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RI Veterans: Did you know? 12.12.24 (Claims, volunteer, gardening, resources) – John A. Cianci
by John A. Cianci, contributing writer, veterans issues
Sleep Apnea: How to understand denial and submit additional evidence
From one of our readers:
I was diagnosed with sleep apnea by the VA last year, however, the VA denied my claim for sleep apnea as “not service connected.”
Q: What do I need to do to prove my “snoring” started while I was in Iraq, since I never had a sleep issue and my sleep problems started in Iraq because of the burn pit smoke I inhaled daily for almost a year. – Jim P. Providence.
Many veterans believe just because the VA diagnosed a condition and provides ongoing treatment he or she should receive approval for monthly disability compensation for that condition. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service.
The VA has a three-element test for service -connection requires (1) a current disability (2) in-service incurrence or aggravation of a disease or injury (3) a casual relationship between the current disability and the in-service disease or injury.
After reviewing Jim’s decision, I see he meets the first test: a current disability.
In Jim’s case, he was discharged over 15 years after being diagnosed with sleep apnea, although according to Jim, his sleep issues started while he was in Iraq and was continuous until he was officially diagnosed by the VA. The diagnosis was from a VA healthcare provider. Moreover, after he filed the claim, a VA private provider confirmed Jim’s diagnosis during the Compensation and Pension (C & P) exam.
VETTIP: Veterans do not need a current diagnosis for an illness prior to filing a claim. After filing a claim, the VA will order a C & P, which could provide the diagnosis at no cost to the veteran.
Why was Jim’s claim denied?
According to the VA decision dated June 2024, evidence listed in the decision lacked documentation proving that an event, injury, or exposure occurred. Reviewing Jim’s decision, he did not submit evidence such as a buddy statement, statement from his wife, etc… For example, buddy statements could have supported the daily exposure to the smoke from the burn pits. Buddy’s statement could have supported Jim’s sleep issues in Iraq. According to Jim, one of Jim’s squad members (who slept in the same room), could validate prior to Iraq (1) Jim did not snore (2) prior to Iraq, he never witnessed Jim awoken from what appeared to be gasping for air prior to his service in Iraq (3) he slept in the same tent with Jim in Iraq, and witnessed after a few month months Jim snoring and being awoken to gasp for air.
In addition, according to Jim, his wife could have provide a statement (1) Jim did not have sleep issues before deployment (2) after returning from Iraq , sleep habits included snoring and instances of being awoken to gasping for air.
Sadly, Jim did not include the statements with the initial claim. Jim could file a supplement claim adding the statements. However, more likely than not, even with the statements, Jim’s claim could be denied, since the evidence submitted lacks a qualified medical opinion linking his service to the illness.
How does Jim get a medical opinion to support his claim?
Jim can seek a private medical opinion “at least as likely as not” Jim’s sleep apnea started while Jim was on active duty. Moreover, the medical opinion should include details of Jim’s exposure to the environment and burn pits that “at least likely as not” was the cause.
To understand better, below is a successful appeal by a veteran being awarded VA disability for sleep apnea, similar to Jim’s.
Citation Nr: 21072804, Decision Date: 12/06/21 Archive Date: 12/06/21,DOCKET NO. 18-15 408
DATE: December 6, 2021
ORDER
Entitlement to service connection for obstructive sleep apnea, to include as due to environmental and burn pit exposure, is granted.
FINDING OF FACT
The Veteran’s obstructive sleep apnea is etiologically attributable to his active duty service.
CONCLUSION OF LAW
The criteria for entitlement to service connection for obstructive sleep apnea have been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty from October 2001 to December 2006 in the United States Army, to include service in Southwest Asia.
In November 2019 the Veteran testified at a hearing before the undersigned; a transcript of the hearing is associated with the record. The claim was most recently before the Board in December 2019. There has been substantial compliance with the remand, and the Board will proceed with adjudication. Stegall v. West, 11 Vet. App. 268 (1998).
The Veteran contends that he has obstructive sleep apnea that is causally related to her active service, to include as due to environmental and burn pit exposure. In August 2021 correspondence, the Veteran’s representative phrased the issue as including secondary service connection. The Veteran is service-connected for post-traumatic stress disorder (PTSD), but the representative did not include any argument as to why secondary service connection is warranted.
Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38C.F.R. §3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).
The Veteran was diagnosed with sleep apnea in April 2015. 38 C.F.R. § 3.385; see also January 2020 VA examination. The question before the Board is whether the Veteran’s obstructive sleep apnea is related to service, his environmental and burn pit exposure, or his service-connected disability.
The Board concludes that the Veteran has obstructive sleep apnea that is related to his environmental and burn pit exposure during service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a).
The Veteran’s service treatment records (STRs) were silent for complaint, injury, or treatment of any sleep apnea or sleep-related disturbances.
Evidence in support of the claim includes the Veteran’s own statements and testimony. The Veteran testified at a November 2019 Board hearing that while in service, he spent two years next to one of the largest burn pits in Baghdad. He specifically noted that every day he was breathing in burn pit fumes and smoke; as well as dust kicked up from the tanks and trucks. The Veteran noted that it was “challenging to breathe in Iraq.” The Veteran stated that he felt tired no matter how much he slept and that, while in service, his ex-wife noted that he would “stop breathing” while he slept. The Veteran also testified that while in service as an MP in Germany, he went into a burning building without a respirator. The Veteran’s wife’s statement was read into the record; in it she described how the Veteran did not have sleep apnea prior to joining the Army, but he would currently suffer from severe sleep apnea symptoms if he did not use the CPAP machine.
The record includes a negative August 2017 VA opinion, but the Board previously determined that the opinion was inadequate because it was solely focused on a negative answer on a post-deployment during service. It will not be considered further.
Pursuant to the December 2019 Board remand, the Veteran was given a VA examination in January 2020 in which the examiner again provided a negative nexus opinion. Prior to offering the opinion, the examiner had elicited the Veteran’s history of exposures during service and his ex-wife’s reports that shortly after he would snore a lot and had periods where he stopped breathing while sleeping.
As rationale for the negative opinion, the examiner referred to an abstract of a 2019 medical journal article that addressed the effect of burn pit exposure on sleep-disordered breathing. Based on that article, the examiner concluded that the Veteran’s sleep apnea was less likely as not due to environmental exposure during military service. The Board affords that opinion little probative value because it did not consider the specific facts of this Veteran’s case, to include his reported history of symptoms possibly related to sleep disordered breathing shortly after.
In August 2021, the Veteran submitted a February 2021 opinion from S.R.B., M.D., PhD. who trained in Internal Medicine and Pharmacology. Dr. S.R.B. concluded that it is “at least as likely as not” that the Veteran’s sleep apnea is secondary to burn pit exposure during service. Dr. S.R.B. detailed the Veteran’s relevant history and reviewed his service and VA treatment records. The opinion provider said burn pits release dioxin and then noted “numerous” literature findings that show occupation hazards, including dioxin exposure, have strong risk factors for sleep apnea. Finally, the examiner noted that since there was no “clear awareness” of the toxic effects of the burn pits at the time the Veteran was in service, variables such as time exposed, dosage, and route of exposure were never quantified. As result, the factors are unknown variables. The examiner then noted however, that this Veteran has no other viable risk factors for sleep apnea. The examiner appended a detailed list of references used in provided the opinion. The opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008).
The Board finds the service connection for sleep apnea is warranted. The Veteran has competently and credibly reported that he was exposed to burn pits while in service, and his spouse at the time reported that she observed related symptoms shortly after. The February 2021 positive opinion is probative evidence in support of the claim. Service connection for sleep apnea is granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.
M.E. Larkin, Veterans Law Judge, Board of Veterans’ Appeals.
In conclusion, when filing for VA disability, veterans should understand the process. Moreover, before submission, layman’s terms, does the evidence support a current diagnosis and how does veteran prove the illness is related to the veteran’s service.
January 25, 2025 – Rhode Island national Guard Reunion, 2:00 to 4:00 PM 13110 S Lake Mary Jane Lane, Orlando, Florida. 32832. $25 BYOB. Please respond no later than January 10, 2025. Payments can be made by check or pay by Venmo at @Patricia-Ryan-37.
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Boots to Bushels farmer training for New England
Military veterans, family members and beginner farmers invited to join market garden program; next class starts in January. URI’s Boots to Bushels farmer training gives military veterans and other beginning farmers the chance to learn skills like Westin Palumbo, shown, a senior in the University’s sustainable agriculture and food systems program.
The University of Rhode Island’s Cooperative Extension is welcoming applications for the second year of a program that connects New England military veterans and beginning farmers with opportunities in agriculture. The University of Rhode Island Boots to Bushels program is a comprehensive nine-month market garden training program for beginning farmers, military veterans, and their family members.
The winter program, which starts in January, offers online classes and farm tours that focus on building a sustainable farm business and connecting learners with agricultural resources for sustainable farming practices.
Registration for the next session is open through Dec. 31.
Tricia Lourenco Boucher, Boots to Bushels program director and a military veteran, says the program began as a way to connect veterans with careers in agriculture; along the way, it also expanded to include beginning farmers and those from underserved populations.
Air Force veteran Jonathan George ’26 is one participant in Boots to Bushels. Applications for the next session are due by Dec. 31.
“We had a very successful first year,” she says, “with about 28 online participants from across the Northeast. We are looking forward to this upcoming year with lots of great subject matter experts including a business mentor. We also changed the time to evenings with the hopes to reach more participants. The class is really for anyone, but especially veterans who are considering starting a small farm but don’t know where to start.”
The course runs from Jan. 21 through March 27 with classes held via zoom on Tuesday and Thursday evenings from 6 to 7:30 p.m.
Classes will be taught by agricultural experts from across the Northeast, from Pasa Sustainable Agriculture, Land for Good, AgrAbility, and Land & Sea Together, with additional speakers from the Natural Resources Conservation Service and Farm Service Agency.
In the spring and summer, there will be optional farm tours across Rhode Island and Maine, offering valuable opportunities to learn and build relationships from farmers with boots on the ground.
Boucher says, “If you are considering B2B but are not from Rhode Island or Maine, and would like to attend a farm tour, we can help facilitate other options closer to you. Many farmers are happy to share their knowledge.”
The final stage of the program includes optional summer workshops at URI’s Kingston Campus. These hands-on opportunities offer added perspective on farming and are free for participants who complete the course.
“This program helps to make those connections and provide practice in the many skills needed to be successful in farming,” says Boucher. “It’s a program that makes sense, both for veterans to continue to serve their country through land stewardship and through providing food to their communities. I’m excited about the potential of Boots to Bushels to have a lasting impact on veterans, beginning farmers and our food system.”
Scholarships are available for veterans with limited resources. Please email [email protected] to learn more scholarship opportunities.
To learn more or apply, visit here. Applications are due by Dec. 31.
Cooperative Extension strives to reach every corner of Rhode Island, providing science-based information through educational programs and services for people to apply to their everyday lives. For more information or to get updates on future training sessions, email [email protected].
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Help our Veterans at the Operation Stand Down Food Bank!
Supplies are low- please stop by with items – or make a monetary contribution.
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VETERANS VOLUNTEER OPPORTUNITIES
Italian American War Veterans of US (ITAM) Volunteer Opportunities:
Leave No Veteran Alone Program – Monday and Saturday, ITAM seeks volunteers to meet up at designated nursing homes to meet and socialize with veterans living at the facility. We schedule the facilities 30 to 60 days in advance. Volunteers socialize with veterans and TRY TO SPOIL them with refreshments we provide. Point of contact, Wendy Cianci, assistant (401) 677-9838.
See our need for delivering Thanksgiving meals – top of this article!
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Free Help for Homeless Veterans or those at housing risk
Veterans who are homeless or at risk of homelessness—and their family members, friends, and supporters—can make the call to or chat online with the National Call Center for Homeless Veterans, where trained counselors are ready to talk confidentially 24 hours a day, 7 days a week.
Who Can Call
- Veterans who are homeless or at risk of homelessness
- Family members, friends and supporters calling on behalf of Veterans
- VA Medical Centers and other VA facilities and staff
- Federal, state and local partners
- Community agencies and providers who serve Veterans who are homeless
Why Make the Call to 1-877-4AID VET (877-424-3838)
- It’s free and confidential
- You’ll get access to trained VA counselors
- It’s available 24 hours a day, 7 days a week
- You’ll get information about VA homeless programs, health care and other services in your area
What Happens When Veterans Make the Call
- A trained VA staff member asks a few questions to find out what you need
- Then, you’re connected to the nearest VA staff person who can help
- What Happens When Others Make the Call
- Family members and non-VA providers receive information about available homeless programs and services
- They can keep their information confidential or leave contact information so staff can follow up
- VA’s Resources for Homeless and At-Risk Veterans
- VA offers a wide array of services to help homeless and at-risk Veterans.
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Free Rhode Island Hunting and Fishing Licenses for 100% Disabled Veterans:
A Veteran who has a 100% disability rating from the VA is eligible for free Rhode Island hunting and fishing licenses. No cost licenses are available if you are: over 65 AND a Rhode Island resident – a veteran with 100% disability status from the Department of Veterans Affairs – a person with 100% total disability status from the Social Security Administration.
To apply in person at DEM, please bring a photo ID and an ORIGINAL DOCUMENT OF THE FINAL DECISION(S). Office hours are 8:30 a.m. to 3:30 p.m. Monday through Friday. (directions)
To apply by mail, please complete an application and mail the application and a copy of your photo ID and the ORIGINAL DOCUMENT OF THE FINAL DECISION(S). Please allow two weeks for processing. The address to obtain your license in person or by mail is: DEM Licensing Office – 235 Promenade Street, Room 360 – Providence, RI 02908 – or call (401) 222-3576.
To purchase online, you will be required to certify that you have an ORIGINAL DOCUMENT OF THE FINAL DECISION(S). You will also be required to enter the date the decision expires. The Department will audit compliance with the certification and may, at any time, request a copy of the current DOCUMENT OF THE FINAL DECISION(S). Failure to submit the documentation by the date requested may result in the suspension of your fishing and hunting license. Also, Rhode Island General Law 11-18-1 prohibits giving false documents to an agent, employee, or public official. The penalty is a misdemeanor punishable by a fine of up to $1,000 or imprisonment up to one year.
Rhode Island Hunting and Fishing Benefits for Service Members and Veterans: Rhode Island offers several hunting and fishing benefits to Service members and Veterans. A short description of each is listed below. Applicants are required to show documentation proving eligibility when they apply: Active-Duty Service members – Military ID – Veterans – DD214 – Disabled Veterans – VA Disability Certification Letter (Contact VA office).
Applicants can apply online at Rhode Island Outdoors, in person at the Rhode Island Department of Environmental Management, Office of Boating Registration and Licenses in Providence (Monday through Friday 8:30 a.m. – 3:30 p.m.), at an Authorized In-Person Sales Agent, or they can mail applications to:
Rhode Island Department of Environmental Management – 235 Promenade Street, Room 360 – Providence, RI 02908 – Phone: 401-222-3576
Free Rhode Island State Park Passes for 100% Disabled Veterans: Rhode Island offers the State Park Disability Pass for use at any state-owned recreational facility to disabled Veterans who have a 100% service-connected disability rating from the VA.
The State Park Disability Pass authorizes free admission and parking but does not exempt the following: Licensing fees – Camping fees – Picnic table fees – Specialized facility use fees – Use of equestrian areas – Performing art centers – Game fields fees – Mule shed fees
If the disabled Veteran cannot drive, the vehicle transporting the Veteran will not be charged.
Veterans must apply in person at the Rhode Island State Parks and Recreation Headquarters and are required to show official documentation (dated within the past year) from the VA that states they have a 100% service-connected disability.
Rhode Island State Parks and Recreation Headquarters – 1100 Tower Hill Road – North Kingstown, RI 02852 – Phone: 401-667-6200 – Email: [email protected]
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RESOURCES & ongoing groups
Below are all the groups the Providence Vet Center is currently offering. As this list changes, I will provide updates. Please send me any questions that you may have, thank you for your time!
***All Vet Center Groups require that the Veteran be enrolled with the Vet Center prior to attending. To check eligibility or for questions, please contact the Vet Center at (401) 739-0167 or reach out to our Veteran Outreach Program Specialist (VOPS)
Post-Traumatic Stress Disorder Group (PTSD) – 2nd and 4th Tuesday of the month from 2:00 – 3:30 p.m. (Group is only active September through May)
Global War on Terrorism (GWOT) and Vietnam Veterans PTSD Group – 2nd and 4th Wednesday of the month from 9:30 – 11:00 a.m.
Vietnam Veteran PTSD Group – 1st and 3rd Monday of the month from 10:30 – 12:00 p.m. and 5:30 p.m. – 7:00 p.m.
Art Expression Group – Every Thursday from 9:00 – 12:00 p.m.
Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) Group – Every Wednesday from 11:00 – 12:00 p.m.
Stress Management – Every Thursday from 9:00 – 10:00 a.m.
Low Impact Walking Group – Every Tuesday from 9:00 – 10:00 a.m.
Guitar 4 Veterans – Every Wednesday from 7:00-8:30 p.m.
Monday Mindfulness Group – Every Monday from 10:00 – 11:00 a.m.
Yoga Group – Every Friday from 12:00 – 1:00 p.m.
Moral Injury Group – Every Friday from 10:00 – 11:00 a.m.
Modern Warrior Support Group – 1st and 3rd Monday of the month from 2:30 – 4:00 pm.
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Discounts for Veterans
Services
No Problem Plumbing and Heating LLC 15% military discount, ask for Ron Gaynor, (401) 568-6666. Veterans must provide proof of eligibility with a VA Card, VA ID Card, or RI State license with veteran identification.
Restaurants
Applebee’s – Military Discount. With more than 2,000 locations, Applebee’s is a family grill restaurant. Applebee’s gives 10% off for active duty and veteran. Last verified 07/31/2022.
Badger’s Pub – 530 Broadway, Pawtucket is now offering a free meal to veterans every first Friday of the month at the bar. Veterans can partake in a variety of activities during the week, including bingo on Mondays, darts on Tuesdays, high-lo jack on Wednesdays, indoor cornhole on Thursdays, and Karaoke on Fridays and Saturdays, Badger said. The bar also hosts poker on Saturdays and Sundays.
Denny’s – Hartford Ave, Johnston offers 10% discount for veterans and active duty. Denny’s is a table service diner-style restaurant chain. Last verified 07/31/2022.
Outback Steakhouse – 10% Discount to active and veterans. Last verified 07/28/2021
99 Restaurant & Pub – The 99 Restaurant & Pub offers a 10% military discount to members of Veterans Advantage. Available at select locations only. Bring valid military ID
Retailers
Advance Auto Parts – 10% for Active Duty, Veterans, and families. Last verified 07/28/2021
Bass Pro Shops – Offers a 5% discount to active-duty military, reservists, and National Guard. Sign up and verify your status online or bring your military ID when you shop at your nearest Bass Pro store (source).
BJs Wholesale – Reduced membership fee. BJ’s offers all military personnel over 25% off their Membership. Last verified 07/28/2021
Lowes – Enroll in the Lowe’s Military Discount Program to activate your 10% discount – “Our way of saying Thank You” to our active duty, retired and military veterans and their spouses with a 10% discount on eligible items. Verification of your military status is fast and easy through our partner
GameStop – is offering a 10% in-store military discount on all pre-owned products, collectibles, and select new products. Available to current and former military members who bring any valid proof of service or when they verify through ID.me
Home Depot – Offers a 10% off military discount on regularly priced merchandise for in-store purchases for active duty, retired military, and reservists at participating locations. Customers are required to show a valid government-issued military ID card to redeem this offer.
Kohls – 15% discount offers for active military, veterans, retirees, and their immediate family members a 15% discount on purchases made on Mondays, in store only. In order to receive the military discount, eligible customers must present proper identification along with any tender type.
Jiffy Lube – HONORING VETERANS ALL DAY EVERY DAY! – We didn’t want to wait for Veteran’s Day to express our appreciation and gratitude for your service. That’s why every Team Car Care owned and operated Jiffy Lube® service center is offering our BEST discount of 10% OFF as a “Thank You” to the men and women of our Armed Forces for their service to our country. *Disclaimer*- I.D. required. No coupon is required. Excludes batteries and brakes, alignment, and diagnostic services. Available only at 3 select locations: Tioque Ave, Coventry RI – Bald Hill Road, Warwick RI – Park Ave, Cranston RI
Michaels – offers a 15% off military discount on the entire in-store purchase including sale items for active duty, retired military, guard, reservists, veterans, and family members. How to get: 1. Create an account. Log in to Michaels Rewards. 2. Get verified. Provide your military information to get verified, instantly. 3. Go shopping! To use your discount online and in store, just sign into your account or provide your Michaels Rewards phone number at checkout.
O’Reilly Auto Parts – 10% discount on in store items for Active Duty, Veterans and families. Last verified 3/4/21.
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If you are a retailer and or a veteran aware of a business not listed above, please forward to: [email protected]: the business’s name, location, and military and veteran discount offered.
If you have an event, meeting, other pertinent veteran information, or email questions or help needed, contact the Italian American War Veteran Service Officer, John A Cianci, [email protected], ITAM Office 1-(401)677-9VET(9838)
To read all columns in this series go to: https://rinewstoday.com/john-a-cianci/
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John A. Cianci is a Veteran Service Officer. Retired, U.S. Army MSgt., Persian Gulf War and Iraq War combat theater.
Cianci, a combat disabled Veteran, served in Desert Shield/Storm and Operation Iraqi Freedom. His awards include Bronze Star, Combat Action Badge, Good Conduct, and others.
Cianci belongs to numerous veterans organizations – Italian American War Veterans, American Legion, Veterans of Foreign War, and many more organizations. He is an active volunteer assisting veterans to navigate federal and state benefits they have earned. He is Department of Rhode Island Department Commander Italian American War Veterans and Veteran Service Officer.
He is a graduate of Roger Williams University (BS Finance), UCONN business school* (Entrepreneur Bootcamp for Veterans), Solar Energy International Residential, Commercial and Battery Based Photovoltaic Systems certificate programs, numerous certificates from the Department of Defense renewable energy programs, including graduate of the Solar Ready Vets Program.