Let’s begin today’s post with the Bottom Line Up Front (BLUF):
It is HARD to get service connected for Sleep Apnea secondary to Depression.
Because the medical research is slim to none on the actual “connection,” if any, between Sleep Apnea and Depression.
For example, the medical research to-date involves small-scale studies (small sample sizes) with limited conclusions regarding the actual relationship between Sleep Apnea and Depression.
One thing we do know for sure: Depression does not “cause” Sleep Apnea.
However, there still might be a path to service connection using VA secondary service connection and principles of “aggravation.”
You’ll also learn about mission critical medical evidence requirements.
Okay, let’s jump-in.
You Might Also Like the Following Blog Posts:
- Top 5 VA Secondary Conditions to Depression
- 40+ Sleep Apnea Secondary Conditions Revealed
- Top 100 VA Disability List of Secondary Conditions
- Top 50 VA Disability Claims Explained
- How to Establish Service Connection for Sleep Apnea Secondary to Depression
- Should I Get a Nexus Letter for Sleep Apnea Secondary to Depression?
- Can I Get VA Compensation for Sleep Apnea Secondary to Anxiety and Depression?
- What is the VA Rating for Sleep Apnea Secondary to Depression and Anxiety?
- Can I Service Connect VA Sleep Apnea Secondary to Obesity?
- How to Prove Sleep Apnea Secondary to Mental Health
- Do I Need a Nexus Letter for Sleep Apnea Secondary to Depression VA Claim?
- Do You Deserve a VA Rating Increase? WE CAN HELP!
- About the Author
How to Establish Service Connection for Sleep Apnea Secondary to Depression
In accordance with 38 CFR § 3.310 disabilities that are “proximately due to,” or “aggravated by,” or the “result of” a service-connected disease or injury shall be service connected.
When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition.
Service connection on a secondary basis requires a showing of causation.
A showing of causation requires that the secondary disability claim be shown to be “proximately due to” or “aggravated by” another service-connected disability.
There are three evidentiary elements that must be satisfied for secondary conditions to Depression to prove service connection under the law:
- A medical diagnosis of the secondary disability condition you’re attempting to link to Depression (in this case, you need a medical diagnosis of Sleep Apnea confirmed by a sleep study) AND
- A current service-connected primary disability (e.g., your current VA Rating for Depression) AND
- Medical nexus evidence establishing a connection between the service-connected Depression and Sleep Apnea
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 veteran’s existing service-connected disability rated at 0 percent or higher, which in this case, is Depression.
The THIRD part, and often the missing link needed to establish secondary service connection, can be satisfied with a credible Medical Nexus Letter (Independent Medical Opinion) from a qualified medical provider.
Veterans This is a MUST READ: Do I Need a Nexus Letter?
Should I Get a Nexus Letter for Sleep Apnea Secondary to Depression?
Yes, you should get a Nexus Letter for Sleep Apnea secondary to Depression to help satisfy the third required element by law for VA secondary service connection.
Did you know you could be missing out on thousands of dollars of tax-free disability benefits you deserve by law, and not even realize that your current VA disability might be caused or aggravated by your service-connected Depression?
Looking for a Nexus Letter to help establish secondary service connection for Sleep Apnea secondary to Depression?
Click HERE now to join VA Claims Insider Elite, our premier education-based membership program, which also gets you discounted access to independent medical providers in our referral network for medical examinations, VA disability evaluations, and Medical Nexus Letters for a wide range of conditions!
Can I Get VA Compensation for Sleep Apnea Secondary to Anxiety and Depression?
Yes, you can get service connected for Sleep Apnea secondary to Anxiety and Depression.
But the way you make it happen is a bit unconventional and requires you to think outside the box.
Depression does not “cause” Sleep Apnea.
However, Sleep Apnea can be “aggravated” by Depression, specifically, with weight gain and obesity as an “interim link” for service connection.
Brian Reese from VA Claims Insider recommends you get a Nexus Letter with high probative value from a private provider to make your argument stronger.
In addition, you should get a DBQ for Sleep Apnea from a private provider and submit it with your Fully Developed Claim (FDC).
This strategy potentially removes a C&P exam from the equation and allows a VA Rater to make a rating decision based on the submitted evidence alone.
What is the VA Rating for Sleep Apnea Secondary to Depression and Anxiety?
VA disability ratings for Sleep Apnea secondary to Depression and Anxiety range from 0 percent to 100 percent with breaks at 30 percent and 50 percent.
- A 0% VA rating for Sleep Apnea is warranted if you’re asymptomatic (no symptoms), but with a documented sleep disorder.
- A 30% VA disability rating for Sleep Apnea is warranted if you have persistent daytime hypersomnolence, but do not require the use of a breathing device.
- A 50% VA rating for Sleep Apnea secondary to Depression is warranted if you require the use of breathing assistance device such as a Continuous Positive Airway Pressure (CPAP) or Bi-level Positive Airway Pressure (BiPAP)
- A 100% VA rating for Sleep Apnea is warranted for chronic respiratory failure with carbon dioxide retention or cor pulmonale or requires tracheostomy.
Sleep Apnea secondary to Depression is rated under diagnostic code 6847, Sleep Apnea Syndromes (Obstructive, Central, Mixed):
|VA Rating Scale for Sleep Apnea Secondary to Depression||VA Rating|
|Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or requires tracheostomy||100%|
|Requires use of breathing assistance device such as a CPAP machine||50%|
|Persistent daytime hypersomnolence||30%|
|Asymptomatic but with documented sleep disorder breathing||0%|
Can I Service Connect VA Sleep Apnea Secondary to Obesity?
Yes, you can service connect VA Sleep Apnea secondary to Obesity.
Sleep Apnea can be service connected secondary to any ratable Mental Health condition, but usually only with “Weight Gain / Obesity as an Intermediate Step.”
Thus, if the veteran is not overweight or obese, this option won’t work.
Obesity as an intermediate step for secondary service connection is only reasonably raised when there is evidence in the record that draws an association or suggests a relationship between the veteran’s current obesity or weight gain resulting in obesity, and service connected disability.
Incidental references to a veteran’s weight or weight gain are not sufficient to reasonably raise the issue.
Obesity per se is not a “disability” for the purposes of SC under 38 CFR 3.310 for secondary service connection.
However, obesity may be an “intermediate step” between a service connected disability (e.g., Depression) and a current disability (e.g., Sleep Apnea) that may be service connected on a secondary basis under 38 CFR 3.310(a) or on the basis of aggravation under 38 CFR 3.310(b).
How to Prove Sleep Apnea Secondary to Mental Health
To determine whether obesity is an intermediate step between a service connected disability and the development of a current disability that may be service connected on a secondary basis, including by aggravation, the following criteria must all be satisfied:
- The service connected disability (e.g., Depression) must have caused the veteran to become obese
- The obesity, as a result of the service connected disability, must have been a substantial factor in causing the claimed disability, OR
- Aggravating the claimed disability, AND
- The claimed disability would not have occurred but for the obesity caused or aggravated by the service connected disability.
Okay, let’s recap in simple terms:
A Nexus Letter will be needed to connect the veteran’s weight gain and obesity to their service connected disability, such as Depression or Anxiety.
The Nexus Letter for Sleep Apnea must clearly define:
- Why/How the service connected mental health disability caused the veteran to become overweight and/or obese.
- Why/How the weight gain and/or obesity, as a result of the service connected mental health disability, was a substantial factor in causing the Sleep Apnea, typically Obstructive Sleep Apnea.
- Why/How Sleep Apnea would not have occurred if not for the weight gain and/or obesity caused by the current service connected mental health disability.
We have seen a handful of these types of claims approved, however, they are rare to win on your first claim, and usually are only approved via a Higher Level Review, Supplemental Claim, or BVA decision.
In our experience helping over 20,000 veterans since 2016, we recommend attempting to connect Sleep Apnea secondary to a respiratory condition, such as Sinusitis, Rhinitis, or Asthma.
Do I Need a Nexus Letter for Sleep Apnea Secondary to Depression VA Claim?
Yes, you’ll need a Nexus Letter to service connect Sleep Apnea secondary to Depression.
Veterans who become members of the VA Claims Insider Elite program get access to a network of independent medical providers who can write a Nexus Letter for Sleep Apnea Secondary to Depression, usually with weight gain and/or obesity as an “interim link” for service connection.
Our advice is to be weary of private providers charging $2,000 or more for a Nexus Letter for Sleep Apnea Secondary to Depression—especially those who suggest the two conditions are medically connected—they aren’t.
Do You Deserve a VA Rating Increase? WE CAN HELP!
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About the Author
Founder & CEO
Brian Reese is a VA benefits expert, author of the #1 Amazon Bestseller You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned, and founder of VA Claims Insider – “The Most Trusted Name in Education-Based Resources for Veterans.”
His frustration with the 8-step VA disability claims process led him to create “VA Claims Insider,” which provides U.S. military veterans with tips, strategies, and lessons learned for successfully submitting or re-submitting a winning VA disability compensation claim.
Brian is also the CEO of Military Disability Made Easy, which is the world’s largest free searchable database for all things related to DoD disability and VA disability claims and has served more than 4,600,000 military members and veterans since its founding in 2013.
His eBook, the “9 Secrets Strategies for Winning Your VA Disability Claim” has been downloaded more than 300,000 times in the past three years and is the #1 rated free VA disability claims guide for veterans.
He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).