# Letter Request to Sleep Doctor

**From:** Frederick Book  
**Date:** [Fill in date]  
**RE:** Request for Medical Documentation - DOT Physical & VA Disability Claim

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Dear Dr. [Sleep Doctor Name],

I am writing to request your assistance with two important medical documentation needs related to my hypersomnia and sleep apnea diagnoses.

## Background:

As you know, I have been diagnosed with:
- Obstructive Sleep Apnea (using CPAP nightly with good compliance)
- Hypersomnia (recently diagnosed)
- Service-connected PTSD (30% VA rating)

I am currently employed as a school bus driver, which requires a valid DOT medical certificate. I am also pursuing a VA disability claim for sleep apnea secondary to PTSD.

## Request #1: Letter for DOT Medical Examiner

I need a letter for my DOT medical examiner that addresses my ability to safely operate a commercial motor vehicle. The letter should include:

**Suggested content:**
- Confirmation of diagnosis: Hypersomnia secondary to obstructive sleep apnea
- Current treatment: CPAP therapy (note my compliance rate)
- Management strategy: CPAP therapy, sleep hygiene, behavioral modifications
- **Important:** Statement that I am NOT using stimulant medications (Modafinil, Armodafinil, etc.)
- Clinical opinion: With proper treatment adherence, my condition does not impair my ability to safely operate a commercial motor vehicle
- Recommendation: [1-year / 6-month] medical certification with follow-up evaluation

**Purpose:** This letter will be provided to the DOT medical examiner at my next physical to demonstrate that my condition is being appropriately managed.

**Format:** Professional letter on your letterhead, addressed "To Whom It May Concern" or "To DOT Medical Examiner"

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## Request #2: Letter for VA Disability Claim (Medical Nexus Opinion)

I need a separate medical nexus opinion letter for my VA disability claim establishing that my hypersomnia is secondary to my service-connected conditions.

**Suggested content:**

**Introduction:**
- Your credentials and specialty
- How long you've been treating me
- Confirmation of diagnoses: OSA, Hypersomnia

**Medical Opinion:**
"It is my medical opinion, to at least a 50% degree of medical probability, that Mr. Book's hypersomnia is at least as likely as not caused or aggravated by his service-connected obstructive sleep apnea and/or PTSD."

**Medical Rationale:**
- Hypersomnia is a recognized residual symptom in 10-20% of OSA patients despite adequate CPAP therapy
- Mr. Book demonstrates good CPAP compliance (cite specific compliance data)
- Despite CPAP treatment, he continues to experience excessive daytime sleepiness
- PTSD-related hyperarousal and sleep disruption contributes to poor sleep quality even with CPAP
- [If applicable] PTSD medications (SSRIs) can cause or worsen hypersomnia

**Functional Impact:**
- Document how hypersomnia affects my daily functioning
- Excessive daytime sleepiness requiring [frequency] naps
- Impact on ability to maintain employment
- Difficulty with concentration, alertness during activities

**Timeline:**
- When OSA was diagnosed
- When CPAP therapy began
- When hypersomnia was diagnosed
- Temporal relationship showing hypersomnia developed after/concurrent with OSA

**Conclusion:**
"Based on the medical evidence and my clinical evaluation, Mr. Book's hypersomnia is causally related to his service-connected sleep apnea and PTSD."

**Purpose:** This letter will be submitted to the Department of Veterans Affairs as medical nexus evidence linking hypersomnia to my service-connected conditions.

**Format:** Professional letter on your letterhead, addressed "To Whom It May Concern" or "To the Department of Veterans Affairs"

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## Additional Documentation Needed:

If possible, please also provide:
- CPAP compliance report (last 3-6 months showing usage data)
- Copy of my sleep study results (polysomnography report)
- Any treatment notes relevant to hypersomnia diagnosis

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## Timeline:

**Preferred timeline:** Within 2-3 weeks  
**Reason for urgency:**
- My next DOT physical is scheduled for [date / within X months]
- I am preparing to file my VA supplemental claim soon

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## Contact Information:

**My contact info:**
- Phone: 217-358-2480
- Email: [Your email]

**Questions:** Please contact me if you need any additional information or clarification.

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## Important Notes:

**Two separate letters are needed because:**
- The DOT letter emphasizes that my condition is MANAGED and I can drive safely
- The VA letter documents the FUNCTIONAL IMPACT and service connection
- Both statements are medically accurate but serve different legal/regulatory purposes

**I understand there may be fees** for these letters and reports. Please let me know the cost, and I will arrange payment.

Thank you for your assistance with this important matter. Your documentation will be crucial for both maintaining my employment and securing the VA compensation I have earned through my military service.

Sincerely,

Frederick Book  
Veteran, U.S. [Branch of Service]  
[Phone]  
[Email]

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## Attachments (if helpful):

- [ ] Copy of VA rating decision showing service-connected PTSD
- [ ] Previous VA denial for sleep apnea (if applicable)
- [ ] DOT medical examination form (if you want to see what examiner will evaluate)