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A deviated septum can significantly impact nasal airflow and, in turn, sleep quality.
Medical research suggests a strong link between a deviated septum and the development or aggravation of sleep apnea, making it a viable condition for secondary service connection through the VA.
According to our data, sleep apnea secondary to deviated septum is one of the 10 most common sleep apnea secondary conditions.
In this article from VA disability expert Brian Reese, we’ll explore the connection between a deviated septum and sleep apnea, explore the evidence required for secondary service connection, and review the VA rating criteria for sleep apnea.
Let’s go!
Table of Contents
Summary of Key Points
- Impact of Deviated Septum on Sleep Apnea: A deviated septum can restrict nasal airflow, leading to complications like obstructive sleep apnea (OSA), including airway obstruction, nasal congestion, increased airway resistance, and fragmented sleep.
- Connection Between the Two Conditions: Medical research strongly supports a link between a deviated septum and the development or aggravation of sleep apnea, making it one of the 10 most common secondary conditions for veterans with sleep apnea.
- Evidence Requirements for Secondary VA Claims: Veterans seeking secondary service connection must provide evidence such as a sleep apnea diagnosis confirmed by a sleep study, documentation of a service-connected deviated septum, and medical nexus evidence showing the deviated septum caused or aggravated their sleep apnea. Get a nexus letter from a private healthcare provider!
- VA Disability Ratings for Sleep Apnea: VA disability ratings for sleep apnea range from 0% (non-compensable) to 100% (total disability), with common ratings of 30% (requires CPAP) and 50% (persistent symptoms and functional impairment requiring CPAP).
Can a Deviated Septum Cause or Aggravate Sleep Apnea?
Yes, there is plenty of medical literature and expert opinions to support the connection between a deviated septum and the development of sleep apnea.
A deviated septum occurs when the nasal septum—the wall dividing the nostrils—is displaced or crooked.
This condition can restrict nasal airflow, leading to various complications, including obstructive sleep apnea (OSA).
Here’s why a deviated septum can contribute to or worsen sleep apnea:
- Airway Obstruction: A deviated septum can block one or both nostrils, reducing airflow and forcing mouth breathing, which increases the likelihood of airway collapse during sleep.
- Nasal Congestion: Chronic nasal congestion caused by a deviated septum can worsen apnea episodes, as limited nasal airflow leads to increased reliance on the oral airway.
- Increased Airway Resistance: The altered anatomy in the nasal passages raises resistance to airflow, exacerbating conditions like OSA.
- Snoring and Fragmented Sleep: A deviated septum often causes snoring, disturbed sleep patterns, and reduced oxygen levels, all hallmark signs of sleep apnea.
- Aggravation of Existing Sleep Apnea: For veterans with mild sleep apnea, a deviated septum can worsen symptoms, making the condition more severe and harder to treat.
Veterans with a service-connected deviated septum who later develop sleep apnea may find that this connection supports a claim for secondary service connection.
Evidence Requirements for Secondary Service Connection
Here’s a list of questions the C&P examiner will review along with evidence requirements for VA claims for sleep apnea secondary to deviated septum:
- Does the veteran have a diagnosis of sleep apnea confirmed by a sleep study? If yes, indicate the type of sleep apnea, date of diagnosis, and sleep study results.
- Does the veteran have service-connected deviated septum? If yes, indicate the date of diagnosis and date of service connection.
- Is the veterans’ sleep apnea proximately due to or aggravated by their service-connected deviated septum? If yes, explain your medical opinion and rationale.
- Does the veteran have symptoms of sleep apnea? If yes, indicate the severity in terms of frequency, severity, and duration, along with the current treatment plan to include the need for a breathing device such as a CPAP.
How to Establish Secondary Service Connection for VA Disability Benefits
To establish a secondary service connection, veterans need to provide the VA with two primary pieces of evidence:
- Current Diagnosis of the Secondary Condition: The veteran must have a current diagnosis of the secondary condition, which in this case is sleep apnea. This diagnosis must be documented in a medical record by a qualified medical professional and confirmed by a sleep study.
- Medical Nexus Evidence Between the Two Conditions: The veteran must provide medical evidence that links the secondary condition to the already service-connected condition. Ideally, you submit a Nexus Letter for a secondary condition that explain how the new disability (sleep apnea) is proximately due to or aggravated by the primary service-connected condition (deviated septum).
VA Disability Rating for Sleep Apnea Secondary to Deviated Septum
The VA rates obstructive, central, and mixed sleep apnea secondary to deviated septum from 0% to 100% with breaks at 30% and 50%.
Here’s the current VA disability rating criteria for sleep apnea according to 38 CFR, Part 4, the Schedule for Rating Disabilities, Diagnostic Code (DC) 6847, Sleep Apnea Syndromes:
100% VA Rating for Sleep Apnea
A 100% rating may be assigned if sleep apnea is so severe that it necessitates the use of a CPAP machine or other assisted ventilation devices, and it significantly impacts the individual’s overall health and ability to function. This rating indicates total disability.
50% VA Rating for Sleep Apnea
A 50% rating is assigned when sleep apnea is moderate to severe, persistent, and results in chronic daytime sleepiness and significant impairment of cognitive and social functioning. You require the use of a breathing device such as a CPAP machine. This is the most common VA disability rating for sleep apnea.
30% VA Rating for Sleep Apnea
A 30% rating is typically assigned if sleep apnea requires the use of a CPAP (Continuous Positive Airway Pressure) machine or a similar device for treatment. This rating indicates moderate to severe sleep apnea.
0% VA Rating for Sleep Apnea
A 0% rating is assigned when sleep apnea is diagnosed but does not require the use of a CPAP machine or other breathing assistance devices, and it does not significantly affect daily functioning. This means that there is no associated disability compensation. The 0% rating is non-compensable, meaning a veteran is not eligible to receive compensation.
Example Nexus Letter for Sleep Apnea Secondary to Deviated Septum [Download]
Click the link or button below to download an example nexus letter for sleep apnea caused or aggravated by a veteran’s deviated septum.
Note: This letter is an example only and must be tailored to the facts and circumstances of your case.
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About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
