Conduct A Sleep Apnea Gap Analysis To Include Medical Research And Case Law Precedent
In this step, youll want to conduct a gap analysis of your VA Sleep Apnea disability, to include the approximate timeframe that your symptoms began.
If you have your Service Treatment Records, go through them in detail, and look for any complaints or symptoms related to Sleep Apnea.
If you did have a Sleep Study on active duty, and you have a diagnosis in your Service Treatment Records, make sure to annotate this in your Lay Statement for Sleep Apnea.
In our experience, however, most Veterans didnt do a Sleep Study during the military, which is critical to note prior to moving onto Step #4.
The final part of Step #3 is to conduct some Google Searches of medical research and BVA case law decisions for your VA Sleep Apnea claim.
If youd like to save some time and effort in your research, you can download my FREE eBook, which includes medical research studies and BVA cases for Sleep Apnea:
Youll learn 3 critical things about service connection for Sleep Apnea:
- HOW to get your Sleep Apnea VA claim service connected
- DISCOVER 50+ conditions linked to Sleep Apnea and WHY the word aggravated may be key for you!
- BONUS! FREE video explains how to WIN, and SERVICE CONNECT Sleep Apnea in LESS TIME!
Family And Medical History
At the appointment, a doctor will ask questions about your quality of sleep and how you function during the day. They will also want to know how often you make choking or gasping sounds while sleeping, and how often and loudly you snore.
Tell the doctor if anyone in your family has symptoms of sleep apnea or if they have been diagnosed with the condition.
Is Sleep Apnea A Disability
The Social Security Administration no longer has a disability listing for sleep apnea, but it does have listings for breathing disorders, heart problems, and mental deficits. If you meet the criteria of one of the listings due to your sleep apnea, you would automatically qualify for disability benefits.
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Supporting Evidence For Sleep Disorder Claims
A former servicemember would need to show that they have a current diagnosis of a sleeping disorder, whether sleep apnea, insomnia, or some other sleep disturbance diagnosis, in order to qualify for disability benefits. They should include medical records and doctors notes with any sleep disorder claims to establish the severity of their condition.
It is also necessary to prove entitlement to service connection, which means establishing a relationship between a veterans sleep disorder and his or her active duty service. Service records from an applicants time on active duty may indicate an incident which caused or contributed to their disorder or any documented symptoms of sleep irregularity.
Lay statements from a veteran, spouse, or anyone else who can attest to nighttime symptoms which began on active duty can be very helpful in proving entitlement to service connection for sleep disorder claims. It is better for veterans to be over-prepared when it comes to gathering evidence, which can be made easier with the advice of an attorney from our firm.
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How Does The Va Evaluate Sleep Apnea
The VA evaluates sleep apnea under 38 C.F.R. § 4.97-13, Code 6847 as Sleep Apnea Syndromes . The lowest possible rating, 0 percent, does not qualify you for any monthly compensation, but it makes you eligible for other benefits, such as healthcare. The highest rating, 100 percent, signifies total disability and makes you eligible for the highest schedular amount of monthly compensation.
Per 38 C.F.R. § 4.97-13, Code 6847, the ratings for obstructive, central, or mixed sleep apnea are as follows:
- 100 percent rating for chronic respiratory failure with carbon dioxide retention or cor pulmonare, or requires tracheostomy.
- 50 percent rating requires the use of a breathing assistance device such as a CPAP machine.
- 30 percent rating requires persistent day-time hypersomnolence.
- 0 percent rating for asymptomatic sleep apnea with documented sleep disorder breathing.
As of December 1st, 2021 the VA disability rate benefit amounts are as follows:
- 30 percent disability rating: $467.39 per month
- 50 percent disability rating: $958.44 per month
- 100 percent disability rating: $3,332.06 per month
A rating of at least 30 percent or higher qualifies you for additional compensation if you have a spouse, dependent children, or dependent parents living in your home.
What Causes Sleep Apnea
Veterans are at an increased risk of developing sleep apnea due to various risk factors like weight gain leading to obesity, hypertension, and/or high blood pressure. Additionally, smoking, substance abuse, and alcohol abuse may contribute to sleep apnea. OSA is also commonly seen as a secondary condition in veterans who have PTSD .
In fact, a recent study found that almost 60% of veterans with PTSD also suffer from sleep apnea. This is because people with PTSD often deal with chronic stress have problems relaxing and getting a full nights sleep. Now, were not saying every veteran with PTSD will develop sleep apnea but its worth being aware!
This is just one example of how having a mental health condition like PTSD can impact your health. If you are a veteran who has been diagnosed with sleep apnea and you also have PTSD, then read on to learn more about VA disability benefits for both.
If you have depression or anxiety, you may also be at higher risk of sleep disordered breathing the good news is that if you can prove a service connected condition then you may qualify for disability compensation.
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Common Types Of Sleep Apnea
There are three common forms of sleep apnea that are seen in veterans. The first is obstructive sleep apnea , which occurs when your airway collapses during sleep and you stop breathing for a short time due to your throat muscles relaxing too much. During this time, your body re-opens the airway by waking up just enough to take in a breath.
Many people with this type of sleep apnea do not even realize they have it until someone else tells them. Many veterans known as loud snorers by their buddies think they are sleeping well but in reality, they are only getting short spurts of disturbed sleep throughout the night and are experiencing sleep deprivation due to the veterans sleep apnea.
The second type is central sleep apnea, which occurs when your brain does not send signals to your muscles to breathe during sleep. This can happen due to a problem with your nervous system. The third type is mixed sleep apnea, which occurs when you have both obstructive and central sleep apnea.
Medical research shows that due to obstructive sleep apnea we see decreased quality of REM sleep this can lead to many other medical problems like PTSD.
Lesson #: Sleep Apnea Is A Killer
There are 3 things that the human body cannot live or function without: Blood/Oxygen, Food/Water and Sleep.
You can lose a kidney, and live a full and complete life. You can lose your arms and legs and still survive.
But if your body cannot get sleep, you will die. In fact, sleep deprivation is a common form of torture, as many of us know all too well.
Thats what Sleep Apnea does while you are sleeping, you stop breathing.
You cut off oxygen to the brain and blood, and other body systems break down.
If you are lucky, you start breathing again.
Not a lot of VSOs or advocates get this when helping a Veteran file a VA Claim.
They think of Sleep Apnea as a disease of the obese, and then they tell them one of the big Fairy Tales about VA Claims.
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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.
Could My Other Health Problems Be From Sleep Apnea
Yes! Any medical condition that is caused by your sleep apnea could be service-connected. If you are a veteran and you have a medical condition caused by sleep apnea, that condition could be considered secondary service-connected. Veterans with secondary service-connected impairments are eligible for VA disability benefits.
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What Cpap Machine Does The Va Use For 50% Rating
Importantly, the 50% rating requires a breathing assistance device. There are various devices that VA allows in order for a veteran to get a 50% rating.
First, it is helpful to know the history behind the 50% rating.
In the past, all an eligible veteran needed for a 50% rating was to submit medical proof of a diagnosis of sleep apnea.
Things changed on April 18, 2016, when VA issued a new rule that a breathing assistance device is medically required to earn the 50% rating. This supports the severity of the disability for rating purposes, and supporting documentation should be submitted by a qualified physician. As you will see, the physicians opinion stating that the breathing device is medically required is very important.
The exact wording for the 50% rating is Requires use of breathing assistance device such as continuous airway pressure machine.
Clearly, a CPAP apparatus is just one of several acceptable breathing assistance devices for a veterans rating and subsequent treatment of sleep apnea. Each claim and individual is unique. But initially, VA raters were inclined to favor CPAP machines and not give much weight to other breathing assistance devices as viable options for the disabled veteran.
VA has now updated its adjudicators manualthe M21-1 Adjudication Procedures Manualwith more specifics for the raters to mutually adhere to. These updates include details about
- Sleep Studies
Of great importance to your sleep apnea VA claim is the following requirement:
What If I Have More Questions About My Va Claim
I understand you want your VA claim to be done as quickly as possible. But remember the ultimate goal to win your VA disability compensation claim.
You may eventually get there on your own, but it may be after a series of decisions by the Regional Office and Board of Veterans Appeals. Sometimes claims are appealed and remanded several times, which can cause a claim to drag on for years. If you are interested in avoiding unnecessary delay in your claim and want to do everything you can to maximize your chances of success, it is probably a good idea for you to consult with an accredited veterans disability attorney.
Travis Studdard is an attorney who focuses on representing veterans in VA disability compensation claims. He regularly writes about issues that are important to veterans and their families.
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Getting A Combined Disability Rating
If you have more than one disability connected to your service, you will receive a combined rating. The VA uses the Combined Ratings Table to calculate a combined rating for veterans with multiple service-connected disabilities.
Disability ratings are not added to each other. Instead, the VA uses the rating table to determine a combined rating. This involves listing each disability in order of severity and then using the chart to find a combined rating.
For example, assume that you have already received a rating of 60% for your service-connected asthma. You are then given a 20% disability rating for your sleep apnea. Based on the chart, the combined rating would be 68% this rating is then rounded to the nearest 10, giving you a combined disability rating of 70%.
Applying for veterans disability benefits to include a disability that was obtained on a secondary basis can be complicated. A seasoned New Jersey veterans disability benefits attorney can help you with the process, from filing the paperwork to gathering evidence in support of your claim.
Top 3 Ways To Prove Service Connection For Sleep Apnea
While trying to prove service connection for Sleep Apnea might seem as elusive as a four-leaf clover, in todays post, Im sharing an expert level technique that can help you get your VA sleep apnea service connected, regardless of past denials.
Its called the Most Likely Cause Technique for your VA Sleep Apnea claim, and it works like magic.
The MLC Technique relies on you to map-out the most likely causation factors of your Sleep Apnea in a simple, 6-step process.
Its kind of like the choose your own adventure books you may have read as a kid.
So, strap-in, and lets start our journey to learn how to service connect your VA Sleep Apnea claim.
You may also be interested in the following Blog posts about Sleep Apnea VA Claims:
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Get A New Sleep Study
Truth bomb: Just because you snore doesnt mean you have Sleep Apnea.
Its certainly a marker though.
Some other common symptoms of Sleep Apnea include: Trouble staying asleep at night , episodes where you stop breathing , daytime sleepiness , morning headaches, dry mouth, difficulty concentrating, and anger .
If you have any of these signs and symptoms, you should consider doing a Sleep Study, which is also known as a Polysomnography.
Even if youve had a Sleep Study before, we recommend having a current one on-file, which will confirm a medical diagnosis and current symptoms, especially if theyve become more severe over time.
A Sleep Study is THE ONLY WAY to confirm whether you meet the clinical diagnostic criteria for Sleep Apnea.
The Polysomnography study records your brain waves, the oxygen level in your blood, heart rate and breathing, and eye and leg movements, among others.
So, now you might be wondering, how do Veterans get a Sleep Study?
There are 3 primary ways for Veterans to get a Sleep Study:
- The first way is to discuss your sleep issues with your VA primary care doctor and ask for a referral to a sleep specialist at the VA.
- The second way is to ask your private doctor for a referral to a sleep specialist in your area .
- The third, and easiest way, is to order a Sleep Apnea At-Home Test Kit, although itll cost you a couple hundred dollars or more .
Linked Sleep Apnea And Ptsd Symptoms
Research has shown that combat veterans with post-traumatic stress disorder, also known as PTSD, may be at higher risk for sleep apnea than the general population. There are risk factors that overlap in both disorders affecting sleep apnea and symptoms of PTSD, often times aggravating the conditions. Some of these factors are issues that military personnel may have frequently experienced while deployed overseas in active duty or other combat-related duties, such as disturbed sleep in combat, excessive sleep deprivation, sleep fragmentation, hyperarousal, and chronic stress.
Although all of these symptoms contribute to the interaction between sleep apnea and PTSD, the main culprits seem to be sleep deprivation and chronic stress. Studies have shown that war veterans exhibiting these symptoms tend to have increased frequency and length of apneic events.
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How To Prove Service Connection For Sleep Apnea: The 6
- Step #1: Get a NEW Sleep Study
- Step #2: Confirm a medical diagnosis of Sleep Apnea with a sleep specialist
- Step #3: Conduct a Sleep Apnea Gap Analysis to include medical research and case law precedent
- Step #4: Determine Direct Service Connection vs. Secondary Service Connection
- Step #5: Obtain a Nexus Letter for Sleep Apnea
- Step #6: Get at least one VA Buddy Letter for Sleep Apnea
Types Of Sleep Disordersand Their Symptoms
Sleep disorders can be caused by blunt trauma to the head or psychological and mental disorders. Sometimes they can also be caused by physical disabilities. Types of sleep disorders include:
- Insomnia: Sufferers have trouble falling asleep or staying asleep for more than a few hours. This can lead to drowsiness, irritability and a depressed mood.
- Obstructive Sleep Apnea: This condition causes breathing to stop during sleep, either for a few seconds or several minutes. Sleep apnea causes fatigue, slow reflexes and eventually can impact the heartleading to heart problems such as arrhythmia and cardiac arrest.
- Narcolepsy: Those suffering from this condition are extremely fatigued during daytime hours, no matter how many hours they slept the night before. This disorder causes abrupt daytime unconsciousness and cataplexy, an episodic loss of muscle function ranging from sagging facial muscles to physical collapse.
- Daytime somnolence or excessive daytime sleepiness : This condition is linked to each of the disorders listed above, but can be diagnosed on its own. Persons with EDS feel very drowsy during the day and often feel compelled to take naps at inappropriate times.
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