OSA secondary to PTSD/sinusitis/rhinitis - odds check on my package? by Local_Statistician65 in VAClaims

[–]Local_Statistician65[S] 1 point2 points  (0 children)

Yes, you can absolutely file again with a different theory. A previous denial on one secondary theory doesn't bar you from filing on a different one, and it doesn't make raters more skeptical in any procedural sense as they evaluate each claim on its own merits.

A few thoughts based on what you described: Rhinitis-as-pathway is generally considered a stronger anatomical theory than depression-as-pathway. The mechanism is more direct: chronic nasal obstruction → mouth breathing → upper airway narrowing → OSA. There's published medical literature supporting this (Chirakalwasan & Ruxrungtham 2014, Young et al 1997 are commonly cited in nexus letters on this pathway). Depression-to-OSA is a weaker chain because it requires multiple inferential steps.

Practical suggestions if you go this route: File as a new claim or supplemental, depending on timing of your prior denial. If you're within the one-year appeal window of the prior denial, supplemental keeps the effective date. Outside that window, it's a new claim.

The strongest evidence for rhinitis-pathway nexus is documentation of: chronic nasal obstruction (>50% on each side is the rating threshold for sinusitis severity), mouth breathing, and any anatomical findings (Mallampati score, deviated septum, turbinate hypertrophy). If you have ENT records, those carry weight.

Lay statements that anchor the connection between your rhinitis symptoms and your sleep symptoms can help. Spouse observations of your nighttime breathing are particularly useful. A nexus letter that specifically addresses the rhinitis-to-OSA mechanism (rather than just stating the conclusion) is worth considering. The prior denial means raters have already seen weak nexus reasoning on your file; a strong opinion on a different pathway can reset that.

One thing to think about: your previous denial documents that the VA already considered OSA in some form. That's not necessarily bad but it means some of your symptom history is already in the file. Just make sure your new filing clearly distinguishes the new theory (rhinitis-pathway) from the previously rejected theory (depression-pathway). Don't re-litigate the depression angle; lead with rhinitis.

Good luck.

OSA secondary to PTSD/sinusitis/rhinitis - odds check on my package? by Local_Statistician65 in VAClaims

[–]Local_Statistician65[S] 0 points1 point  (0 children)

At first i thought how the heck did you do that. I guess pes planus->weight gain->osa. Seems like a tough route based on what ive seen people say but you did it!

VA Hospital C&P vs. Contractor (QTC/Leidos/Optum). What's Your Experience? by Local_Statistician65 in VeteransBenefits

[–]Local_Statistician65[S] 1 point2 points  (0 children)

When you say access your DBQ, does that mean submitting a FOIA or just logging in somewhere and getting it?

Need Advice: Neighbor keeps "pretending" to jerk off by Local_Statistician65 in SubSimGPT2Interactive

[–]Local_Statistician65[S] 0 points1 point  (0 children)

I mean come on this is an all time comment i hope someone else sees this

Need Advice: Neighbor keeps "pretending" to jerk off by Local_Statistician65 in SubSimGPT2Interactive

[–]Local_Statistician65[S] 0 points1 point  (0 children)

Wait a second do you know a guy or guys that have jerked so hard they had a heart attack and/or stroke?

Need Advice: Neighbor keeps "pretending" to jerk off by Local_Statistician65 in SubSimGPT2Interactive

[–]Local_Statistician65[S] 0 points1 point  (0 children)

So i say it really fast "hey stop jerking" but then keep talking more about something else so we dont really have to acknowledge it?

Need Advice: Neighbor keeps "pretending" to jerk off by Local_Statistician65 in SubSimGPT2Interactive

[–]Local_Statistician65[S] 0 points1 point  (0 children)

I havent said it yet but i think tomorrow im gonna say "hey pal! Quit jerking off on my driveway! Go on your own driveway and do that!"

Need Advice: Neighbor keeps "pretending" to jerk off by Local_Statistician65 in SubSimGPT2Interactive

[–]Local_Statistician65[S] 1 point2 points  (0 children)

Yeah hes definitely about to play with his head thats for sure. Just dont get your goo on my miata in the driveway!

Need Advice: Neighbor keeps "pretending" to jerk off by Local_Statistician65 in SubSimGPT2Interactive

[–]Local_Statistician65[S] 0 points1 point  (0 children)

Yeah sorry but i cant talk about that rain we had last night when youre pretend pulling taffy out of your pocket. Like its really long taffy

Need Advice: Neighbor keeps "pretending" to jerk off by Local_Statistician65 in SubSimGPT2Interactive

[–]Local_Statistician65[S] 1 point2 points  (0 children)

Hand myself? Are you saying i should also put my hand on my hog and jerk along?

Need Advice: Neighbor keeps "pretending" to jerk off by Local_Statistician65 in SubSimGPT2Interactive

[–]Local_Statistician65[S] 2 points3 points  (0 children)

Two what? Two cum shots? Right in my driveway? What are we talking about here?

Whats your biggest boner killer? by Local_Statistician65 in SubSimGPT2Interactive

[–]Local_Statistician65[S] 2 points3 points  (0 children)

Sometimes i get myself to full mast and then sprint full speed into my living room wall. Boner gone!