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October 15, 2019

Getting a VA Rating for Sleep Apnea

Last updated on March 22, 2021

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 (at over 22%). 

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.

How to Win Your VA Sleep Apnea Claim

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Sleep Apnea and the VA

Sleep apnea is a common condition that can potentially be dangerous if it progresses. Veterans suffering from sleep apnea have their breathing consistently interrupted during sleep, sometimes as many as hundreds of times per night. This can be caused by a blockage of the upper airway caused by soft tissue in the back of the throat (obstructive sleep apnea) or by the lack of signals from the brain reaching the breathing muscles (central sleep apnea). It is also possible to suffer from a combination of the two causes (mixed sleep apnea). 

The effects of sleep apnea can result in persistent tiredness during the day, irritability, depression, morning headaches, high blood pressure and an increased risk of stroke or heart attack. 

In order to receive a disability VA rating for sleep apnea, the VA requires a sleep study to be performed. Even if you have been previously diagnosed with sleep apnea, the VA will likely not accept the diagnosis without the conducted study.

Once diagnosed it is still necessary to prove a connection to your time in service. In order to do this, you must be prepared to show records of an in-service injury, illness or event as well as the medical link between your sleep apnea and the occurrence. This is otherwise known as a NEXUS.

There is also the possibility of a connection to be established on a secondary basis. In these cases, the link must be established between a previously accepted service-connected disability. For instance, PTSD has been shown by current research to aggravate sleep apnea. 

Does Already Using a CPAP Machine Make It Easier to Have My Claim Accepted for a VA Rating for Sleep Apnea?

The short answer is no. Even if you have been diagnosed with sleep apnea and prescribed a Continuous Positive Airway Pressure device (CPAP) by a medical professional, the VA is still going to require a sleep study and proven service-connection in order to accept your claim. 

In fact, it is not unusual for a VA physician to be the prescribing doctor of the CPAP and still the VA will require more evidence in order to receive a disability rating for the sleep apnea. 

I Can’t Afford a CPAP and Need The VA Benefits to Recieve One, How Can I File A Successful Claim?

To receive a CPAP covered by the VA, the benefit rating for a veteran must come in at 50% or higher. Currently, there are 4 ratings that can be assigned for sleep apnea:

  • 0%: A documented breathing disorder during sleep, but considered asymptomatic.
  • 30%: Continuous daytime tiredness or sleepiness which leads to work and social deficiencies
  • 50%: The disorder requires the assistance of a CPAP machine
  • 100%: The disorder is leading to chronic respiratory failure and the retention of Carbon dioxide or cor pulmonale, or requires tracheostomy

The best way to ensure your claim reaches the 50% VA rating for sleep apnea threshold, is essential to gather as much evidence as possible before filing.

There are over 30 medical conditions that can cause or aggravate sleep apnea including TBI (traumatic brain injury), diabetes, heart conditions, PTSD, and nerve issues. It will be extremely helpful to your claim to have the information on which condition is causing your sleep apnea submitted. 

Next, include as much detail and evidence possible about the effect your sleep apnea is having on your daily life. This information is necessary for the VA to best validate the seriousness of your condition and reach an accurate VA rating for sleep apnea.

Finally, make sure to include detailed information about the timing your condition began. The more detailed understanding of the underlying causes of your sleep apnea, the better.

Remember, without the proper evidence to support your sleep apnea began with a service-connected condition, there is little chance of your claim finding success.

It is always important to keep in mind that the less that is left for the VA to make speculation about, the better. 

The VA is dealing with thousands of claims in regards to sleep apnea, making the claims that are more detailed and supplied with more evidence much easier to approve, and approve swiftly. 

What to Expect

The truth is that sleep apnea remains one of the more difficult conditions to get benefits approved for by the VA. This is extremely unfortunate as a very high number of veterans suffer from this potentially dangerous condition.

But as the claims continue to pour in, the VA has begun to slowly change its strict approach to granting benefits to those struggling with sleep apnea.

Regardless, it is still important to take the proper time to present the most comprehensive claim possible in order to ensure your best chance of receiving the help you need. 

If you’re tired of fighting the VA and want the tools to get your sleep apnea claim approved, then click here to get started TODAY.

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About the Author

About VA Claims Insider

VA Claims insider is an education-based coaching/consulting company. We’re 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 (Medical Nexus Letters) for a wide range of disability conditions.

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