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How Is Sleep Apnea Rated By The Va

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Where To Start With A Va Sleep Apnea Disability Claim

VA Rating for Sleep Apnea Secondary to PTSD

I get asked more questions about how to file and win a VA sleep apnea disability claim than almost any other topic in all of VA Benefits Law.

True story.

And Ive been getting asked these questions for years.

On top of that, for almost a decade, I noticed that Veterans of all eras were seeking my help from Vietnam to Cold War to Afghanistan and beyond appealing their VA Sleep Apnea disability denials.

So a few years back, I started trying to figure out WHY the sleep apnea disability was such a problem in the Veterans community.

I asked:

Sinusitis & Sleep Apnea

Veterans with obstructive sleep apnea have a heightened risk of chronic sinusitis. There are studies linking the conditions, which means veterans may be able to service-connect the two conditions together. Sinusitis can aggravate obstructive sleep apnea and vice-versa. For this reason, veterans regularly receive both a VA sinusitis rating and a VA sleep apnea rating concurrently.

Did Va Deny Your Disability Benefits Claim

If VA denied your disability claim, there are still options for appealing the decision.

The team of veterans disability attorneys at Chisholm Chisholm & Kilpatrick LTD may be able to help secure benefits for your condition. We have years of experience handling veterans disability appeals for sleep apnea.

Call us today at to get started.

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Sleep Disorders The Va Covers

There are three basic classes of sleep disorders the VA covers for disability compensation: sleep apnea, insomnia, and narcolepsy. Well talk more in-depth about each of these conditions in a moment. But it is important to note that a wide variety of more specific conditions can fall under these three categories.

You can get three different kinds of service connections for sleep disorders. These include direct service connections, secondary service connections, and presumptive service conditions. Which kind you get will determine how much evidence you need to provide for your disability claim.

Sinusitis Secondary To Sleep Apnea

Obstructive Sleep Apnea &  VA Disability Benefits

Sinusitis is a condition where a persons sinuses become swollen and inflamed for three months or longer, despite treatment. Symptoms of sinusitis often include:

  • Nasal inflammation
  • Hissing
  • Humming

Tinnitus is one of the most frequently claimed conditions for service connection. This is likely due to a variety of factors related to service, such as exposure to noise, possibility of traumatic brain injury, and exposure to explosive devices like IEDs.

Research has found that veterans who have chronic tinnitus also prevalently experience sleep apnea. As such, veterans who are service connected for tinnitus may be eligible for secondary service connection for sleep apnea, and vice-versa.

Other Conditions Linked Sleep Apnea

There are many conditions that have been linked to sleep apnea that veterans can receive benefits for through secondary service connection. Some of the following conditions can be secondary to sleep apnea, while others may be the primary condition to which sleep apnea is secondary.

  • Allergic Rhinitis

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Is Sleep Apnea A Permanent Va Disability

Generally, sleep apnea is not automatically rated a permanent disability by VA, but if a veteran meets certain qualifications, they may be able to secure lifelong compensation.

If VA considers your sleep apnea permanent in nature, meaning they are reasonably certain that the condition will continue with zero or close to zero chance of improvement, veterans will not be scheduled for a re-examination. If this is the case, VA cannot propose a rating reduction.

Higher/more Severe Va Ratings

50% Rating

The VA rates sleep apnea at a 50% rating if you need a breathing device to assist with your sleeping habits.

Military personnel or veterans that rely on a CPAP machine for breathing assistance fall under this distinction.

Under this rating, you have a 50/50 chance of receiving approval for disability benefits.

You should do your research when submitting the claim to make sure you submit any evidence of sleep apnea .

100% Rating

The VA rates sleep apnea at a 100% rating when chronic respiratory failure is evident through carbon dioxide retention.

Furthermore, the 100% rating for sleep apnea includes the need for a tracheostomy.

Additionally, veterans can file a claim if the right side of the heart is enlarged or experienced failure as a result of lung disease.

Under this rating, military personnel has the strongest likelihood of gaining acceptance for VA disability benefits.

The VA generally approves claims at this rating because it is considered the most severe form of sleep apnea.

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Getting A Va Rating For Sleep Apnea

Are you looking to apply for a VA Rating for sleep apnea? Sleep apnea claims with the VA have spiked over the past decade, at one point being the most prevalent service-connected respiratory disability .

Unfortunately, the VA does not have a record of recognizing most of these claims, with the vast majority being rejected. This is due to the difficulty veterans are having proving that their sleep apnea disability began during their service.

While the continuing rise of these claims has the VA beginning to better recognize the issue, the truth remains that If you are experiencing sleep apnea as a result of your time in the service you should be well prepared before filing your claim.

Questions About The New Va Rating Changes For Sleep Apnea

How does the VA Rate Sleep Apnea?

Because so many veterans are on disability for sleep apnea, the changes to the rating system could have a broad and significant impact. If youre receiving VA compensation for sleep apnea, here are answers to some questions you may have:

  • What are the new changes being made to the VA sleep apnea rating system? There are two changes being made to the rating. Change 1: A veteran must show that the CPAP hes using is a medical necessity. Thus, a letter from your doctor will be needed to explain that the prescribed breathing device is needed for medical treatment of your sleep apnea. Change 2: Veterans can use breathing devices other than a CPAP and still be eligible for a rating of 50 percent. This is helpful for veterans because doctors can prescribe different devices to treat sleep apnea, including APAP and BiPAP machines and dental aids. Consequently, if your doctor prescribes a CPAP or any other breathing device, and he can provide evidence that in order to treat your sleep apnea condition, your device is medically necessary, its likely youll be approved for a 50 percent rating.
  • If you are a veteran who suffers from sleep apnea due to your military service, and your symptoms make it difficult to work, or you were denied benefits for this condition, contact us at 402-933-5405. Well discuss your situation and determine how we can help get you the VA benefits you deserve.

    Related Links:

    Read Also: How To Win Sleep Apnea Va Claim

    Sleep Apnea Secondary To Ptsd

    Research shows that combat veterans with PTSD may be at higher risk for sleep apnea than the general population. Both disorders have risk factors that affect both sleep apnea and symptoms of PTSD, and the conditions can aggravate each other.

    A study conducted by the VA Healthcare System for San Diego and National Center for PTSD found that between 40 percent and 98 percent of veterans with PTSD also have a co-occuring sleep disturbance, including obstructive sleep apnea . If youre dealing with sleep apnea as a secondary condition to PTSD, you arent alone!

    Sleep apnea also ranks #2 on our List of the Top 5 Secondary Conditions to PTSD.

    PTSDand the side effects of medications taken to address PTSDcan lead to the development of sleep apnea in a few different ways. PTSD is well-known for causing sleep deprivation, chronic stress, and an increase in body mass or obesity due to prescribed medications. All of these can contribute to sleep apnea.

    In order to prove a secondary service connection, youll need three things:

    • A medical diagnosis of sleep apnea confirmed with a sleep study
    • A service-connected PTSD disability rating
    • A medical nexus establishing a connection between your PTSD and sleep apnea

    PTSD doesnt have to be the main cause of your sleep apnea, but it does have to be connected. You can link these two by detailing the side effects of PTSD that impact your sleep apnea, with the doctor writing your nexus letter.

    How Do I Know If I Have Sleep Apnea

    Symptoms of obstructive sleep apnea include:

    • Loud snoring
    • Daytime sleepiness or insomnia
    • Lack of focus or difficulty concentrating
    • Irritability or anger

    If you experience many of these symptoms, we recommend seeing a doctor as soon as possible and seeking a diagnosis. If you meet the requirement of having a current diagnosis, you can obtain a service connection and VA rating for sleep apnea and receive disability benefits.

    Its likely your doctor will need to order a sleep study to determine if you have sleep apnea. A doctors diagnosis will be one of the keys to getting a sleep apnea VA rating.

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    How Does The Diagnosis Drive Your Va Sleep Apnea Claim

    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.

    Lets take a quick look at each.

    Obstructive Sleep Apnea: aka, OSA, is a type of sleep apnea that occurs when your airway is blocked or obstructed.

    Central Sleep Apnea: aka, CSA, is essentially a type of sleep apnea where the brain and the lungs are not communicating properly. It is, at its core, an interruption of the communication network between the brain and the breathing muscles.

    Complex Sleep Apnea: In September 2006, researchers at the Mayo Clinic identified a new type of Sleep Apnea which they are calling complex sleep apnea. At its core, Complex, or mixed, Sleep Apnea is a type of sleep apnea with mixed causes. The causes of the condition can be a combination of CSA and OSA causes it can also be that your CSA presents as OSA, and only becomes apparent as CSA after OSA treatment .

    As an aside, there is a fourth type of sleep apnea that has popped up lately in the medical world: idiopathic sleep apnea. Its sleep apnea that appears by itself, with no apparent causation. Im not going to talk about it much here because Im not seeing it in VA claims and appeals just yet. Just be mindful that a sleep apnea diagnosis isnt all about neck girth and obesity.

    #1: Air is pulled in through the nasal passages.

    #2: It crosses the uvula that dangling thing in the back of your throat

    * Deviated Septum

    Va Rating For Sleep Apnea

    [VIDEO] Do you get the max Sleep Apnea VA Disability ...

    VA Rating for Sleep Apnea

    Pursuant to Diagnostic Code 6847, VA disability ratings for Sleep Apnea are as follows:

    • The0 percent VA rating for Sleep Apnea is warranted if youre asymptomatic , but with documented sleep disorder breathing.
    • A 30 percent VA disability rating for Sleep Apnea is warranted if you have persistent daytime hypersomnolence, but do not require the use of a breathing device.
    • The 50% VA rating for Sleep Apnea is warranted if you require the use of breathing assistance device such as a Continuous Positive Airway Pressure or Bi-level Positive Airway Pressure
    • A 100 percent VA rating for Sleep Apnea is warranted for chronic respiratory failure with carbon dioxide retention or cor pulmonale or requires tracheostomy.

    Sleep Apnea is rated under diagnostic code 6847, Sleep Apnea Syndromes :

    6847, Sleep Apnea Syndromes :

    Sleep Apnea VA Rating

    VA Rating Scale for Sleep Apnea

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    Can I Qualify For Tdiu Due To Sleep Apnea

    Sleep apnea is a disorder that causes a person’s breathing to be repeatedly interrupted during the course of a typical night. Sufferers experience symptoms such as loud snoring, gasping for air during sleep, and waking up with a dry mouth. They may also struggle with headaches, daytime sleepiness, and difficulty concentrating. If a Veteran’s sleep apnea is severe enough to interfere with their ability to hold substantially gainful employment, they may qualify for Total Disability Individual Unemployability benefits.

    Do I Get A Sleep Apnea Rating When Va Gives Me A Cpap

    Unfortunately, VAs disability rules are not easy to understand. This often means that veterans are not sure whether VA is handling their claim correctly or not.

    Many veterans have questions about VAs rules, and I try to answer many of those in the articles I write on this blog. In this article, I would like to discuss an issue that pops up quite frequently when I talk to veterans about sleep apnea.

    Here is a fairly common situation. A doctor at a VA medical center recommends a sleep study for a veteran. After the sleep study, the doctor prescribes a CPAP. But, VA does not assign a rating.

    If you have a service connected sleep apnea disability, then a CPAP would usually entitle you to a 50% rating. So, many veterans wonder why they do not necessarily get that rating when a VA medical center prescribes a CPAP. They also wonder why VA denies them when they file their claim for sleep apnea.

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    Get At Least One Va Buddy Letter For Sleep Apnea

    In the final step, Step #6, youll want to obtain at least one Lay Statement, aka Buddy Letter to support your VA claim for Sleep Apnea.

    A VA Buddy Letter is simply a credible Statement in Support of a Claim, written by a competent individual 18 years of age or older, who has direct, first-hand knowledge of an event or injury, and offers an account of what they witnessed or are witnessing in support of a veterans VA disability claim.

    These lay statements can be from a fellow service member, spouse, friend, pastor, co-worker, boss, adult child, or any other competent and credible adult witness.

    A Buddy Letter can be the linchpin to winning your VA disability claim.

    Why?

    Because a Buddy Statement constitutes lay evidence under the law, which simply means after the fact evidence written by a competent lay person 18 years of age or older who does NOT have any specialized education, training, or experience.

    The Rating Veteran Service Representative at the VA MUST consider a buddy letter because its considered a secondary source of evidence in support of your VA disability claim.

    When writing or obtaining a buddy letter for Sleep Apnea, you can simply use the VA Form 21-4138, Statement in Support of a Claim.

    A great VA buddy letter is short, simple, and factual to the best of the knowledge and belief of the writer.

    Think LESS is MORE.

    What should you include in a Buddy Letter for Sleep Apnea?

    Get Help With Your Va Sleep Apnea Rating

    How The VA Rates Sleep Apnea for VA Disability

    Think you need help with your sleep apnea disability claim? Havent applied and want assistance? Were you denied a VA sleep apnea rating and want to appeal? Just not sure what to do next? Give Woods & Woods a call.

    Since 1985, we have successfully represented thousands of veterans and their families. We offer free legal consultations and free help filing your application. Our lawyers only charge if you hire us for an appeal and we win. Our law firm is here to answer any questions you have and make a recommendation for your claim. If you need help, reach out to us about your VA disability sleep apnea rating.

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    Is It Possible To Claim Sleep Apnea As A Secondary Disability

    Since there are several medical conditions that are linked to sleep apnea, yes, you can claim sleep apnea as a secondary disability to a service-related condition thats already been granted.

    For any claim on a secondary basis, establishing service connection needs sufficient evidence to show that there is a current disability , and that this disability was caused or aggravated by the service or closely connected to it.

    How Does The Va Diagnose Sleep Apnea

    The VA will usually order a sleep study to be performed in order to confirm a current diagnosis of sleep apnea. As a part of the VAs duty to assist veterans in obtaining evidence to help prove their claim, the VA has a duty to assist veterans in scheduling the examination for a sleep study. This study will serve as medical evidence for the veterans case.

    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.

    Read Also: Sleep Apnea Service Connected

    Symptoms Of Sleep Apnea

    The signs and symptoms of Obstructive Sleep Apnea and Central Sleep Apnea are similar.

    According to the Mayo Clinic, most patients suffer from one or more of the following symptoms:

    • Loud snoring
    • Difficulty staying focused or paying attention
    • Episodes where you stop breathing while sleeping

    Moreover, most patients with a form of sleep apnea report either difficulty staying asleep or excessive sleep patterns .

    It is difficult to diagnosis the correct type of sleep apnea without speaking to a medical professional since many of the symptoms overlap.

    Why Dont I Automatically Get A 50% Rating When Va Diagnoses Me With Sleep Apnea And Prescribes A Cpap

    Pin on DIY

    Whats wrong here? Unfortunately, receiving medical treatment for your sleep apnea at a VA medical center does not automatically entitle you to VA disability compensation benefits for your sleep apnea.

    Here is why. Sleep apnea is no different than any other VA disability compensation claim. A veteran must prove three things to win a VA disability claim.

    A current diagnosis.

    A current diagnosis means you currently have the condition for which you are seeking benefits. In the example which we are discussing, the current diagnosis is present.

    VA diagnosed the veteran with sleep apnea and prescribe a CPAP. So ,the veteran should have satisfied that element of proof.

    But, the current diagnosis is not the only part that you have to prove to VA. You also have to prove two additional elements.

    An incurrence or aggravation of sleep apnea during your active duty military service

    Your sleep apnea either had to start or worsen during your military service. This is part of the idea of service connection. It is a connection between your service and the condition for which you are claiming compensation.

    The incurrence or aggravation is like the starting point on a line. Your current diagnosis is the ending point. Then, you need to have a line connecting those two points which is the third thing you must prove to VA:

    A nexus between your current diagnosis and your in service event

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