Question:
I am filing for Sleep Apnea secondary to Hypothyroidism for which I am approved. My ENT wrote a nexus letter, but it was not good enough. It seems they want more details on how he got to the nexus. Do you know of any references I can use to justify the connection? Thanks.
Jim's Reply:
Whenever a provider writes a nexus letter to help us establish service connection and an appropriate rating that person must provide a rationale for their opinion that is based in current science. If your doctor says that your OSA is more likely than not secondary to your hypothyroidism, the doctor must then state how and why he or she arrived at that conclusion. It isn't your task to sort out the science and that you're trying to isn't a great sign.
I can think of a couple of options that may help. First, go to the Board of Veterans Appeals site and use their search engine to learn how cases similar to yours have done in an appeal. Enter your key words and choose 1 or 2 years to search and read some cases. You'll learn a lot about how VA views cases similar to your own.
The other option...and the one most likely to prevail...is to retain a disability medicine professional to provide the nexus you need to prevail. You can learn more about the Independent Medical Opinion (IMO) here.
Good luck!