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VA Sleep Apnea Claims - Demystifying The VA

VA Sleep Apnea Claims

Sleep apnea is a concern for many veterans, as over half a million are service connected for it, and many more have it and either don’t know or are not service connected. VA sleep apnea claims can be difficult to understand, so we are answering some common questions regarding these claims. 
 

What is sleep apnea? 

The most common form of sleep apnea is OSA, or Obstructive Sleep Apnea. Basically, OSA is when a person stops and restarts breathing in their sleep over and over again. Sleep apnea can make it difficult for a person to feel fully rested, as their sleep is continually disrupted.  

 

Some indications that you may be dealing with sleep apnea are daytime fatigue, brain fog, headaches, and mood alterations; as well loud snoring, gasping for air in your sleep and waking with a dry mouth. 

 

If not treated, sleep apnea can cause some very serious health problems, such as congestive heart failure, arrhythmia, diabetes, and stroke, to name a few.  

 

How do I know if I have sleep apnea? 

The only way to know for certain whether or not you have sleep apnea is to participate in a sleep study. This will require either being referred by your doctor to a sleep clinic or prescribed an at home sleep test. 

 

In today’s world, more and more medical technology can be brought home. But like many at home medical tests, the at home sleep test is not as accurate as a sleep study conducted at a sleep clinic. If you do an at home test and believe the results may be incorrect talk with your doctor about a referral to a sleep clinic.  

 

Once your sleep test has been completed and you are given a diagnosis of sleep apnea your doctor will discuss potential treatment options. If your sleep apnea is mild your doctor may recommend weight loss or other lifestyle changes. If your sleep apnea is more severe you may be prescribed a CPAP machine or dental appliance. 

 

VA ratings for sleep apnea 

The most common ratings for sleep apnea are 30% and 50%. The criteria are as follows: 

 

  • 10% - documented sleep disorder with no evidence of symptoms 

  • 30% - mild sleep apnea with daytime hypersomnolence 

  • 50% - requiring the use of a breathing assistance device (such as a CPAP machine) 

  • 100% - chronic respiratory failure with carbon dioxide retention, or requiring a tracheostomy 

 

If you have been prescribed a CPAP machine you should be rated at 50% for sleep apnea providing you are service connected, diagnosis is key to getting the rating you deserve.  

 

How do I prove my VA claim for sleep apnea 

For any VA disability claim you need three things for connection and rating.  

 

  1. A diagnosed disability resulting from an incident, injury or exposure that occurred on active duty 

  1. Current symptoms and/or current medical evidence 

  1. A nexus that connects number 1 and number 2

 

If you were diagnosed with sleep apnea in service and you are still being treated for it today, you should file a VA claim for service connection.  

 

If you were not diagnosed until after service, you could still connect sleep apnea secondary through another already service connected disability. This is more difficult, but certainly not impossible.  

 

What are some conditions to which sleep apnea can be filed secondary claim? 

 

The conditions that are most likely to connect sleep apnea are respiratory conditions, like asthma. However, the VA cannot grant a rating for more than one respiratory condition. Therefore, the VA will likely grant the condition that is rated the highest and lower the other condition to 0.  

 

Other conditions that sleep apnea is often filed secondary to are as follows: 

  • PTSD 

  • Sinusitis 

  • Rhinitis 

  • GERD 

 

In addition, weight gain and medication can be bridges to sleep apnea from other service connected conditions. A specialist in VA claims can help you determine if this may be a path for your sleep apnea claim.  

 

When filing a sleep apnea claim a letter from your doctor, known as a nexus letter, can be helpful to prove the secondary connection. 


Is it hard to file VA sleep apnea claims for disability 

Sleep apnea can be a difficult claim to service connect if you were not diagnosed while on active duty and if you do not have any other conditions to which you could connect on a secondary basis. However, there are some markers of the disability that could be pointed to in to try to prove you were suffering with sleep apnea while in the military.  

 

For example, if your military buddies often commented on your loud snoring you could reach out to them and ask them write what is known as a buddy letter. A buddy letter, or lay statement, is a signed document attesting to the statement made about a veterans VA disability claim. In addition, visits to sick call for daytime fatigue or issues with sleep can be cited.  

 

What to expect at a C&P exam for sleep apnea 

A C&P exam is a Compensation and Pension examination to verify a condition and its severity. When a veteran submits a disability claim, the VA will often request the veteran attend a C&P exam.  

 

C&P exams are conducted by either a VA doctor or a qualified VA contractor. The examiner should have access to your claim file to review a copy of your sleep study and prescriptions associated with your diagnosis.  

 

The examiner will use a sleep apnea disability benefits questionnaire, or a DBQ, at your exam. This is a check list of sorts that the examiner goes through to provide all the necessary information to the VA in order to rate your claim.  

 

Depending on the unit, CPAP machines can collect data on patient usage, the number of interruptions in sleep, and the amount of air that leaks from the mask. From time to time an examiner will request this data.  

 

The examiner may also inquire about your symptoms and how those symptoms affect your daily life. For this, or any C&P exam, be prepared with information about the frequency, severity, and duration of your symptoms.  

 

Sleep apnea can be a difficult VA disability claim to service connect. Talk to one of our Veteran Benefit Specialists for help with the process. 

 

 

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This information is made available for educational purposes only. This information is not a substitute for legal or medical advice. United Veteran Benefits Agency makes no guarantee of the outcome on VA rating decisions. 

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