What Are The Va Disability Rates For Sleep Apnea
The VA rating you receive for sleep apnea determines how much you will receive in monthly compensation for disability.
The VA sleep apnea rating system is under federal code 38 CFR 4.97 Code 6847.
There are 4 distinct VA disability ratings for sleep apnea .
The VA disability rating is non-compensable.
Regardless, you may be entitled to other military benefits such as VA healthcare.
The VA disability rating may receive partial disability coverage.
However, the majority of sleep apnea claims currently get denied by the U.S. military which is why compensation is not guaranteed at the 30% rating.
In most instances, the military deems this rating an inconvenience to your sleep/lifestyle habits yet not detrimental enough to warrant compensation.
The 50% VA disability rating drastically improves your chances of receiving compensation.
The military grants this liability rating when the patient requires a breathing device to assist with sleeping and getting rest.
The 50% rating can have a noticeable impact on your overall combined rating and compensation received.
The highest rating recognizes chronic respiratory problems and failure.
Thus, patients with this rating are entitled to full benefits as long as they can prove the condition is service-connected.
The Va Disability Rating Schedule
Under the Rating Schedule, benefits increase as a veterans level of disability increases (from 0 to 100%. If a veteran is deemed totally disabled exclusively due to service-connected impairments, then the benefits are paid at 100%. In some situations, veterans may receive additional compensation for very serious injuries.
The Rating Schedule groups disabilities into broad categories, such as the musculoskeletal system, the skin, and mental disorders. Each category contains a schedule of ratings for specific diagnoses, with specific symptoms that are required for various ratings of disability. An individual must suffer from those particular symptoms to qualify for a given rating.
To rate a disability, the VA will first look at the broad category and find your diagnosis such as sleep apnea. From there, the VA will find the diagnostic code that best matches your symptoms, which will result in your rating.
About Va Claims Insider
VA Claims insider is an education-based coaching/consulting company. Were here for disabled veterans exploring eligibility for increased VA disability benefits and who wish to learn more about that process. We also connect veterans with independent medical professionals in our referral network for medical examinations, disability evaluations, and credible Independent Medical Opinions & Nexus Statements for a wide range of disability conditions.
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Va Service Connection For Tinnitus
To establish service connection for tinnitus on a direct basis, veterans must prove that there is a connection between their diagnosis and their time in service. Specifically, the following elements must be present: a current diagnosis of tinnitus an in-service event, injury, or illness and a medical nexus linking the current diagnosis of tinnitus to the in-service event, injury, or illness. The following types of evidence are often used to develop and strengthen claims for tinnitus:
- Service personnel records these may show evidence of regular and prolonged noise exposure during training exercises or in combat
- Medical records these may help establish that a veteran did not have hearing-related issues prior to their military service
- Doctors statements may establish when the veteran began complaining of tinnitus symptoms and what, if any, types of treatment the veteran received
- Medical opinion a medical expert can opine that the veterans tinnitus is at least as likely as not due to their time in service
Common Symptoms Of Sleep Apnea
The inability to get the kind of restful sleep necessary for optimal health can affect a veterans ability to effectively secure and maintain gainful employment, which is often the case with sleep apnea. If sleep apnea is making it so difficult to concentrate, stay awake, and maintain effective relationships with colleagues that you cant feasibly do your day-to-day work, you may be eligible for VA disability benefits.
While the VA often denies VA disability claims associated with sleep apnea, there is reason for optimism when the right sleep disturbance symptoms are supported with the right kind of documentation, theres no reason to believe that the VA would deny your sleep apnea claim, or at the very least that you cant ultimately win your case through the appeals process. Once your VA claim has been approved, you also may be eligible for VA disability back pay.
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How To Prove Sleep Apnea Is Service Connected
The Veterans Affairs Resource Center states that there are 4 common ways that a service connection can be made:
Manyvariables are taken into consideration when making service connections to your disabilities. These include documented records, your type of service, your pre-existing conditions, and the VAs overall ruling.
Normally, a sleep study is conducted to diagnose sleep apnea. A nexus letter can then be written by a doctor. A Nexus letter helps in linking service-connected conditions with your sleep apnea, and is a requirement to receive VA disability.
How Does The Va Determine Disabilitywhat Is A Disability Rating Level
Before diving further into a discussion of how disability compensation is awarded for Sleep Apnea, its important to understand how the VA determines disability.
First of all, in order for the VA to pay anything on a disability claim, the disability has to be connected to a veterans time spent in the Armed Services.
Once the VA confirms the disability exists they then assign it a rating level. This rating level determines the amount of compensation paid by the VA. Getting a 50% disability rating level means higher compensation. However, recently, the VA has changed how the 50% disability rating level is awarded.
It used to be much easier for a veteran to get VA disability for Sleep Apnea. In the past, VA disability for Sleep Apnea could be awarded based on a prescription for a CPAP machine alone. However recently, the VA disability Sleep Apnea eligibility criteria rules were rewritten.
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S To Veteran Disability Benefits For Sleep Apnea
The SECRETS to Veteran disability benefits for sleep apnea REVEALED!!
Whats up Insiders! We know how difficult it can be to file and WIN a Sleep Apnea claim.
The frustration of having a CPAP machine and not being able to get it service-connected is real!
Which is WHY we have created this guide to walk you through a sleep apnea claim!
We are going through 3 Steps to Veteran Disability Benefits for Sleep Apnea!! Including, the CRITICAL aspect of secondary sleep apnea claims, and how you can get service-connected for sleep apnea.
The good news is you can get your sleep apnea claim service-connected!
And as always, if you need anything you can reach out to my team HERE!
How Can You Receive Va Disability For Sleep Apnea
Sleep apnea is a common condition that affects about 22 million people nationwide. If you are among the former military service members living with sleep apnea, you may be eligible for veterans disability compensation. This guide will outline the basics of sleep apnea, how the VA disability rating works for this condition, and how qualifying veterans can prove service connection.
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Sleep Apnea And Secondary Service Connection
Many veterans with Sleep Apnea, especially those who were diagnosed long after leaving the military, might still be eligible if medical evidence shows your Sleep Apnea is proximately due to or aggravated by another service-connected disability such as musculoskeletal conditions and/or mental health conditions.
Service connection on a secondary basis requires a showing of causation.
A showing of causation requires that the secondary disability be shown to be proximately due to, or the result of, a service-connected disability.
The first part can be satisfied with any existing medical evidence in service treatment records, VA medical records, or any private medical records.
The second part can be satisfied with a veterans existing service-connected disability rated at 0 percent or higher.
The third part can be satisfied with a Medical Nexus Letter, aka, Independent Medical Opinion from a qualified medical professional.
Did you know there are more than 50 conditions that can be medically linked to cause or aggravate sleep apnea?
Higher/more Severe Va Ratings
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 .
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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Will It Affect Past Claims
Again, the M21-1MR doesnt state. However, as mentioned above, it is better to be safe than sorry.
Get the medical necessity letter now.and even if you dont want to poke the bear right now, tuck it in a safe deposit box in the event the VA proposes a Claims Reduction in your 50% VA Sleep Apnea Rating.
Preparation & Medical Appointments
Step 1: Schedule an appointment with a medical professional to discuss your sleep problems and symptoms.
Step 2: Request that the VA schedule a sleep study examination for sleep apnea. Make sure the sleep test is performed at an approved clinic.
Step 3: Obtain the test results from the sleep study along with a nexus letter from a medical professional. The nexus letter contains the professional opinion that sleep apnea is related to your military service and therefore service-connected. This process is referred to as a direct service connection.
Step 4: Consider making your case more persuasive by adding a secondary basis . The secondary service connection, such as linking PTSD to sleep apnea helps add value to the claim that you deserve VA disability benefits. There are several conditions linked to sleep apnea in the military such as asthma, hypertension, type 2 diabetes, and mental health conditions.
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Veterans With Sleep Disorders: Finding A Preferred Provider
You may be wondering why you received a Veterans Choice Card in the mail.
On November 5, 2014 the Department of Military and Veterans affairs began implementation of the Veteran’s Access, Choice, and Accountability Act of 2014. The program’s goals are to help alleviate difficulties veterans have been having in finding adequate and expedient health care.
Problems veterans were experiencing included long wait times to receive care at VA owned medical facilities and difficulty traveling to these health facilities that were far from their home. The Veterans Choice Program allows veterans to find care at non-VA medical facilities as long as they meet certain criteria. To meet the criteria, certain situations must apply to you:
A local VA medical facility tells you that you need to wait more than 30 days from your preferred date or the date medically determined by your physician
Your current residence is more than 40 miles from the closest VA health care facility
You need to travel by plane or boat to the VA medical facility closest to your home
You face an unusual or excessive burden in traveling to a VA medical facility based on the presence of a body of water or a geologic formation that cannot be crossed by road
To find out if you qualify and to schedule an appointment, .
For more information on the Veterans Choice Program, visit here, or check out the video below from the U.S. Department of Veterans Affairs.
How Sleep Apnea Impacts Veterans
Sleep impacts a persons mental, physical, and emotional health. Sleep is required to function. How sleep apnea can impact a veteran differs from person to person however, in some cases, the veteran is unable to work because of the extent of hypersomnia and difficulty to focus. One out of five veterans have obstructive sleep apnea, and the number has been increasing over the years. Bosley & Bratch understands how detrimental sleep apnea can be in a veterans life, we want to help.
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Calculating Multiple Va Disability Ratings
Multiple disability ratings are a little tricky to calculate and are beyond the scope of this article. But well give a brief overview. In short, the VA uses a special method for calculating multiple disabilities.
Here is a simplified example:
Example: If you have a 30% disability rating, the VA would multiply that against 100%, which is assumed to be good health. This gives you 30%. Subtract that from 100% which leaves you with 70% . Then subtract 70% from 100% and you are left with 30%. If that is your only disability, then your final VA Service-Connected Disability Rating is 30%.
If you have multiple ratings, you continue with the process, using your final number each time as your starting point. Continuing with our example, if your next rating is 10%, you would multiply 10% against 70%, which is 7%. You subtract that from 70%, which leaves you with 63%. Subtract 63% from 100% and you get 37%. Your disability rating is 37%, which rounds up to 40%.
It can get complicated quickly, so I have an in-depth article and podcast that explain how the VA calculates combined disability ratings. I highly recommend reading and/or listening to get a good idea of how the process works!
What Are The Types Of Sleep Apnea
There are three main types of sleep apnea.
Chronic snoring is a strong indicator of sleep apnea is worth having your health professional evaluate. Sleep apnea tends to result in sleep deprivation, so you may notice signs such as tiredness during the day, morning headaches, depression, high blood pressure, and ultimately a stroke or heart attack. Sleep apnea can also increase the likelihood of Type 2 diabetes.
With sleep apnea, its normal to wake up in the morning feeling tired despite having a full nights sleep. This can mean feeling fatigued during the day, having difficulty concentrating or even falling asleep unintentionally. Many people with sleep apnea have even reported falling asleep at the wheel of their car. Since people with sleep apnea wake up numerous times throughout the night they are unable to get the rest they need. Many times these people are not conscious that they are waking up.
Sleep apnea can occur at any age, including infants, although the chances of having sleep apnea increase with age.
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In 5 Veterans Has Obstructive Sleep Apnea
Sleep apnea is the recurring interruption of breathing during sleep, which can lead to reduced sleep quality, short-term memory loss, and irritability and is related to serious health concerns such as diabetes and heart disease.
Sleep apnea is especially common among veterans, whose exposure to materials such as dust and fumes, as well as mental anxiety related to combat, make them more likely to develop chronic health conditions. According to the VA, 1 in 5 veterans has obstructive sleep apnea. Iraq veterans who reported mental conditions such as Post Traumatic Stress Disorder were almost 45% more likely than non-combatants to develop sleep apnea.
Within the VA, veterans with sleep apnea are some of the first to receive treatment. Patients with apnea are considered 50% disabled, which puts them in Priority Group 1 for treatment. Sleep apnea is rated so seriously because reduced sleep quality affects virtually all aspects of a veterans waking hours, including concentration, mood, and overall job performance.
Veterans with the condition are entitled to disability compensation of over $800 per month, provided that the condition was documented while they were still serving. The VA spends upwards of $500,000 a year to treat these men and women. Use of a CPAP machine can alleviate nearly all symptoms of the condition.
We perform sleep studies for veterans through the VA in Southern California.
In The Past Va Disability For Sleep Apnea Could Be Awarded Based On A Prescription For A Cpap Machine Alone
How much does va pay for sleep apnea. 100 rating for sleep apnea. In order to qualify for 50 rating the va disability board must see that a cpap machine is required for breathing assistance. Veterans are assigned a 0 30 50 or 100 percent rating depending on the severity of their condition.
Va reconsiders disability ratings for apnea. How much does the va pay for sleep apnea. Believe it or not the va does assign some veterans a 0 va sleep apnea rating.
Beware this pitfall in va sleep apnea claims. This rule is to be published in the april 18 2016 va manual m21 1mr click here to find out what the m21 1mr is. Home sleep what are the va compensation rates for sleep apnea.
The diagnostic criteria for a va sleep apnea claim found in the code of federal regulations have not changed. This means the va found your sleep apnea service connected but not severe enough to receive va disability compensation every month. If your sleep apnea claim is approved you may receive up to 3 350 87 per month.
The most common rating given by the va for sleep apnea eligibility is 50. That is currently the max that the va will pay veterans with sleep apnea if at the 100 rating criteria for sleep apnea. The rating criteria is as follows.
However recently the va disability sleep apnea eligibility criteria rules were rewritten. Your sleep apnea va disability benefits lawyer will never ask for money upfront. Our fee is 20 of back pay and case expenses.
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