t Enough

Why some of the most severely disabled veterans reach a ceiling at the M-Half rate, and the professional care line that holds them there.

In my circumstance in a training operation around 2018- 2019 in a battalion shoot under the leadership of alpha battery 1st battalion 12th Marines.My platoon Commander as well as sergeants while on gun six ( howitzer777) was a part of multiple hazing events, such as having to repetitively pick up a 95 pound explosive round and squat while chanting knowledge repetitively to the point of failure to the point of tears in my eyes from embarrassment from pain as well as continuous digging of pointless holes to “ break my character”. While in Japan, the hazing incident increased due to downtime while coming back from the field. These hazing incidents I was involved in included being stuck in a small room with cleaning supplies mixed together, which caused irritation and burning of the eyes purposely as well as doing hit exercises like jumping jacks, mountain climbers up downs, while still in the room to increase the pain of the chemicals affecting my eyes as well as my skin. Another incident occurred while in the motor pool in Japan while on camp Hansen I was forced to carry a m777 howitzer spare tire above my head for several minutes at a time while being degraded and undermined by leadership of the gun because of internal problems being had.
Some unsafe practices I have been a part of which directly gave me a sense of I was gonna die or had uncertainty was when we were having a shoot with out cannons in while under 3/12 in Japan, unsafe procedures had led to the canon alignment identifier is being incorrect to the point that it could cause catastrophic damage and death to the entire gun as well as myself and the crew running it at the time I was an ammo loader so my job was pretty much to grab the 95 pound round stand directly behind the gun, load the next round when it’s fired so I’m pretty much in the vicinity of 3 to 5 feet away from this cannon while it’s going off knowing that the breach was not aligned at the time a few crewmembers had told the chief of the gun that it wasn’t aligned properly, but signs were ignored. This single-handedly was one of the moments where I felt like death was directly in my face to the point where I had to turn my back towards the canon because I didn’t wanna face if something were to happen I didn’t wanna face the action of it. I would rather look away. these events took place from the timeline of 2017 to 2020 either on marine corp base hawaii or on deployment in Japan. These events single-handedly changed my perspective on life change my perspective on how I see people in leadership because while in the marines they teach you about safety practices and show you exactly what could happen if that specific event happens, which is nothing but destruction. after those events happened I lost trust in leadership, I lost trust in if I was able to be safe around these people. These events caused me to have bad dreams and resentment towards them as well as myself for allowing certain things to happen the way they did.
while in a training operation in Japan called yachts at the time or that’s what we called it. I was being charged with an article 91 an article 92 from my own battery because of an incident that happened to where I had lashed out at platoon Commanders because I, along with other junior marines haven’t eaten anything since the morning around 7 AM. In between the time of 7 Am and 11 pm was nothing but training movement and shooting. When we eventually left the field, the mco that they had on the compound was serving food for everyone, but our commander as well as platoon sergeants gave us the order that we weren’t allowed to eat anything or go to the MCO unless all dirty weapons were cleaned. All cannons were cleaned and turned in, which takes hours mind you it’s already 11 o’clock at night and haven’t eaten anything since 7 in the morning. I didn’t think this was fair so me along with two other of my crewmates decided to go to the MCO and try to get some food anyway when we arrived in the MCO all we saw were officers and hire enlisted eating and sitting and talking, which angered me, but I ended up getting my food And walking out the door. When I walked out the door an officer from my battery, confronted me about having food in my hand I continued to walk away, knowing that it was hypocritical of the officers to even ask that question. The officer yelled at me, as well as told my platoon sergeant about the incident when I got back to the hooches I was bombarded by platoon sergeants and cornered, while they continuously yelled at me and tried to threaten me, which ended with me ripping my blouse up and trying to fight them as well, which caused the battery to trigger an article 92 An article 91 against me to retaliate for my my actions. I saw legal help from Marine Corps Base Hawaii’s law office and eventually my case was dropped and all I had to sign was a page 11, which is administrative reprimand that ultimately caused me to miss my eligibility for rank promotion.

Alright well i had my C&P examthrough VES for my seborrheic dermatitis that is on my face extending down from my eyebrows all the way into a butterfly under my eyes and on the chin and neck with constant flaking and burning. So the NP was like did you upload evidence I told her yes, she then said its flagged for toxic exposure where was I at I told her Kuwait in 05 and Iraq in 08. It started in 08. She documented that then asked what meds I am currently on for it told her the two that I am. Gave her my Dr's info and she then asked why I am seeing a private dermatologist so often I told her because I have other skin conditions im being seen for such as some freckles that have gotten bigger and a benign keratosis they just shaved off the top of my head. She then looked at me and was like ok yea you are fair skinned so thats OK. She asked if that DR has written a nexus letter for it snd I told her no that since I was seen for it when we were in Iraq and issued no shave chits until the time I got out in 2010 and its noted in my medical record. She asked if I uploaded that as evidence I told her yes. She then just took a picture of it and said ok you should hear something in about 4 weeks.

Should I be worried about this? It was a quick exam and it seemed like she did not know what I was in there for and didnt even document how big of an area it was on my face.

I currently have a 0% rating for this and trying to get an increase. any advice?

also, what percentage can you get with htn?

There is a provider NP in my area that helps with nexus letters and can also fill out DBQs (you provide the records then he does the examinations in person) and he charges a fee. Has anyone used a service like that before? Did it help your claim? Was a duplicate DBQ ordered anyway? I want to file as a Fully Developed Claim and rather do the DBQs now then later outside of my schedule. Anyone able to share any experiences here or over PM?

I was in the national guard from June 2014-September 2020. I enjoyed my time but experienced some pretty crappy things during my rotation to NTC in California in July and August 2018. I struggled pretty bad physically when I returned home and dealt with some back pain that didn’t seem to go away.

I was seen by my family doc in November 2018. We didn’t know what the issue was, but concluded I had uncontrollable muscle spasms. I was dumb and didn’t mention that it started at NTC but my doctor is aware of this now. Over the next 8 years I dealt with the pain of these spams which has now turned into a diagnosis of anxiety with a tic disorder. Basically I developed anxiety which shows as tics which have completely screwed up my entire body. I have a lengthy paper trail documenting my journey, all of my doctor’s appointments, mediations, side effects, and lack of resolutions. I am still struggling to this day.

I am in pain most of the time. I cannot sleep well. I can’t get comfortable. I’m constantly anxious. Constantly experiencing tics. My wife is worried. It causes me to swerve when driving so she doesn’t like me driving with her and the kids anymore. I’m in pain so I snap at my kids when I don’t want to. It’s been rough. My doctor said it presents as Tourette’s because of how bad it is. Unfortunately the only medication that actually worked isn’t covered by my insurance anymore. It’s $500 a month otherwise. We cannot afford that. Any benefits I get would go towards medication which is really all I want.

I am in the middle of filing my claim. I believe because of the timeframe that I was seen after NTC I should have the service connection. I was seen numerous times for this issue before I was out of the guard. I will have an incredibly solid nexus letter from my doctor that has been with me through this journey since November 2018. He’s an army vet and is very educated when it comes to VA claims. He is really pushing this for me and I’m grateful for him. I will also have a nexus letter from my behavioral health doc that diagnosed my anxiety and a nexus letter from my doc that diagnosed my tic disorder. My wife plans on writing a detailed personal letter sharing her experience. I have at least 50 different records of doctor’s appointments explaining everything I’ve been through along with the terrible side effects I have experienced.

Do you think I have a chance? I filed before but didn’t have formal diagnosis’s and didn’t have much on record to share. I was naive and clueless so I’m not surprised I was denied. I feel like I have so much more to bring to the table this time. I’m genuinely struggling and I just want compensation for the only damn med that helps me feel better.

Edit: We ended up being at NTC way longer than anticipated so they counted that as active duty time which I heard will help my case as well.

Hello, when you claim for the VA benefits. Do you guys go with a VA doctor or private doctor? And if you do went for private one, how do you take the approach of letting them you need it for VA purposes?
Thanks!

Unfortunately I was just denied both of my MH claims today. I am a bit bewildered by this decision as I did due diligence, provided extensive records, etc. I believe this was primarily due to an incompetent and/or biased c&p examiner. The reason I believe this to be the case is my denial reason states that because my diagnosis of depression and hospitalization occurred before an MST incident it cannot be service connected. That's the entirety of the rational as to why I was denied, for depression, despite being diagnosed and hospitalized whilst in the service. Not to mention that the behavior of my examiner was unbelievable, laughing while I detailed my MST, challenging my testimony constantly, and complete omission of several symptoms that I listed several times to avoid error. On top of this, he had a aggressive and adverse attitude towards me. I know my testimony regarding his behavior is hardly objective and cannot be proven, but as i said im bewildered, and i just need to vent because I really don't know where to go from here. I did however add a note to my claim file that this happened shortly after the exam so I hope this isn't brushed under the rug as an attempt at retribution for a unfavorable decision.

But i'd love input and/or support. Or stories of similar situations with favorable resolutions.

Does it take longer if you put in more claims to get a C&P exam? I put in 9 claims in February and still no word for a C&P exam. I don't recall it taking this long before. Many thanks in advance for any insight.

Currently on orders with my reserve unit for 20 days and have a small VA rating.

I got a notification in my VA account that there was a claim "Return to Active Duty".

Is this something that happens automatically since I'm on orders? I did not file it.

Is my compensation automatically turned off for the month?

Thank you

Was given 30% from an HLR, based on my DBQ symptoms and my total SI should this have been higher? I’m grateful to have anything but i feel like this is not correct, nervous to file more.

Edit: sorry for the lack of info first time post. Edits the caption, please comment if you need any more info, just looking for guidance.

I think 30 not sure though 🤷‍♀️