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Created by Funky (OpenClaw) on Thu Feb  5 02:54:14 UTC 2026

projects/va-strategy/va-dr-wall-email-draft.md

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+# Email Draft to Dr. Michael Wall
+
+---
+
+**Subject:** Request for Review: VA Nexus Statement for Sleep Apnea Secondary to PTSD
+
+---
+
+Dear Dr. Wall,
+
+I hope this message finds you well. I'm reaching out because I need your medical expertise and guidance on an important matter regarding my VA disability claim.
+
+**Background:**
+As you may know, I'm a veteran with service-connected PTSD (currently rated at 30%). I've been experiencing significant sleep disturbances and was diagnosed with obstructive sleep apnea, for which I now use a CPAP machine nightly. The VA previously denied my claim that the sleep apnea is secondary to (caused or aggravated by) my PTSD, and I'm preparing to file a supplemental claim with new evidence.
+
+**My Request:**
+I've drafted a medical nexus statement that establishes the connection between my PTSD and sleep apnea. Given your long history as my family physician and your knowledge of both my medical history and general medical principles, I would greatly appreciate it if you could:
+
+1. **Review the attached nexus statement** for medical accuracy
+2. **Add any additional medical context** or observations from your knowledge of my case
+3. **Suggest any strengthening language** or additional medical literature/mechanisms I should reference
+4. **Let me know if you'd be willing to sign it** as a supporting medical opinion (if you feel comfortable doing so)
+
+I understand this is a significant ask, and I want to be respectful of your time. If you're unable to sign the statement yourself, even your feedback on the content and suggestions for improvement would be invaluable.
+
+**What I'm Trying to Establish:**
+The medical nexus needs to demonstrate that my sleep apnea is "at least as likely as not" (50% or greater probability) caused or aggravated by my service-connected PTSD. Current medical research strongly supports this connection:
+
+- 69% of young combat veterans with PTSD have OSA (compared to ~10-15% in general population)
+- PTSD hyperarousal disrupts sleep architecture
+- Chronic stress from PTSD affects upper airway muscle tone
+- The relationship is bidirectional and well-documented in peer-reviewed literature
+
+**Timeline:**
+I'm hoping to submit this claim within the next 2-3 weeks. If you need more time or have questions, please let me know. I'm happy to provide any additional medical records or context you might need.
+
+**Attached:**
+- Draft Nexus Statement (Word/PDF)
+- My current CPAP prescription and compliance report
+- Sleep study results (polysomnography)
+- VA rating decision showing service-connected PTSD at 30%
+
+Dr. Wall, I cannot thank you enough for considering this request. Your support over the years has meant the world to my family and me. If there's any way I can make this easier for you, or if you'd prefer to discuss this by phone, please let me know.
+
+With deep appreciation and respect,
+
+Frederick Book
+[Your Phone Number]
+[Your Email]
+
+---
+
+**P.S.** - If you're unable to provide a full nexus opinion but know of another physician (pulmonologist, sleep specialist, or psychiatrist) who might be willing to review my case, I would be grateful for a referral.
+
+---
+
+## Alternative Shorter Version (if you prefer brief):
+
+---
+
+**Subject:** Quick Favor - Review VA Medical Statement?
+
+---
+
+Hi Dr. Wall,
+
+Hope you're doing well! I'm working on a VA disability claim and could really use your medical insight.
+
+**The situation:** I have service-connected PTSD and was diagnosed with sleep apnea (using CPAP nightly). The VA denied my claim that the sleep apnea is secondary to PTSD, so I'm filing a supplemental claim with better evidence.
+
+**My ask:** Would you be willing to review a draft medical nexus statement I've prepared? I'm hoping you can:
+- Check it for medical accuracy
+- Suggest any improvements or additional context
+- Let me know if you'd be comfortable signing it (or just providing feedback is hugely helpful too)
+
+The medical literature strongly supports the PTSD→sleep apnea connection (69% of combat vets with PTSD have OSA), so this should be straightforward medically. I just need to present it properly to the VA.
+
+I've attached:
+- Draft nexus statement
+- My sleep study results
+- CPAP compliance report
+- Current VA rating decision
+
+No pressure if you're not comfortable signing it - even feedback would be incredibly valuable. And if you know a pulmonologist or sleep specialist who might help, I'd appreciate a referral.
+
+Thanks so much for considering this, Dr. Wall. Your support means everything.
+
+Best,
+Fred
+
+[Phone]
+[Email]
+
+---
+