I refuse to use CPAP now.What will happen

[joemburrell]

I am going thru an MEB for my back pain. During the process i was diagnosed with sleep apnea and was given the CPAP. I have used it for 30 days now and there is no improvements. I feel sufacated and it restricts my breathing. MEB Tech told me that Pulmonary doc said it meets retention, so I told the doc that i will not use CPAP or any other treatment for my apnea. He then told me that my sleep apnea doesnt meet retention standards because i refuse treatment. Will i still get the 50% rating from VA? Will the Army give me any benefits, now that it does not meet retention? Will this give more backbone to my MEB? Thanks guys.

[AFPEBLO]

Generally, being non compliant with treatment will not help you in an MEB/PEB. If the CPAP isn’t working for you I suggest you try to work with your provider on other treatments like a mouth piece or different types of masks, etc.

[xeno]

Hi & welcome,

Refusing medical treatment may lead to an admin sep.

X

[Jason]

First, from my interactions with PEB Medical Board members, the common reaction to the situation you describe is that the issue is proper fitting and titration of the CPAP. I do not say this to agree or disagree with your decision, just what I think their response would be.

I think that the outcome, if your sleep apnea, untreated by CPAP use, is unfitting, would be separation without benefits due to "unreasonable refusal of treatment." Not that I am saying your decision is unreasonable, just what the theory would be to deny you benefits. However, if your back pain is separately rated, you may yet get to severance pay or retirement, depending on the facts.

The other thing to consider is that current experience shows that the PEBs are very unlikely to find Sleep apnea based on CPAP use. I do not agree that this de facto policy/common outcome is correct, just that in many cases your use or non-use of CPAP may not change the compensation outcome at the PEB (fit vs. unfit, but non-compensable).This is not to say you would not have a case on appeal, it is just to offer my observation on recent outcomes at the PEB. The issues are complicated, and if you want to get legal advice on your specific situation (which I do not give in posts) you should talk to an attorney. Your JAG may be able to help you with this issue.

The question regarding the VA outcome is more complicated and I would not want to offer a guess as to how this would play out. The only thing I would say is that the VA would clearly rate you at 50% if you used the CPAP.

I hope you get a good outcome at the PEB. Best of luck.

[BDH]

You had stated, "Will i still get the 50% rating from VA?"

The short answer is no. VA has been rating OSA at 50% when the veteran uses the CPAP machine >4 hrs/night. Less than that, usually 30%. These are my observations from pre-sep and veteran's claims here in the San Diego area. There is a chip or card in the machine that is read and the charts are printed for inclusion in your medical record.

Certainly, non-compliance can cause issues if nothing else, due to bruised egos of MDs and others when you don't follow instructions. One of the main reasons for the CPAP (other than the problems with stopping breathing at night) is the level of oxygenation during the daytime. If it's higher, you are more alert and awake. See if there are options for the mask or machine if you are having difficulty at night.

You don't have to be "in their face" about not using the machine. A more subtle approach may be better.

JMO

Bruce