If you developed an illness or other health conditions directly connected to your service as a Gulf War veteran from 1990 to now, you might qualify for Gulf War presumptives.
This guide details qualifying conditions considered to be Gulf War presumptives, how to file a VA disability claim and qualification requirements.
What are Gulf War Presumptives?
Gulf War Presumptives refers to veterans suffering from VA presumptive conditions related to their service in the Gulf War region.
Qualifying for Gulf War Presumptives
To qualify for Gulf War presumptive illnesses, you must have first appeared during active duty in the Southwest Asia theater of military operations between August 2, 1990, and the present.The VA considers the following locations to be part of the Southwest Asia theatre of operations:
Afghanistan (airspace not included)
Egypt (airspace not included)
Israel (airspace not included)
Jordan (airspace not included)
Syria (airspace not included)
Turkey (airspace not included)
Iraq
Kuwait
Saudi Arabia
The neutral zone between Iraq and Saudi Arabia
Bahrain
Qatar
The United Arab Emirates (UAE)
Oman
The Gulf of Aden
The Gulf of Oman
The waters of the Persian Gulf, the Arabian Sea, and the Red Sea
Note: The airspace above all of the countries and locations listed in this section is recognized, unless specified that it’s not included.
Gulf War Syndrome Symptoms
Many Gulf War veterans were exposed to hazardous substances and adverse environmental conditions, leading to a range of health issues commonly referred to as Gulf War Veterans’ Illnesses.
NOTE: The VA does not use the terms “Gulf War Syndrome” or “Gulf War Syndrome presumptive conditions” but instead categorizes these conditions into two main types:
Medically Unexplained Chronic Multisymptom Illnesses (MUCMI): This includes chronic fatigue, headaches, joint pain, muscle pain, indigestion, difficulty sleeping (insomnia), dizziness, memory problems, and other similar symptoms.
Undiagnosed Illnesses: These are illnesses with symptoms such as skin issues, cardiovascular symptoms, weight loss, and menstrual disorders that do not fit into a specific diagnosis but are recognized as presumptive conditions by the VA.
Gulf War Presumptive Conditions List
The new VA presumptive conditions Gulf War list aims to streamline the process for veterans seeking compensation for illnesses related to their service in the Gulf War region.
If you qualify for one of the below presumptive conditions, you don’t have to prove that your service caused your condition. Instead, you only need to meet the service requirements for the presumption.
Conditions Diagnosed During Active Duty or at Any Time After Separation
Other undiagnosed illnesses, such as cardiovascular signs and symptoms, muscle and joint pain, and headaches
Conditions Diagnosed Within 1 Year of Separation
The VA considers these infectious diseases presumptive if you served in a recognized location and a health care provider diagnosed you within 1 year of separation:
Brucellosis
Campylobacter jejuni
Coxiella burnetii (Q fever)
Malaria (or sooner in some cases)
Nontyphoid salmonella
Shigella
West Nile virus
Conditions Diagnosed Any Time After Separation
The VA considers these infectious diseases presumptive if a health care provider diagnosed you any time after separation:
Mycobacterium tuberculosis
Visceral leishmaniasis
Filing VA Claims for Gulf War Presumptive Conditions
No. Diverticulitis is not on the Gulf War presumptive conditions list.
When is the Gulf War presumptive deadline?
The Gulf War presumptive deadline to file is December 31, 2026.
Does military service in Afghanistan qualify for Gulf War presumptives?
You may qualify for a Gulf War presumptive due to military service in Afghanistan for certain infectious diseases, including West Nile virus and malaria, but not undiagnosed illnesses or MUCMI.
Conclusion
We understand the complex nature of applying for VA benefits. From DBQs and Nexus letters, to mental health and telemedicine evaluations, the team at Telemedica is standing by to serve you. Contact us today!
Anxiety and depression are common mental health issues among veterans, and they can often lead to or exacerbate secondary conditions.
Understanding the various VA secondary conditions to anxiety and depression is crucial, as these conditions can significantly affect your quality of life.
This guide examines common VA secondary conditions to anxiety and depression. We’ll discuss VA ratings for secondary conditions, how to file your VA claim for a secondary condition, and steps to service-connect your condition.
We’ll also take a closer look at the value of a nexus letter for secondary conditions.
VA secondary conditions occur when a service-connected disability causes or aggravates a new or pre-existing condition, illness, or injury.
For example, suppose you’re service-connected for anxiety or depression, and your anxiety/depression causes another VA-ratable condition. In that case, you may qualify for a VA rating for your secondary condition (e.g., sleep apnea).
In addition, anxiety and depression can be secondary conditions if they are caused secondary to a different primary service-connected condition (e.g., GERD)
VA Secondary Conditions to Anxiety and Depression
There are many VA-ratable conditions that can manifest due to your service-related anxiety or depression. Below are some of the most-common VA secondary conditions to anxiety and depression.
Headaches/Migraines
Anxiety and depression can trigger or worsen migraine headaches, leading to severe pain and disability. It’s not uncommon for migrainesto be accompanied by vomiting, nausea, and sensitivity to light and sound.
These headaches can range from tension headaches to migraines and are often exacerbated by the stress and emotional turmoil associated with mental health conditions.
In addition, research shows that those who experiencemigraines with aura (a classic migraine) are more likely to develop depression than those without it.
While waiting for an official diagnosis, you can help manage your migraines by:
Finally, if you can keep a migraine diary, it may help you determine potential triggers, how long the migraines lasted, and what treatment methods helped.
VA Rating for Migraines Secondary to Anxiety and Depression
The VA rates migraines secondary to anxiety and depression at 0%, 10%, 30%, and 50% under diagnostic code (DC) 8100.
When filing your VA claim for migraines secondary to anxiety, it’s crucial to include medical evidence. This evidence can strengthen your claim and increase the likelihood of a successful outcome.
Sleep Apnea
Anxiety and depression can contribute to the development of obstructive sleep apnea, which is characterized by pauses in breathing during sleep. In addition, anxiety can exacerbate already diagnosed sleep apnea by making it harder to fall asleep.
Obstructive Sleep Apnea (OSA) is the most common type of sleep apnea and occurs when the throat muscles relax and block airflow to the lungs.
Central Sleep Apnea (CSA) occurs when the brain fails to send the correct signals to the muscles that control breathing.
Complex Sleep Apnea or Treatment-emergent central sleep apnea occurs when obstructive sleep apnea turns into central sleep apnea after receiving treatment.
When you can identify specific triggers, you can determine the best treatment methods.
Common triggers for sleep apnea caused by mental health disorders include:
Physiological – If your anxiety or depression has also caused chronic stress, you may be prone to a reduced quality of sleep.
Psychological – If you’re prone to nightmares or worry about not being able to breathe while sleeping, you’re more likely to experience sleep disturbances.
Environmental – Specific lifestyle factors, including substance use, can worsen sleep apnea and make it challenging to get quality sleep.
VA Rating for Sleep Apnea Secondary to Anxiety and Depression
The VA rates sleep apnea secondary to anxiety and depression at 0%, 30%, 50%, or 100% underDC 6847-Sleep Apnea Syndromes(Obstructive, Central, Mixed).
In addition, the VA requires you to attend a sleep study to receive an accurate sleep apnea diagnosis and eventual VA rating.
It comes as no surprise that anxiety and depression are likely to elevate your blood pressure. Chronic stress increases your body’s production of stress hormones like cortisol, which puts you at risk for long-term increases in blood pressure.
While anxiety doesn’t cause long-term high blood pressure, bouts of anxiety can cause temporary elevations in blood pressure. However, these temporary elevations can damage your blood vessels, kidneys, and heart.
To avoid unnecessary rises in blood pressure, it’s important to avoid smoking and alcohol, and maintain a healthy diet.
In good news, studies show patients with anxiety and/or depression had faster rates of hypertension control because they demonstrated more primary care and specialty visits.
If lifestyle changes don’t improve your hypertension, your healthcare provider may prescribe medication to help regulate your blood pressure.
VA Rating for Hypertension Secondary to Anxiety and Depression
The VA rates hypertension at 10%, 20%, 40%, and 60% under DC 7101 – hypertensive vascular disease. Your VA rating for hypertension secondary to anxiety and depression will depend on your diastolic and systolic pressure levels.
Gastroesophageal Reflux Disease (GERD)
GERD is a condition where there is a backflow of stomach acids into your esophagus. Stress and anxiety can increase the production of stomach acid, leading to GERD.
A 2023 study found that up to 1 in 3 subjects with GERD experience anxiety and depression. While genetics play a significant role in developing GERD, it’s also common in veterans.
Potential symptoms of GERD include:
Difficulty breathing
Nausea
Heartburn
Vomiting
In addition, if your anxiety and depression are affecting your sleep, you may be prone to GERD since lying down frequently worsens the condition.
Your doctor may prescribe medication to help your condition, with some cases requiring surgery. You can help manage GERD with lifestyle changes, including:
Dietary changes
Losing weight
Quitting smoking
VA Rating for GERD Secondary to Anxiety and Depression
The VA rates GERD from 0% to 80%, with breaks at 10%, 30%, and 50%. You can find the schedule of ratings for GERD underDC 7206.
Your GERD secondary to anxiety VA disability rating will depend on the severity of your esophageal strictureand its impact on your health.
Arthritis
Arthritis is a debilitating condition that can significantly impact your quality of life. When you’re stressed, your body releases chemicals to help you handle the situation, leading to an increased heart rate, faster breathing, or tense muscles.
Over time, the increased tension in your muscles can worsen your arthritis pain, causing a vicious cycle of constant pain and fatigue.
In addition, psychological factors play a role in developing arthritis secondary to anxiety and depression. For example, constantly managing chronic pain can lead to feelings of helplessness and hopelessness.
Know your limits and don’t overdo it with activity
Keep your joints moving throughout the day
Obtain good posture and avoid slouching
Manage a health body weight
Quit smoking
Avoid activities that involve high impact and repetitive motion (i.e., running and jumping)
It’s important to talk to your doctor about your arthritis pain because treatment can help relieve symptoms and improve joint function.
VA Rating for Arthritis Secondary to Anxiety and Depression
The VA generally rates arthritis secondary to anxiety and depression between 10% and 50%, with breaks at 20%, 30%, and 40%, depending on the type and severity of your symptoms.
For example, degenerative arthritis is rated under DC 5003with ratings of 10% or 20%. However, if you develop rheumatoid arthritis secondary to anxiety and depression, you may qualify for a 20%, 40%, 60%, or 100% under DC 5002, Multiple-Joint Arthritis.
Irritable Bowel Syndrome (IBS)
While the exact cause of IBS isn’t well understood, there seems to be a significant link between its development due to anxiety and depression.
For example, anxiety and depression can worsen IBS symptoms, leading to abdominal pain, bloating, and changes in bowel habits.
Symptoms of IBS include, but are not limited to:
Cramping or bloating
Abdominal pain or discomfort
Excessive gas
Indigestion
Mucus in your stool
Changes in your bowel movement patterns
It’s recommended you keep a journal of your symptoms to share with your doctor. While many cases of IBS can be treated with lifestyle changes, it’s vital you talk to your doctor if your anxiety and depression is severe enough to cause significant changes to your GI tract.
The following are not signs of IBS and are reasons to get medical attention:
Bloody stool
Chronic diarrhea
Severe abdominal pain
Bowel movements that completely stop
VA Rating for ISB Secondary to Anxiety and Depression
The VA rates IBS secondary to anxiety and depression using DC 7319with ratings at 10%, 20%, and 30%, depending on factors like abdominal bloating, change in stool frequency, and subjective distension.
TMJ with Bruxism
Temporomandibular joint (TMJ) disorder is a condition affecting the jaw joint and the muscles responsible for moving your jaw. TMJ with bruxism is a condition that causes you to clench, grind, or gnash your teeth while you’re awake or asleep.
While TMJ can vary from one person to the next, common symptoms include:
Difficulty opening and closing your mouth
Tooth pain or sensitivity
Clicking or popping sound when opening and closing your mouth
Pain or tenderness in your jaw
Neck pain, earaches, or headaches
Research shows a significant link between bruxism and mental health disorders, especially in emotional disorders and occupational exposures.
For example, if you are anxious, it’s common for the muscles in your jaw to become tense or tight. When you clench your jaw or grind your teeth, it can lead to inflammation and muscle tension in your jaw joint, which can cause TMJ.
VA Rating for TMJ with Bruxism Secondary to Anxiety and Depression
The VA rates temporomandibular joint disorder (TMD) under DC 9905, with ratings ranging from 10% to 50%, with breaks at 20%, 30%, and 40%.
Your TMJ with bruxism secondary to anxiety VA rating will depend on the severity of your symptoms and limitations, including the extent of jaw movement.
Nexus Letter for Secondary Condition to Anxiety and Depression
Claims for VA secondary conditions to anxiety and depression benefit significantly from a nexus letter with high-probative value.
A nexus letter with high-probative value should include:
The physician’s credentials, particularly ones that make them a trustworthy source for the following opinion
A reference indicating that the physician composing the letter has thoroughly reviewed the veteran’s medical records and military records that pertain to the claim.
The physician’s opinion regarding the cause of the current diagnosed condition and its relation to the veteran’s military service.
Medical rationale that fully supports the physician’s opinion.
To receive a VA rating for secondary conditions to anxiety and depression, you must service-connect your condition.
A VA service connection for secondary conditions requires the following:
A current medical diagnosis (documented in a medical record) of the secondary VA disability you’re attempting to link to the current service-connected disability (anxiety and depression) AND
A current service-connected primary disability (anxiety and depression) AND
Medical nexus evidence establishing a connection between the service-connected primary condition (anxiety and depression) AND the current disability you’re trying to connect secondary
Filing a VA Claim for Secondary Conditions
You can file for VA secondary conditions to anxiety and depression by following the steps below:
Go to VA.gov and open a new claim using the online VA Form 21-526EZ– Application for Disability Compensation and Related Compensation Benefits
You can also print the form, fill it out, and send it to this address:
Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville, WI 53547-4444
A secondary service connection requires a primary service connection.
For example, in order to receive a secondary service connection for bruxism caused by your anxiety (e.g., a bruxism secondary to anxiety VA rating), you must first have a primary service connection (and VA rating) for your anxiety.
It’s important to understand that you can’t get separate ratings for anxiety and depression, as all mental health conditions are rated under the same VA criteria.
Conclusion
Recognizing VA secondary conditions to anxiety and depression is crucial for comprehensive care and management of your health.
If you need a nexus letter to provide that missing link between your disability and an in-service event, injury, or disease, Telemedicais here as your nexus letter expert.
We can connect you with a licensed provider who understands your unique needs through our secure, private, and convenient platform. Contact us today!
The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022, or VA PACT Act, added more than 20 additional presumptive conditions for burn pits, Agent Orange, and other toxic exposures.
This guide will cover all of the conditions on the PACT Act presumptive conditions list, including eligibility requirements.
PACT Act Presumptive Disabilities
With PACT Act presumptive disabilities, you don’t need to prove that your service caused your condition. Instead, you only need to meet the service requirements for the presumption.
The VA assumes or “presumes” that your military service caused your condition. However, you must still have a current medical diagnosis.
PACT Act Eligibility: Dates and Locations
To qualify for PACT Act presumptive disabilities, you must have served:
On or after August 2, 1990, in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, the UAE, or the airspace above these locations, OR
On or after September 11, 2001, in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, or the airspace above these locations.
If you served in these areas, it’s presumed you were exposed to the following airborne particulates:
Burn pit fumes and smoke
Sand and dust
General air pollution
Fuel, jet fuel, exhaust, and mechanical fumes
Smoke from oil well fires
Note: You may still be eligible for VA healthcare based on your service even if the above doesn’t apply to you.
The following 25 conditions are now “presumed” to be service-connected due to a veteran’s exposure to burn pits and other airborne hazards, including two new conditions caused by Agent Orange:
Asthma that was diagnosed after service (Diagnostic Code 6602)
When it comes to the PACT Act list of conditions, there is no deadline for filing a claim for VA disability benefits.
PACT Act Back Pay
However, to receive PACT Act back pay, you must have submitted a PACT Act VA disability claim by August 14, 2023. If eligible, your benefits would be backdated to August 10, 2022.
If you submitted your PACT Act claim after August 14, 2023, you may still receive VA disability benefits but not PACT Act back pay.
How Telemedica Can Help
While you don’t need to prove your military service caused a presumptive condition, you still must provide an official medical diagnosis.
At Telemedica, we are proud to help open the door to high-quality telehealth services for Veterans. We understand time is of the essence and waiting around for required medical evidence should not be the norm.
Medical Evidence Wins VA Claims
At Telemedica we understand that high-quality medical evidence wins VA disability claims.
Click below to see the services we offer, including high-quality Nexus Letters, Mental Health Evaluations and Independent Medical Opinions, Telemedicine Evaluations, and Rebuttal Letters.
Tinnitus can significantly affect daily life, but the side effects are more pronounced when coupled with a secondary condition.
There are several secondary conditions to tinnitus, and understanding your eligibility may increase your monthly VA benefits.
This guide will cover the top four secondary conditions to tinnitus. We’ll explain more about VA secondary conditions, how the VA rates secondary conditions to tinnitus, how to service-connect your condition, and how to file a VA claim.
Understanding VA Secondary Conditions
Tinnitus is considered a low-value claim because the highest VA rating is 10%. However, if your service-connected tinnitus leads to a secondary condition, you may be entitled to a higher VA rating.
For example, if you’re service-connected for tinnitus, and your tinnitus causes another VA-ratable condition, you may qualify for a VA rating for your secondary condition (e.g., insomnia).
(In addition, tinnitus can be a secondary condition if it is caused by another primary service-connected condition).
4 VA Secondary Conditions to Tinnitus
Insomnia
Migraines
Depression
Somatic Symptom Disorder
Insomnia Secondary to Tinnitus
Insomnia is a sleep disorder characterized by the inability to fall asleep, stay asleep, or both.
A 2021 study found that insomnia occurs in 10%-80% of tinnitus patients, with most reports noting over a 40% frequency.
For example, you may notice the ringing in your ears more at night and, therefore, have difficulty sleeping.
VA Ratings for Insomnia Secondary to Tinnitus
The VA rates insomnia at 10%, 30%, 50%, 70%, and 100%, under CFR Title 38, Part Schedule for Rating Disabilities, Diagnostic Codes (DC) for Mental Disorders.
Migraines Secondary to Tinnitus
Tinnitus is frequently linked to several types of headache disorders, including migraines.
VA ratings for migraines secondary to tinnitus range from 0% to 50%, with breaks at 10% and 30%.
Nexus Letter for Migraines Secondary to Tinnitus
A nexus letter for migraines secondary to tinnitus may help strengthen your VA claim by providing a clear link between your two conditions. A nexus letter is a document written by a medical professional that explains the relationship between your service-connected tinnitus and the secondary condition you’re claiming.
Researchshows a direct link between depression and veterans suffering from tinnitus, primarily due to the distress and impairment across cognitive, functional, and psychiatric spectra.
In addition, veterans with tinnitus are also at a greater risk for additional mental health disorders, including anxiety.
Depression secondary to tinnitus can be rated at 0%, 10%, 30%, 50%, 70%, or 100% under the General Rating Formula for Mental Disorders, depending upon the severity of your depression and how your mental health symptoms affect your work, life, and social functioning.
Note: You can contact the Veterans Crisis Line 24/7 for confidential support by dialing 988 and selecting 1. (You don’t have to be enrolled in VA benefits or health care to connect.)
Somatic Symptom Disorder Secondary to Tinnitus
Somatic Symptom Disorder (SSD) is defined by the Mayo Clinicas an “extreme focus on physical symptoms, such as pain, fatigue, or tinnitus, causing major emotional distress and functional problems.”
If you constantly focus on the ringing in your ears, you may experience significant occupational and social impairments.
Generally, a person’s reaction to their condition is excessive to the actual severity of their medical condition.
VA Ratings for SSD Secondary to Tinnitus
SSD secondary to tinnitus is rated at 0%, 10%, 30%, 50%, 70%, or 100% under the General Rating Formula for Mental Disorders, depending on the severity of the condition and its impact on work, life and social functioning.
Secondary Conditions to Tinnitus: Nexus Letters
If you can prove your service-connected tinnitus caused an additional condition or worsened a preexisting one, you may qualify for a higher VA rating.
Generally, a nexus letter for secondary conditions is needed unless the condition is straightforward, like a back nerve condition secondary to a service-connected back problem.
Establishing a Service Connection for a Secondary Condition
You must service-connect your condition to receive a VA rating for a secondary condition to tinnitus.
A VA service connection requires:
A current medical diagnosis (documented in a medical record) of the secondary VA disability you’re attempting to link to the current service-connected disability (tinnitus) AND
A current service-connected primary disability (tinnitus) AND
Medical nexus evidence establishing a connection between the service-connected primary condition (tinnitus) AND the current disability you’re trying to connect secondary
Receiving VA Benefits for Multiple Health Conditions
You may be familiar with the complicated “VA Math” concept, where 1+1 doesn’t necessarily equal 2.
For example, if you have a 10% VA rating for tinnitus and receive a 50% VA rating for depression, you’re not awarded a 60% VA rating.
Instead, tinnitus secondary conditions are based on schedules, which calculate your impairment after the primary disability is considered. You can use a VA Disability Calculatorto check your combined VA rating.
Filing for Secondary Claims to Tinnitus
You can file for VA secondary conditions to tinnitus by using one of the three options below:
Go to VA.gov and open a new claim using the online VA Form 21-526EZ– Application for Disability Compensation and Related Compensation Benefits
You can also print the form, fill it out, and send it to this address:
Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville, WI 53547-4444
If you have been previously denied, you can file an appeal. Our team at Telemedica can prepare a Rebuttal Letterto help address incorrect or inaccurate statements in your VA denial letter.
Secondary conditions vary among veterans with tinnitus, and your treatment and support should be tailored to your specific needs.
It’s vital you seek professional help when addressing both the primary symptoms of tinnitus and any secondary conditions as a comprehensive approach for effective management and recovery.
The team at Telemedica is standing by to answer your questions. Contact us today!
Post-traumatic stress disorder (PTSD) is a significant condition on its own, but when you add a secondary condition, life can become even more crippling.
There are several secondary conditions to PTSD, and knowing whether you qualify can significantly impact your monthly VA benefits.
It’s common for veterans to file secondary VA claims if their PTSD caused or worsened another VA-ratable condition.
This post will cover seven secondary conditions of PTSD. We will explain how the VA rates secondary conditions to PTSD, how to establish secondary service connection, and how to file a VA claim for secondary conditions to PTSD.
How the VA Rates PTSD
The VA rates PTSD at 0%, 10%, 30%, 50%, 70%, or 100%, depending on the severity and frequency of your PTSD symptoms.
What are Secondary Conditions to PTSD?
Secondary conditions to PTSD are VA-ratable conditions that are caused by or made worse because of your service-connected PTSD.
For example, if the stress caused by your PTSD caused you to develop migraines that negatively affect your ability to function, you might qualify for a VA rating for migraines secondary to PTSD.
Secondary Conditions to PTSD: Nexus Letters
If you can prove your service-connected PTSD caused an additional condition or worsened a preexisting one, you may be eligible for further compensation. One way to help prove secondary service connection is through a Nexus Letter from a qualified medical professional.
The VA rates secondary conditions to PTSD up to 100%, depending on the condition and the severity and frequency of symptoms.
Common VA Disabilities Secondary to PTSD
This VA disability list of secondary conditions to PTSD can help lead you in the direction of the benefits and compensation you deserve.
Migraine Headaches Secondary to PTSD
Veterans with PTSD are likely to develop migraines, and it’s one of the most common secondary conditions to PTSD.
If you’ve served, you know the heightened stress and anxiety it can bring. These added emotions in connection with your PTSD commonly lead to migraine headaches, a frequently debilitating condition.
In addition, the stress from PTSD leads to tension in the head and neck, causing migraines. Migraines can significantly affect your quality of life, and PTSD can trigger these extreme headaches.
Hypertension Secondary to PTSD
Hypertension, or high blood pressure, is frequently associated with PTSD, especially for veterans stationed in higher-stress areas like Iraq and Afghanistan.
Unfortunately, veterans who were severely injured in war are at a greater risk for developing hypertension. Left untreated, high blood pressure can lead to severe conditions, including heart and kidney disease, stroke, and vision loss.
While the finding was for female and male veterans, it showed females have a slightly higher risk for early blood pressure elevation into the hypertension range.
GERD Secondary to PTSD
GERD frequently occurs in veterans due to the symptoms of PTSD, including stress, anxiety, and depression. These symptoms can lead to an overproduction of stomach acid, causing GERD.
Even if you were diagnosed with GERD before your time in the service, you may qualify for a secondary condition if you can prove your service-connected PTSD aggravated the condition.
The following are triggers for GERD and should be avoided:
Drinking alcoholic beverages
Drinking caffeinated beverages
Eating late in the evening
Eating large portions
Smoking
Irritable Bowel Syndrome (IBS) Secondary to PTSD
Veterans with an increased severity of PTSD are more likely to experience increased gastrointestinal symptoms, including irritable bowel syndrome (IBS).
A common link between IBS and PTSD is based on the signaling between the brain and the gut. If your PTSD causes you to be hypervigilant, the brain signals the gut to enter a hyperarousal state, resulting in side effects like diarrhea or constipation.
In addition, IBS can cause significant psychological impairment to veterans with an already-diagnosed case of PTSD.
Erectile Dysfunction (ED) Secondary to PTSD
PTSD is known to cause physical and psychological responses, like fear or anxiety, leading to an interference with the ability to become aroused.
Veterans who develop or have a worsened condition of erectile dysfunction because of their PTSD may be entitled to additional benefits and compensation.
Sleep Apnea Secondary to PTSD
While PTSD doesn’t cause sleep apnea directly, it’s not uncommon for PTSD to aggravate an already diagnosed case of sleep apnea. It’s essential to understand the two conditions aren’t medically connected.
Many veterans face difficulty when trying to service-connect sleep apnea and PTSD because there is a lack of medical evidence linking the two.
To help confirm your sleep apnea diagnosis, it’s highly recommended you provide a nexus letter to help establish a secondary service connection for sleep apnea secondary to PTSD.
You can receive a Nexus Letter from one of our independent professional providers at Telemedica, which can help lead you to a winning claim. Get in touch with us today to get started.
Substance Abuse Disorders Secondary to PTSD
Many veterans with PTSD develop a substance abuse disorder as a way to cope with their condition. It’s a serious condition, and you deserve the proper treatment, care, and compensation.
Unfortunately, substance abuse disorders frequently exacerbate PTSD symptoms, which can significantly impact daily life.
You are NOT alone.80% of veterans struggle with alcohol abuse, and 7% have had an issue with both alcohol and illegal drugs.
How to Establish Service Connection for Secondary Conditions to PTSD
To be service connected for secondary conditions to PTSD, you must provide the following:
A medical diagnosis of the secondary disability condition you’re attempting to link to PTSD
A current service-connected primary disability (In this case, PTSD)
A medical nexus or link establishing a connection between the service-connected PTSD and the current disability you’re trying to connect (i.e., sleep apnea, GERD, depression). A qualified Nexus Letter can go a long way in helping to prove service connection for a secondary condition
How to Receive Benefits for Multiple Health Conditions
Many veterans are familiar with “VA Math,” knowing it’s not as easy as 1+1=2. For example, if you have a 50% rating for PTSD and receive a 30% rating for sleep apnea as a secondary condition, you aren’t awarded an 80% VA rating.
Instead, secondary conditions of PTSD are based on schedules, which calculate your impairment after the primary disability is considered.
For quick and easy combined VA disability rating percentages, you can use a VA Disability Calculator to check your Combined VA Rating.
4 Steps for Filing Secondary Claims to PTSD
You can file for PTSD secondary conditions by following the below steps:
Go to VA.gov and open a new claim using the online VA Form 21-526EZ – Application for Disability Compensation and Related Compensation Benefits
You can also print the form, fill it out, and send it to this address:
Ensure your non-service-connected secondary disability condition is medically diagnosed and that the primary disability condition is service-connected at 0% or higher
Obtain a Nexus Letter from a private healthcare provider to help show the link or connection between the non-service-connected secondary disability and the service-connected primary disability
File the non-service-connected secondary disability condition secondary to the primary service-connected disability in VA.gov
If you have been previously denied, you can file for an appeal. Our team at Telemedica can prepare a Rebuttal Letterto help address incorrect or inaccurate statements on your VA denial letter.
Telemedica Can Help
The presence of secondary conditions varies among individuals with PTSD, and your treatment and support should be tailored to your specific needs.
It’s crucial to seek professional help when addressing both the primary symptoms of PTSD and any secondary conditions as a comprehensive approach for effective management and recovery.
The team at Telemedica is standing by to answer your questions. Contact us today!
In this post, we examine what the VA is changing and how it impacts your GERD VA disability rating.
What is Changing?
The most notable change is the complete restructuring of the GERD VA disability rating criteria.
Currently, the VA rates GERD analogous to Hiatal Hernia (Diagnostic Code 7346). This means they use the same criteria to evaluate and assign a rating percentage to GERD symptoms as they do for Hiatal Hernia symptoms.
Under this diagnostic code, GERD can be rated at 10%, 30%, or 60%, depending on the frequency, severity, and duration of your symptoms.
(Old)GERD VA Disability Rating Chart
7346 Hernia Hiatal
Rating
Symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health
60
Persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health
30
With two or more of the symptoms for the 30 percent evaluation of less severity
10
(New)GERD VA Disability Rating Chart
Beginning May 19th, 2024, the VA will rate GERD under its own Diagnostic Code, DC 7206. This is a new diagnostic code created specifically for rating GERD symptoms.
Under DC 7206, a GERD VA disability claim can be rated at 0%, 10%, 30%, 50%, or 80%, depending on your symptoms.
7206 Gastroesophageal reflux disease (GERD):
Rating
Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia with at least one of the symptoms present: (1) aspiration, (2) undernutrition, and/or (3) substantial weight loss as defined by § 4.112(a) and treatment with either surgical correction of esophageal stricture(s) or percutaneous esophago-gastrointestinal tube (PEG tube)
80
Documented history of recurrent or refractory esophageal stricture(s) causing dysphagia which requires at least one of the following (1) dilatation 3 or more times per year, (2) dilatation using steroids at least one time per year, or (3) esophageal stent placement
50
Documented history of recurrent esophageal stricture(s) causing dysphagia which requires dilatation no more than 2 times per year
30
Documented history of esophageal stricture(s) that requires daily medications to control dysphagia otherwise asymptomatic
10
Documented history without daily symptoms or requirement for daily medications
0
Note (1): Findings must be documented by barium swallow, computerized tomography, or esophagogastroduodenoscopy.
Note (2): Non-gastrointestinal complications of procedures should be rated under the appropriate system.
Note (3): This diagnostic code applies, but is not limited to, esophagitis, mechanical or chemical; Mallory Weiss syndrome (bleeding at junction of esophagus and stomach due to tears) due to caustic ingestion of alkali or acid; drug-induced or infectious esophagitis due to Candida, virus, or other organism; idiopathic eosinophilic, or lymphocytic esophagitis; esophagitis due to radiation therapy; esophagitis due to peptic stricture; and any esophageal condition that requires treatment with sclerotherapy.
Note (4): Recurrent esophageal stricture is defined as the inability to maintain target esophageal diameter beyond 4 weeks after the target diameter has been achieved.
Note (5): Refractory esophageal stricture is defined as the inability to achieve target esophageal diameter despite receiving no fewer than 5 dilatation sessions performed at 2-week intervals.
Are These Changes Good or Bad for Veterans?
Even though these changes increase the highest GERD VA disability rating from 60% to 80%, most veterans will not qualify for a GERD rating above 0% for claims filed after May 19th. This is because the new rating criteria requires the presence of esophageal stricture.
Esophageal strictureis an abnormal narrowing of the esophageal lumen, which causes difficulty swallowing. While esophageal stricture is the most significant and chronic symptom of GERD, not all veterans suffering from GERD have esophageal stricture. Many suffer primarily from other serious symptoms such as chronic cough or Laryngitis.
But unless they also suffer from esophageal structure, they won’t qualify for a VA rating under DC 7206.
Why is the VA Making These Changes?
According to the 57-page final ruling released by the VA, “the [intended] effect of this action is to ensure that the rating schedule uses current medical terminology and provides detailed and updated criteria for evaluation of digestive conditions for disability rating purposes.”
The ruling also cites the VA’s larger strategy of aligning evaluation criteria with a condition’s most chronic and debilitating symptoms
Will The New Rating Criteria Affect my GERD VA Disability Rating?
No, if you already have a GERD VA disability rating, these changes won’t affect your rating or any other VA benefits.
Anyone who is rated for GERD before May 19th, 2024, will be “grandfathered in” under the old rating criteria. You’ll keep your rating at the same compensation level.
Also, anyone who files for GERD before May 19th will be evaluated by whichever rating criteria is more favorable to them.
When is the GERD VA Disability Rating Change Effective Date?
The new GERD VA disability rating criteria is effective May 19, 2024.
Can You be Re-evaluated for GERD to Get a Higher Rating Under the New Criteria?
Yes, but it’s not recommended unless your symptoms qualify you for a higher rating on the scale.
In this case, if you aren’t certain you have esophageal stricture to the extent you could qualify for a rating higher than you already have, contacting the VA to be reevaluated could result in the VA lowering your GERD VA disability rating.
But if you’re confident you qualify for a higher GERD rating, you can file an increase claim.
Secondary Conditions to GERD
It’s also possible to increase your combined VA rating for GERD if you believe your GERD is responsible for a secondary condition.
A secondary condition is a medical condition that is caused or made worse by a disability that’s already rated by the VA. For example:
Your service-connected knee pain is causing your back pain
Your migraines are due to your service-connected tinnitus
Conditions that GERD can cause or aggravate include, but are not limited to:
Asthma
Migraines
Sleep Apnea
If you’re able to prove through medical evidence that your GERD caused or aggravated any of the above conditions (known as secondary service connection), you should consider filing a claim for a secondary condition.
Yes, many conditions and medications could be responsible for causing or aggravating GERD.
NOTE: Don’t stop taking any medications prescribed to you without first talking with your doctor.
GERD Secondary to Medications
In some cases, asthma medications such as Elixophyllin, Theo-24, NSAIDs, and Theochron can exacerbate acid reflux.
Drugs taken to treat anxiety and depression can also contribute to GERD by causing mucosal damage, reducing lower esophageal sphincter pressure (LESP), or affecting esophagogastric motility.
GERD Secondary to Asthma
According to a study published in The Gastroenterology and Hepatology Journal, there is a connection between acid reflux and Asthma. It’s difficult to say why, but it’s known that acid reflux can make asthma worse, and vice versa.
GERD Secondary to Anxiety
GERD can develop when mental health conditions, such as anxiety and panic disorder, lead to an overproduction of stomach acid.
GERD Secondary to PTSD
Similar to anxiety, GERD can develop when symptoms of Post-traumatic Stress Disorder (PTSD), such as stress and depression, lead to an overproduction of stomach acid.
Medications taken to treat PTSD can also lead to GERD as a side effect.
GERD Secondary to Migraines
If migraines are causing your GERD, it’s likely because of the medication you’re taking to treat them.
In fact, a study published in The Journal of Headache and Pain recommends that physicians “minimize prescribing NSAIDs or NSAID-containing acute migraine medications in this population” (referring to patients who also have GERD).
GERD VA Disability Frequently Asked Questions (FAQs)
Below we address several frequently asked questions about GERD and VA disability benefits:
What is GERD?
GERD is an acronym that stands for gastroesophageal reflux disease. It is a severe case of acid reflux and occurs when stomach acid “backwashes” into your esophagus enough times to irritate the lining tissue.
A burning sensation in your chest (heartburn), usually after eating, which may worsen at night
Chest pain
Difficulty eating and swallowing
Regurgitation of food particles or sour liquid
The sensation of a lump in your throat
If you have nighttime GERD and acid reflux, you might also experience:
Chronic cough
Laryngitis
New or worsening asthma
Disrupted sleep and insomnia
How is GERD Diagnosed?
A qualified medical provider can diagnose GERD using:
Upper endoscopy. This is when a thin, flexible tube fitted with a light and camera is inserted into your throat to check your esophagus for signs of reflux and inflammation.
Ambulatory acid (pH) probe test. This is when a monitor is placed in your esophagus to identify when, and for how long, stomach acid regurgitates into your esophagus.
X-ray of the upper digestive system. GERD can be diagnosed using X-rays to track any reflux of a chalky liquid that coats and fills the inside lining of your digestive tract.
Esophageal manometry. This is a test designed to assess rhythmic muscle contractions in the esophagus during swallowing. It evaluates the coordination and strength of esophageal muscles and is commonly performed for individuals with difficulty swallowing.
Transnasal esophagoscopy. This test is done by putting a thin, flexible tube with a video camera through your nose and moving it down your throat into the esophagus.
NOTE: If you’ve received a GERD diagnosis but treatment isn’t helping, it’s a good idea to double check with a specialist that you’ve been correctly diagnosed. Gastrointestinal illnesses that don’t fit the mold of any diagnosable condition are sometimes mistakenly diagnosed as GERD.
If your condition doesn’t fit a known diagnosable condition, and you meet the minimum service requirements, you could be eligible for a VA rating for a presumptive condition.
How Many Veterans Have GERD?
According to publicly available data, as of 2023, the VA has rated more than 488,655 veterans for Hiatal hernia (DC 7346).
Because the VA has historically rated GERD using the rating criteria for Hiatal Hernia (DC 7346), it’s hard to say exactly how many of these ratings are for GERD.
This figure also only accounts for veterans who have successfully won their claim. It does not include veterans who haven’t filed or who have been denied.
How do You Service Connect GERD?
Service connection is when you can prove your military service caused your disability or made it worse. The VA will not award disability compensation if your service is not responsible for your condition.
All VA claims must have the same three things in order for your condition to be considered service-connected:
A current medical diagnosis of your condition. The VA can’t rate a condition that hasn’t been formally diagnosed.
Evidence of an in-service event, injury, disease, or aggravation. You need evidence showing that what you claim caused your disability occurred. This evidence can be military medical records or lay statements from people who were there.
A “nexus” (or link) between #1 and #2 via competent medical evidence. If you get a nexus letter, this link will usually be expressed using one of these statements of probability:
“Is due to” = 100% certain
“More likely than not” = greater than 50% certain
“At least as likely as not” = equal to 50% certain
This is because GERD is a structural condition and not a functional condition. Most presumptive conditions are functional conditions, meaning that there are symptoms present but no physical evidence of a condition. Structural conditions have symptoms and physical evidence of the condition.
Medical Evidence Wins VA Claims
Whether you need a Nexus Letter for GERD or another digestive condition, we make it EASY for veterans to connect with a licensed provider through our HIPAA-compliant telemedicine platform—anytime, anywhere!
From DBQs and nexus letters, to mental health and telemedicine evaluations, the team at Telemedica is standing by to serve you.
Tara Thompson PA-C is a board-certified Physician Assistant. She completed her training through Chatham University, graduating with a Master’s of Physician Assistant Studies Degree in 2007. Her work experience has been diverse and includes first assist in all surgical specialties, Plastic Surgery and ENT clinical work, and Emergency Medicine. She served as a Physician Assistant in the US Army from 2009-2021 and has been an expert in medical evidence for VA disability claims since 2019.
If your VA claim was denied or you didn’t receive the disability rating you deserve, you may be missing crucial information like a nexus letter.
A nexus letter frequently proves to be the missing link when service-connecting your condition to your military service.
In this post, we’ll discuss how a sleep apnea secondary to allergic rhinitis nexus letter can be the key to winning your VA claim and how the team at Telemedica can help.
Let’s get started.
Sleep Apnea Secondary to Allergic Rhinitis Nexus Letter
It’s highly recommended to obtain a nexus letter if you have sleep apnea that may have been caused or aggravated by a service-connected condition like allergic rhinitis. While nexus letters aren’t required, they can help strengthen your claim and offer the credibility you need to win your VA disability claim.
A nexus letter with high-probative value should include:
The physician’s credentials, particularly ones that make them a trustworthy source for the following opinion (i.e., a cardiologist talking about a heart condition, etc.).
A reference indicating that the physician composing the letter has thoroughly reviewed the veteran’s medical records and military records that pertain to the claim.
The physician’s opinion regarding the cause of the current diagnosed condition and its relation to the veteran’s military service.
Medical rationale that fully supports the physician’s opinion.
The Connection Between Sleep Apnea and Allergic Rhinitis
Allergic rhinitis, or hay fever, causes inflammation and congestion in your nasal passages and airway. While allergic rhinitis has similar symptoms to the common cold, it is caused by allergens instead of a virus.
If you have existing obstructive sleep apnea (OSA), your condition may be aggravated by symptoms of allergic rhinitis.
An increase in airway resistance due to higher nasal resistance; and
Reduction in pharyngeal diameter from mouth breathing that moves the jaw insufficiently
Service-Connecting Sleep Apnea Secondary to Allergic Rhinitis
As part of your VA disability claim for sleep apnea secondary to allergic rhinitis, you must be able to prove service connection. Service connection requires:
A current medical diagnosis (documented in a medical record) of the secondary VA disability you’re attempting to link (Sleep Apnea) to the current service-connected disability (Allergic Rhinitis) AND
A current service-connected primary disability (Allergic Rhinitis) AND
Medical nexus evidence (can be a Nexus Letter) establishing a connection between the service-connected primary condition (Allergic Rhinitis) AND the current disability you’re trying to connect secondary (Sleep Apnea)
The VA requires you to attend a sleep study to receive an accurate sleep apnea diagnosis. A sleep study is crucial in finding evidence of irregular breathing, gasping, and other common signs of sleep apnea.
VA Ratings for Sleep Apnea Secondary to Allergic Rhinitis
The VA rates sleep apnea at 0%, 30%, 50%, and 100%, depending on the severity, frequency, and duration of symptoms.
The highest VA rating for sleep apnea secondary to allergic rhinitis is 100%, with most veterans receiving a 50% rating for obstructive sleep apnea.
Whether you need a nexus letter for sleep apnea secondary to rhinitis or something else, we make it EASY for veterans to connect with a licensed provider through our HIPAA-compliant telemedicine platform—anytime, anywhere!
From DBQs and Nexus Letters to Psych Evals and Telemedicine Evaluations, the Telemedica team is standing by to serve you. Get the evidence you need to win your VA claim today.
Do you need a nexus letter for sleep apnea secondary to asthma? A nexus letter is frequently the missing link to receiving a winning VA disability claim.
It’s common for veterans to develop asthma due to toxin, smoke, or burn pit exposure causing an inflammation of the airways which may increase the chances of developing sleep apnea.
This guide will cover the importance of a nexus letter for sleep apnea secondary to asthma, how to get service-connected and how the team at Telemedica can help.
A Nexus Letter is crucial evidence when submitting a VA claim for sleep apnea secondary to asthma, linking your service-connected asthma and the development or worsening of sleep apnea.
A nexus letter with a high probative value for sleep apnea secondary asthma should include the following four things:
The physician’s credentials, particularly ones that make them a trustworthy source for the following opinion (i.e. a cardiologist talking about a heart condition, etc.)
A reference indicating that the physician composing the letter has thoroughly reviewed the veteran’s medical records and military records that pertain to the claim
The physician’s opinion regarding the cause of the current diagnosed condition and its relation to the veteran’s military service
Medical rationale that fully supports the physician’s opinion
It’s important to note that the VA only accepts nexus letters written from licensed providers.
Many research studies show a connection between sleep apnea and asthma, where one condition negatively affects the other. According to the National Institutes of Health, an increased vagal tone during sleep apnea episodes could be a trigger for nocturnal asthma attacks in sleep apnea patients.
While neither sleep apnea nor asthma causes the other condition, there are shared risk factors, and each condition may worsen the other.
How to Get Service-Connected for Sleep Apnea Secondary to Asthma
To win a VA disability claim for sleep apnea secondary to asthma, you must be able to prove service connection. Service connection requires:
A current medical diagnosis (documented in a medical record) of the secondary VA disability you’re attempting to link (sleep Apnea) to the current service-connected disability (asthma) AND
A current service-connected primary disability (asthma) AND
Medical nexus evidence establishing a connection between the service-connected primary condition (asthma) AND the current disability you’re trying to connect secondary (sleep Apnea)
You must attend a sleep study to receive an accurate sleep apnea diagnosis. A sleep study is critical in finding evidence of irregular breathing, gasping, and other obvious signs of sleep apnea.
Sleep Apnea Secondary to Asthma VA Ratings
The VA rates sleep apnea secondary to asthma at 0%, 30%, 50%, and 100%, depending on the severity of your symptoms and whether you require a breathing device.
It’s important to understand that, in most cases, the VA will NOT give you two separate ratings for sleep apnea AND asthma; and instead, you’ll receive a combined rating.
Do I Need a DBQ for Sleep Apnea Secondary to Asthma?
No, a VA disability benefits questionnaire (DBQ) isn’t required when filing a VA claim for sleep apnea secondary to asthma; however, it may strengthen your case.
A VA DBQ is another way to collect crucial medical evidence to help support your VA disability claim. You can go to a civilian provider to complete your DBQ; however, it’s highly recommended you visit a VA or VA-contracted physician.
How Telemedica Can Help You Win Your VA Disability Claim
Understanding the need for a nexus letter for sleep apnea secondary to asthma may help secure a winning VA claim. The licensed, trusted professionals at Telemedica can help with your nexus letter, paving the way for the VA benefits you deserve.
Is a nexus letter for sleep apnea secondary to sinusitis your missing link? If you’ve received a denied claim, you’ll want to understand the significant impact a nexus letter can make.
In this guide, we’ll cover how a nexus letter impacts your VA disability claim, the steps to get service connected for sleep apnea secondary to sinusitis, and what VA rating you deserve.
The VA claims process can be challenging, but we’re here to help guide you.
Nexus Letter for Sleep Apnea Secondary to Sinusitis
A nexus letter for sleep apnea secondary to sinusitis is vital evidence when applying for VA benefits.
Sinusitis can contribute to sleep apnea by causing sinus congestion and inflammation that blocks the nasal passages. But is your military service the culprit?
Many veterans are susceptible to sinusitis due to burn pit exposure and other hazards. Obtaining a nexus letter is highly recommended if you want a better chance of winning your claim.
A Nexus Letter establishes a connection between your service-connected sinusitis and the development or worsening of sleep apnea.
It outlines a healthcare provider’s medical reasoning and professional opinion, clearly stating that sleep apnea results from sinusitis and makes you eligible for benefits.
Sleep apnea and sinusitis can be connected in several ways, so it’s essential to understand what is causing your condition.
Here’s a look at common reasons why sleep apnea can be secondary to sinusitis:
Nasal congestion – When nasal passages are blocked due to mucus buildup or inflammation, it can contribute to obstructive sleep apnea.
Airway obstruction – Sinusitis can worsen the obstruction of your airways while sleeping, making it difficult for air to flow freely.
Inflammation – Inflammation caused by sinusitis can affect the soft tissues of your throat and airway, increasing the chances of sleep apnea.
Disrupted sleep – Sinusitis frequently leads to disrupted sleep, which can exacerbate sleep apnea symptoms and may contribute to the development or worsening of the condition long term.
Managing sinusitis and addressing nasal congestion can be important components of sleep apnea treatment, as improving nasal airflow may help reduce the severity of sleep apnea symptoms and improve overall sleep quality.
How to Get Service-Connected for Sleep Apnea Secondary to Sinusitis
In order to win a VA disability claim for sleep apnea secondary to sinusitis you must be able to prove service connection. Service connection requires:
A current medical diagnosis (documented in a medical record) of the secondary VA disability you’re attempting to link (Sleep Apnea) to the current service-connected disability (Sinusitis) AND
A current service-connected primary disability (Sinusitis) AND
Medical nexus evidence establishing a connection between the service-connected primary condition (Sinusitis) AND the current disability you’re trying to connect secondary (Sleep Apnea)
You will likely be required to attend a sleep study to receive an accurate sleep apnea diagnosis. A sleep study is vital in finding evidence of irregular breathing, gasping, and other obvious signs of sleep apnea.
Sleep Apnea Secondary to Sinusitis: Do I Need a DBQ?
No, you don’t need a DBQ for sleep apnea secondary to sinusitis; however, it can help strengthen your claim. Adding a DBQ to your claim can make it a fully developed claim, where all of the evidence needed to decide a claim is present, and the VA rater can choose to decide your claim without sending you to a C&P exam.
Is Sleep Apnea Secondary to Chronic Sinusitis and Rhinitis?
Yes, if you have a primary service-connected diagnosis of chronic sinusitis or rhinitis, you may be eligible for a secondary sleep apnea connection.
If your chronic sinusitis causes congestion and inflammation, blocking your nasal passages, you will likely develop or worsen a previously diagnosed case of sleep apnea.
How Telemedica Can Help With Your Nexus Letter
Understanding the need for a nexus letter for sleep apnea secondary to sinusitis may help secure a winning claim. The licensed, trusted professionals at Telemedica can help with your nexus letter, paving the way to the benefits you deserve.
You can contact us with any questions; we will gladly assist you.
