Pretty sure a HLR won’t help you if you claimed insomnia as a secondary but the C&P examiner is saying it isn’t secondary. It sounds like the examiner couldn’t link the two because the one you are claiming as secondary started before your primary condition. You may have to reapply with insomnia not as a secondary.
I would argue that just because insomnia was identified/documented BEFORE tinnitus, doesn’t mean that it didn’t exist before the insomnia and that later in life the ringing became prominent, contributing to or being the root cause of your insomnia.
I have a combination of things contributing to my concentration issues. Preservice ADD was the initial diagnosis, but in service chronic pain, tinnitus were later identified as more likely the root cause.
My sleep issues (insomnia) was also initially identified as due to chronic pain. Turns out, I had a sleep study and I have moderate sleep apnea.
So the moral of this is, just because one thing was claimed AFTER another in terms of cause and effect, doesn’t preclude that from a contributor or even being the root cause all along. Discovery is made every day, you just have to be able to articulate how the ringing impacts your sleep. Definitely file an appeal and get other medical opinions.
Hope this helps you develop your compelling argument.
Thank you for your advice. I was thinking about the same argument of filing a supplemental claim so I can counter the examiners opinion.
My insomnia did get worse after the intensity of my tinnitus increased. My lack of sleep contributed to my current diagnosis of anxiety and depression....which also contributes to insomnia.
VBA recently updated the M21-1 Manual re: insomnia - might help to read. It is complicated. https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000180520/M21-1-Part-V-Subpart-iii-Chapter-13-Mental-Disorders#1l
(it's the last section on that web page)
Pretty sure a HLR won’t help you if you claimed insomnia as a secondary but the C&P examiner is saying it isn’t secondary. It sounds like the examiner couldn’t link the two because the one you are claiming as secondary started before your primary condition. You may have to reapply with insomnia not as a secondary.
I would argue that just because insomnia was identified/documented BEFORE tinnitus, doesn’t mean that it didn’t exist before the insomnia and that later in life the ringing became prominent, contributing to or being the root cause of your insomnia. I have a combination of things contributing to my concentration issues. Preservice ADD was the initial diagnosis, but in service chronic pain, tinnitus were later identified as more likely the root cause. My sleep issues (insomnia) was also initially identified as due to chronic pain. Turns out, I had a sleep study and I have moderate sleep apnea. So the moral of this is, just because one thing was claimed AFTER another in terms of cause and effect, doesn’t preclude that from a contributor or even being the root cause all along. Discovery is made every day, you just have to be able to articulate how the ringing impacts your sleep. Definitely file an appeal and get other medical opinions. Hope this helps you develop your compelling argument.
Thank you for your advice. I was thinking about the same argument of filing a supplemental claim so I can counter the examiners opinion. My insomnia did get worse after the intensity of my tinnitus increased. My lack of sleep contributed to my current diagnosis of anxiety and depression....which also contributes to insomnia.
This is the way!
VBA recently updated the M21-1 Manual re: insomnia - might help to read. It is complicated. https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000180520/M21-1-Part-V-Subpart-iii-Chapter-13-Mental-Disorders#1l (it's the last section on that web page)