Your sleep apnea rating will compensate you based on your conditions severity. Youll need to make the call on direct service connection versus secondary service connection. Research has shown that combat veterans with post-traumatic stress disorder, also known asPTSD, may be at higher risk for sleep apnea than the general population. Why do so many veterans have sleep apnea? study conducted by the VA Healthcare System for San Diego and National Center for PTSD. Brian Reeseis a VA benefits expert, author of the #1 Amazon Bestseller You Deserve It: The Definitive Guide to Getting the Veteran Benefits Youve Earned, andfounder of VA Claims InsiderThe Most Trusted Name in Education-Based Resources for Veterans.. You can choose to have a legal representative speak on your behalf at the informal conference, but I am a strong advocate in speaking for yourself in this matter. Some doctors may have you fill out a questionnaire about your sleep habits. Broadly, its defined as the occurrence of five or more breathing-related events per hour, measured by polysomnography (sleep study). Heres the brutal truth about VA disability claims: We use cookies to ensure that we give you the best experience on our website. Sleep apnea is a common condition that affects about22 million people nationwide. Even if you have a medical diagnosis during active-duty service, without a sleep study this is difficult to claim successfully. As a veteran, youre four times more likely than other Americans to develop sleep apnea. Is a CPAP machine the only treatment for sleep apnea? You're not alone. He is aformer active duty Air Force officerwith extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM. * Sleep Apnea is NOT a disease of the obese: just about any neurological condition, or any interference (physical or neurological) with the body's airway can - and will - cause some form of sleep apnea over time * 3 out of every 4 Veterans who file a claim for Sleep Apnea are denied by the VA Regional Office or the Board of Veterans Appeals. San Jose, CA: 2880 Zanker Road, Ste. VA may deny a sleep apnea claim based on different aspects, whether theres not enough medical evidence of sleep apnea or perhaps no logical connection between your military service and your current sleep apnea. As an aside, there is a fourth type of sleep apnea that has popped up lately in the medical world: idiopathic sleep apnea. 203, San Jose, CA 95134 Conditions like COPD (due to asbestos or particulate exposure in burn pits, for example), blocks the air path at the point where the lungs move oxygen into the blood stream. Check out the VA Sleep Apnea Field Manual. NOW ITS YOUR TURN. Sleep apnea is extremely common among veterans, as the disorder is frequently caused or exacerbated by time in service. The VA has been moving a lot of claims through this process. If your Obstructive Sleep Apnea was caused by damage to your throat focus on the in-service events that caused that damage. A polysomnogram at a sleep center might be preferred if you have heart or lung disease, risk factors for central sleep apnea or a history of other sleep disorders. All of these can contribute to sleep apnea. Medical evidence and documented medical records from a VAC&P exam will be necessary for the process of filing your claim and could even reveal other secondary conditions. document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); Copyright 2016 - VeteransLawBlog.org - All Rights Reserved | Terms & Conditions | Legal Disclaimer, The Veterans Law Blog is NOT a law firm. Regulation Update: VA Ratings for Kidney Disease and Renal Dysfunction. VA Sleep Apnea Claim #1: This Veteran served in Iraq and Kuwait in 2003 to 2004. A 2023 Guide to VA Disability Rates & Pay Schedules, Individual Unemployability Rating Calculator, List of Blue Water Navy Ships Exposed to Agent Orange (Interactive Vietnam Map), Social Security Disability Benefits Guide, sleep apnea as a secondary service connected condition to PTSD, Calculate Your Potential Compensation Now. The disability rating youre given for sleep apnea is combined with any other disability ratings you have, if any, to give you an overall rating based on VA math. * She sought treatment, and after a couple of sleep studies, was diagnosed with OSA Obstructive Sleep Apnea. may be at higher risk for sleep apnea than the general population. Sleep apnea is proven to significantly reduce a persons quality of life (in one study, the reduction in quality of life was equivalent to that observed with diabetes or hypertension). Posted May 20, 2022 (edited) 1. we represent clients nationwide. Some of the most common symptoms of sleep apnea include: People who suffer from sleep apnea are often unaware of the breathing disturbances, finding out about them from a bed partner or roommate. A VA claim for sleep apnea can be denied for many reasons. 10 percent disability rating: $165.92 per month. this was in Sept last year, fast forward to now, and as i suspected my sleep apnea was denied connection to my PTSD. The medical examination may seem like extra hard work but could qualify that veteran for additional monthly compensation. Id like to tell you about their VA sleep apnea claims and show you why they had such different results. In our experience, an upper respiratory disability is one of the easiest choices for claiming OSA secondary to another service-connected disability. The private physician noted post-deployment symptomatology of sleep apnea, and opined that the Veterans Sleep Apnea was, at least as likely as not, related to the Veterans tours of duty in Iraq. Regulation Update: VA Ratings for Kidney Disease and Renal Dysfunction. What made the difference was that the veteran inVA sleep apnea claim #1 lacked ANY lay evidence of sleep apnea symptomatology from service to diagnosis. OSA is a common denial veterans receive when pursuing a VA claim, but it doesnt have to beif you understand the condition and what your claim must include in order to be successful. Its sleep apnea that appears by itself, with no apparent causation. Copyright 2023 Hill & Ponton, P.A.. All Rights Reserved. Required fields are marked *. The polysomnography study records your brain waves, the oxygen levels in your blood, your heart rate and breathing, and eye and leg movements, among other criteria. For veterans who have already been diagnosed with sleep apnea without a sleep study by the VA, the veteran may have to undergo a sleep study done by the VA in order to confirm the diagnosis for benefit purposes. Richmond, VA: 7400 Beaufont Springs Drive, Suite 300, Richmond, VA, 23225 PTSDand the side effects of medications taken to address PTSDcan lead to the development of sleep apnea in a few different ways. Hear from fellow Veterans just like you, with many of our Business Development Representatives having gone through our programs. This book is a must-read: I wrote it after talking to several doctors, hundreds of veterans who were denied sleep apnea in their VA disability claim, and after reading hundreds if not thousands of BVA and Court Decisions about Sleep Apnea. As a fellow disabled Veteran this is shameful and Im on a mission to change it. It is essential that you document symptoms and evidence to submit. By covering all the bases in your sleep apnea VA claim processhaving your sleep apnea diagnosed with a sleep study and connecting your sleep apnea to a service-connected condition with medical evidenceyoull set yourself up for success to get a service-connected VA rating for sleep apnea. Studies have shown that war veterans exhibiting these symptoms tend to have increased frequency and length of apneic events that can be proven by a medical professional. LIFETIME Subscription to the Veterans Law Blog, Quarterly Subscription to the Veterans Law Blog, Annual Subscription to the Veterans Law Blog, describing the sleep apnea symptomatology, opined that the Veterans Sleep Apnea was, at least as likely as not, related, lay evidence of sleep apnea symptomatology from service to diagnosis. The doctortold her that the genioglossus muscle the muscle that connects the tongue to the jawbone was substantially weakened and causing her tongue to fall backward while sleeping, blocking the airway. The number of VA disability ratings that are awarded for sleep apnea is on the rise, however, it still fails to address the entire issue. This can range from CPAP therapy, lifestyle changes such as diet, exercise, and others. As a fellow disabled Veteran this is shameful and Im on a mission to change it. Lets look a little deeper at OSA for a minute Obstructive Sleep Apnea is by far the most common type of Sleep Apnea that affects veterans. Anxiety and depression can interfere with sleep patterns. Its FREE to get started, so click Go Elite Now below to complete our 3-step intake process. Just be mindful that a sleep apnea diagnosis isnt all about neck girth and obesity. So if this proposed change for sleep apnea ratings goes through, its possible that veterans may start getting lowballed ratings. At VA Claims Insider, we help veterans understand and take control of the claims process so they can get the rating and compensation theyre owed by law. When youre granted a sleep apnea VA rating, you may also be assigned a re-evaluation period (unless the condition is classified as static). We answer your questions about VA claims for sleep apnea compensation. We also connect veterans with independent medical professionals in our referral network for medical examinations, disability evaluations, and credible independent medical opinions and nexus statements (medical nexus letters) for a wide range of disability conditions. How to Get a 100 Percent VA Rating (if deserved)! * She filed a claim with the VA, but was told that without a sleep study in the military, there was no evidence of service connection for her Sleep Apnea. Philadelphia, PA: 1 International Plaza, Suite 550, Philadelphia, PA, 19113 Keeping a list of your symptoms and treatments can be beneficial evidence to submit. The 2 veterans had very different results at the BVA. VA is currently reviewing the other disabilities reviewed by NASEM in the 2020 report for consideration for potential presumptive service connection. Copyright 2023 VA Claims Insider, LLC. The Office of the Inspector General found that 1.3 million veterans enrolled in VA Healthcare have a sleep apnea diagnosis. Think about it this way: if you are diagnosed with severe hearing loss, then to win your hearing loss claim, you arent going to waste your time telling the VA about your knee injuries. This field is for validation purposes and should be left unchanged. If I had a nickel for every time I heard someone say the following statement about a VA Sleep Apnea claim, I might be able to buy a damn nice race car: The VA denied sleep apnea in my claimthey said it was because I had no sleep study in service, the veteran says. This blockage is caused when the back throat muscles relax, impairing the airflow. This means you do NOT currently have the VA disability rating and compensation YOU deserve, and you could be missing out on thousands of dollars of tax-free compensation and benefits each month. Is it difficult to stay awake performing tasks like driving, reading or watching TV? Were seeing veterans coming back from Iraq, Afghanistan, and the southwest Asia theater of war with severe sleep issues, which can oftentimesbe linked to PTSD. Camp Lejeune Lawsuit. Todays post is about 2 veterans at the BVA, both with very similar VA sleep apnea claims. Making the Sausage: Heres what you need to know about new VA Claims regulations. Since 2009, veterans' claims for sleep apnea have increased 150%, more than 94% of these coming from veterans of Gulf War I or the Iraq and Afghanistan wars. For all about getting a VA rating for sleep apnea, see our post Your Sleep Apnea VA Rating A Guide to Getting a VA Disability Rating for Sleep Apnea. Required fields are marked *. The VA Regional Office denied his claim. I applied for sleep apnea secondary PTSD about a year ago. During an evaluation for sleep apnea, a doctor may ask some of the following questions: During the exam, the doctor may also take into consideration your weight, neck circumference, or blood pressure (all which could put you at higher risk for sleep apnea). Obesity greatly increases the risk of obstructive sleep apnea, due to excessive weight constricting the airway. No current medical diagnosis (within the last 12 months), or improper diagnosis #3. VA regional office denied the claims and she appealed. Many veterans are diagnosed with obstructive sleep apnea, and thereforewith an effective claim that includes the right evidenceshould be eligible for a sleep apnea VA rating. A person must have a polysomnogram, either in a sleep lab or at home, in order to be diagnosed with sleep apnea. Both sinusitis and rhinitis are linked to sleep apnea. Sleep apnea often is thought of as a mild annoyance, but it is a significant condition that can lead to health issues ranging from hypertension, stroke and heart attack to depression, anxiety and headaches. Also see our post on receiving a VA rating for sleep apnea secondary to PTSD. Thousands of other Veterans in our Community are here for you. The most common VA rating for sleep apnea is 50 percent. Now, it wasnt just the mere existence of lay evidence of sleep apnea symptomatology from service discharge to diagnosis that made the difference. Brian isalso the CEOofMilitary Disability Made Easy, which is the worlds largest free searchable database for all things related to DoD disability and VA disability claims and has served more than 4,600,000 military members and veterans since its founding in 2013. Although all of these symptoms contribute to the interaction betweensleep apnea and PTSD, the main culprits seem to be sleep deprivation and chronic stress. Symptoms of obstructive sleep apnea include: If you experience many of these symptoms, we recommend seeing a doctor as soon as possible and seeking a diagnosis. Lets take a look at 2 VA Sleep ApneaClaims. 3 Steps to Veteran Disability Benefits for Sleep Apnea, 6 Tips for Your C&P Exam for Sleep Apnea Secondary to PTSD, 3 Ways to Get a VA Rating for Insomnia (The Insiders Guide). Dear Veteran, Heres the brutal truth about VA disability claims: According to our data, 8/10 (80%) of veterans reading this message right now are underrated by the VA. Sleep apnea is a sleep disorder in which breathing is repeatedly interrupted during the course of sleep. Exposure to materials such as dust and fumes, and the resulting rhinitis or sinusitis, is also a common issue for veterans thats associated with sleep apnea. In this article, well help you understand the top 5 reasons OSA claims are deniedand even better, what to do about it if youve received a denial for your OSA claim. Many of them have been diagnosed with the condition many years after leaving active duty. (If you need an independent medical opinion in the VAs language, take a look at our VA Claims Insider Elite program. Click Go Elite Now below to get started today and a member of our team will be in touch within minutes. High Blood Pressure Secondary to Obstructive Sleep Apnea: What Veterans Should Know Are you suffering from obstructive sleep apnea syndrome and hypertension? Can the VA take away my sleep apnea rating? This field is for validation purposes and should be left unchanged. Since 2016, VA Claims Insider has helped thousands of Veterans just like you get the VA rating and compensation they deserve in less time. The resulting reduction in sleep quality and in the bodys supply of oxygen can have serious consequences on health and quality of life. Why? The hard copy, if you would like to get that, is also the second editionyou can get the hard copy by clicking here. You can also check out our 2022 Facebook live video on the Top 5 Causes for OSA Denials and How to Fix Them! New Rule allows Presumptive Service Connection for Veterans particulate matter (burn pit) claims. Many veterans dont even know what sleep apnea is while on active duty, let alone that they need a sleep study to prove they have it! Take advantage of a FREE VA Claim Discovery Call with an experienced Team Member. You wouldnt necessarily focus on proving the same in-service events if you were diagnosed with central sleep apnea, though. Here are some of the most common symptoms of central and obstructive sleep apnea: Morning headache Having a dry mouth when you wake up Loud snoring Periods in which you stop breathing when you sleep Difficulty staying asleep Trouble paying attention while awake Irritability Daytime sleepiness Sexual dysfunction In our experience, OSA denials are almost always due to one or more of these five gaps: #1. I hope this post can give you some insight into how to improve your VA sleep apnea claims. This sleep-disordered breathing leads to poor sleep quality and is a risk factor for the poor quality of life. Lay Statements are important! Portland, OR: 650 N. E. Holladay Street, Suite 1600, Portland, OR, 97232 Conditions like COPD (due to asbestos. Signup to never miss a beat with special offers, blog updates, exclusive trainings, and more delivered right to your inbox! Disability Denials LTD Insurance Denial Attorneys - National Disability Law Firm A National Disability Benefits Law Firm Home About Us Attorneys Our Legal Staff Client Services Denied Disability Claim for Sleep Apnea December 28, 2015 Jim, I retired in 2011 with 22 active duty yrs of service. (The VA had already conceded the rape occurred as part of another part of this Veterans claim). His eBook, the9 Secrets Strategies for Winning Your VA Disability Claimhas been downloaded more than 300,000 times in the past three years and is the #1 rated free VA disability claims guide for veterans. Traumatic brain injury and physical pain are also conditions that affect many veterans and can lead to sleep apnea. To learn more about how this works, check out my book: Put it to Rest: Your VA Sleep Apnea Claim. Because sleep apnea affects how your body takes in oxygen, it can be linked to strokes. Here are a few examples of how sleep apnea could be impacting your life, which youll want to clearly state and demonstrate in your C&P exam and in your claim: We recommend a nexus letter from a medical professional to connect your condition to your military service (or secondary to a service-connected disability) in order to improve your chances of receiving a rating for sleep apnea as a secondary condition. Learn what youve been missing so you can FINALLY get the disability rating and compensation youve earned for your service. #1: Air is pulled in through the nasal passages. The most trusted name in education-based resources for Veterans. The VA Regional Office denied his claim. The independent opinion of a private medical professional can also influence the C&P examiners medical opinion, as well as the VA rating officials final disability decision. Our process takes the guesswork out of filing a VA disability claim and supports you every step of the way in building a fully-developed claim (FDC). yet assertive representation for our clients. Record Before the Agency ("R.") at 4-12. Ask your private doctor for a referral to a sleep specialist in your area (a good option if you have private health insurance). Citation Nr: 21055584 Decision Date: 09/08/21 Archive Date: 09/08/21 DOCKET NO. Mr. Davis filed his initial brief on September 9, 2019 ("App. According to the VA, 1 in 5 veterans has obstructive sleep apnea. The condition is given a serious VA disability rating . book: Put it to Rest: Your VA Sleep Apnea Claim. If your VA disability claim has been denied, contact our office today for a free consultation at (401) 753-6359. In this blog post, we will discuss how. A private physician note indicates that prior to deployment to Iraq, the Veteran had no symptoms of, or treatment for, sleep apnea. In this case, there must be a medical nexus to link the sleep apnea to their already service-connected disability. Columbus, OH: 100 E. Campus View Boulevard, Suite #250, Columbus, OH, 43235 In our experience, a well-crafted nexus letter for sleep apnea is the single most crucial document you can provide to help prove service connection on an at least as likely as not basis. You see, somewhere out there the general thinking generally wrong thinking has become that you need a sleep study in the military to prove that your current diagnosis of sleep apnea is related to your military service. If accepted into our ELITE membership program, youll get free up-front access and permission to use $13,119 worth of proprietary VA claim resources, including access to our network of independent medical professionals for medical examinations, disability evaluations, and credible Medical Nexus Letters, which could help you get a HIGHER VA rating in LESS time. An obstruction or a problem anywhere along that path of air, can cause Obstructive Sleep Apnea. Symptoms of Sleep Apnea Loud snoring Gasping for air during sleep Awakening with a dry mouth Morning headache Hypersomnolence, or excessive daytime sleepiness Difficulty concentrating Oftentimes, the symptoms of the three types of sleep apnea can overlap, making diagnosis more difficult. What really makes your VA Sleep Apnea claim race through the VA disability claim system is this one thing: Your response, I imagine, might be something like this: To understand HOW the diagnosis drives a veterans VA Sleep Apnea Claim, we have to first understand the 3 different types of Sleep Apnea: obstructive, central, and complex. What is the current VA rating for sleep apnea? Heres the deal Lets begin today's post with the Bottom Line Up Front (BLUF): It is HARD to get service connected for Sleep Apnea secondary to Depression. For a limited time, you can book a free, no-obligation VA Claim Discovery Call with one of our experts. Deland, FL: 1607 South State Road 15A Suite 12 Deland, FL 32720, Satellite Offices Obstructive Sleep Apnea: aka,OSA, is a type of sleep apnea that occurs when your airway is blocked or obstructed. This is because the fact is that many veterans suffer from PTSDand sleep problems are a common symptom of PTSD. Were here for disabled veterans exploring eligibility for increased VA disability benefits and who wish to learn more about that process. If a doctor thinks its highly likely you have sleep apnea, the sleep study may also involve a positive air pressure (PAP) device. The first step we like to suggest (aside from starting with VA Form 21-526EZ) is to get a medical opinion from your doctor when it comes to proving a sleep apnea claim. Hypersomnolence (i.e., excessive daytime sleepiness), Mental anxiety and/or depression related to combat, Use of alcohol, sedatives, certain medications or tranquilizers. * About 2 years after her discharge, she began having sleeping problems. If so, how often and how long are your naps? If youre claiming sleep apnea as a secondary condition, make sure you already have a medical diagnosis before you make your claim. There are many factors during and after service that make veterans vulnerable to this condition. Your email address will not be published. In fact, even if the Veteran inVA sleep apnea claim #2 had not had a private medical opinion, that lay evidence would have completely undercut the VA C&P examin that claimbecause that VA C&P opinion did NOT consider the lay statements of the ongoing and chronic symptoms of sleep apnea from discharge to diagnosis. He was denied service connection for sleep apnea by the BVA, despite extensive evidence of treatment for sleep apnea from 2007 2014, at VA medical facilities. Discuss your sleep issues with your primary care VA doctor and ask for a referral to a sleep specialist at the VA. The VA prescribes several different types of CPAP machines. A nexus letter is often the missing link in a VA claim. Therefore, a well-crafted nexus letter for sleep apnea is the single most crucial document a veteran can provide the VA adjudicator to help prove service connection on an at least as likely as not basis. This can occur from ten times to hundreds of times per night. The veteran in VA sleep apnea claim #2 had exactly that. 40 percent disability rating: $731.86 per month. If you are among the former military service members living with sleep apnea, you may be eligible for veterans disability compensation through the Department of Veterans Affairs. Has anyone in your family been diagnosed with sleep apnea? However there are several rules that must be followed in order for this to occur: If the VA does propose a reduction of rating, then the veteran can submit an argument against it. Do I need a nexus letter for sleep apnea? Was it inhaling the air around the Burn Pits? No proof of service connection (missing a nexus letter) Excessive daytime sleepiness is the most noticeable signal for those who live alone. One common scenario is when a veteran tries to claim sleep apnea as a primary condition when there was no diagnosis during active-duty service. At VA Claims Insider, we can help you win your claim and get the highest VA rating for sleep apnea. VA claim for sleep apnea denied? That means that 3 out of every 4 Veterans are spending years in the VA Hamster Wheel trying to prove their Sleep Apnea service connection claims and appeals! For now, these ratings are merely a proposal so stay tuned to this page while we update. Obstructive sleep apnea can cause daytime sleepiness, snoring, depression, difficulties with concentration, and loss of memory. Since 2016, VA Claims Insider has helped thousands of Veterans just like you get the VA rating and compensation they deserve in less time. Its this simple: without a bullet, a rifle is powerless. He was diagnosed with sleep apnea in 2007, after his military service. I already have 70% for PTSD. Your final VA Disability Rating for Insomnia depends upon the Top 5 Reasons for Obstructive Sleep Apnea Claim Denials (Plus OSA Service Connection Tips), Steps and Strategies: How to Prove Service Connection for Sleep Apnea, Step #1: Get a NEW Sleep Study (within the past 12 months), Step #2: Obtain a medical diagnosis of sleep apnea from a sleep specialist, Step #3: Get a nexus letter for sleep apnea from a credible independent medical professional, Lack of Medical Evidence is the #1 Reason VA Claims are Denied, Step #4: Consider secondary service connection instead of direct service connection, Secondary Service Connection Requirements. Sleep apnea is classified by the VA as sleep apnea syndromes (diagnostic code 6847). The statements of the veterans wife in sleep apnea claim #2, while not at all competent to show the causeof the sleep apnea, or its medical relation to sleep apnea, did show that the sleep apnea symptoms had existed from service to diagnosis. Its free to join and we dont win unless you win.). These sleep disturbances can occur from tens to hundreds of times per night. Finally, a 100% rating is available when sleep apnea is so severe that it involves organ damage. 17-59 208 DATE: September 8, 2021 REMAND Entitlement to service connection for sleep apnea is remanded. Weve supported more than 15,000 veterans to win their claims and increase their ratings. The most common symptoms include: There are a multitude of potential causes of sleep apnea in adults, but in veterans specifically, the causes could include: To confirm a diagnosis of sleep apnea, a sleep study must be given to show that you are experiencing breathing problems, and other sleep disorders and health problems have been ruled out. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This site uses Akismet to reduce spam. This is the most common route of veterans' claims for sleep apnea. When he got to the BVA, the following evidence was in his C-File: Statements from the Veterans wife describing the sleep apnea symptomatologysince the Veteran returned from Iraq until his 2007 diagnosis. We share our top tips and a step-by-step guide to a successful claim for obstructive sleep apnea! The VA assigns the following ratings for veterans based on the severity of their sleep apnea: PTSD, Hypertension, Asthma, Cardiovascular Conditions, Type II Diabetes, Mental Health Conditions, Respiratory Conditions, Alzheimers disease. Beyond the PTSD criterion symptoms of insomnia and nightmares, 40% to 98% of veterans with PTSD also have a co- occurring sleep disturbance such as obstructive sleep apnea (OSA), periodic leg movement disorder, sleep terrors, or nocturnal anxiety attacks. Regardless of whether you are dealing with OSA, its important to pursue all the benefits available to you as a veteran. See our tips on how to obtain a credible nexus letter. These temporary breathing disruptions or lapses can occur from dozens to hundreds of times per night. A disability with a secondary service connection is a condition that was caused or made worse by an already existing service-connected condition. (The Insiders Guide). document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); Copyright 2016 - VeteransLawBlog.org - All Rights Reserved | Terms & Conditions | Legal Disclaimer, The Veterans Law Blog is NOT a law firm. Lesson learned:Lay Evidence is the Bullet, and Medical Evidence is the rifle.

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