Tdiu Benefits For Sleep Apnea
Certain symptoms of sleep apnea, such as excessive daytime sleepiness, fatigue, and difficulty concentrating, may impact a veterans ability to work. If you are unable to find and maintain substantially gainful employment due to your service-connected sleep apnea, you may be entitled to total disability based on individual unemployability .
Veterans can qualify for TDIU under 38 CFR § 4.16, provided they meet the following schedular requirements:
- A veteran must have one service-connected disability rated at 60 percent disabling or higher or
- More than one service-connected disability, with one disability rated at least 40 percent, and a combined rating of 70 percent or higher.
How Common Is Sleep Apnea
The American Sleep Apnea Association estimates that around 22 million individuals in the U.S. experience problems with sleep apnea a large portion of them living undiagnosed. In 2017, the Veterans Benefits Administration reported that the VA awarded 282,323 service-connected sleep apnea ratings. Many veterans are affected by sleep apnea as a result of mental health problems or physical injuries. Whether it be CSA, OSA, or complex sleep apnea, Veterans who developed some form of debilitating sleep apnea during their time in the military are entitled to compensation.
Mental Health Conditions Secondary To Sleep Apnea
Like PTSD, other conditions rated as mental health conditions can be related to sleep apnea. Specifically, both anxiety and depression can be linked to sleep apnea.
Anxiety and depression can interfere with a persons sleep patterns, as well as cause symptoms of hyperarousal or hypervigilance. As such, a veteran with anxiety and depression faces a higher risk of sleep apnea.
If a veteran is service-connected for anxiety or depression, they may be able to receive secondary service connection for their sleep apnea. Veterans may also receive secondary service connection for anxiety and depression if they are already service-connected for sleep apnea.
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Sleep Apnea And Ptsd: A Match Made In Hell
One of the complications of having both PTSD and sleep apnea a match made in hell is that it makes adherence to CPAP therapy difficult. Weve heard from plenty of veterans with PTSD that they find it hard to get consistent rest using the cumbersome, claustrophobia-inducing breathing machine.
The rate of CPAP adherence among veterans without PTSD is 70%. That number drops to just 50% for veterans with PTSD. The most common reasons veterans with PTSD gave for not using their CPAP machine were discomfort, nightmares/night terrors, and claustrophobia.
Veterans with other psychiatric conditions, such as anxiety and depression, also struggle with CPAP adherence for similar reasons to the ones weve described above.
Making matters worse, in June of 2021, Philips recalled millions of their CPAP machines because the sound reduction foam has been linked to respiratory illnesses and cancer.
Want More Help With Your Sleep Apnea Va Claim
At VA Claims Insider, we can help you win your claim and get the highest VA rating for sleep apnea.
At VA Claims Insider, we help veterans understand and take control of the claims process so they can get the rating and compensation theyre owed by law. Our process takes the guesswork out of filing a VA disability claim and supports you every step of the way in building a fully-developed claim .
If youve filed your VA disability claim and have been denied or have received a low rating, or youre not sure how to get started, reach out to us for a FREE VA Claim Discovery Callso you can FINALLY get the disability rating and compensation you deserve. Weve supported more than 15,000 veterans to win their claims. NOW ITS YOUR TURN.
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Sleep Apnea And Military Service Connections
The key in getting a VA disability rating for sleep apnea involves establishing military service caused the problem.
But in cases where you may not be able to establish a direct link between military service and the condition, it may be possible it is due to effects of a different service-connected medical issue.
For example, PTSD is said to aggravate sleep disorders or introduce them veterans suffering from Gulf War Syndrome or other Gulf War-related conditions may also suffer from sleep apnea as a result.
How do you establish that sleep apnea is service-connected? If the first appearance of the problem occurs in your military medical records as opposed to being a preexisting condition, that may be a step toward a VA disability rating.
Any military member experiencing sleep disorders should, in anticipation of needing this data at a later date, request a sleep study to be done in a military medical facility where possible to establish whether there is a service connection to the sleep issues.
You can also see a civilian medical provider to get supporting documentation of a service-connection for sleep apnea. The key will be having as much of the issue medically documented while still continuing to serve, as possible, and getting supporting medical opinions in addition to whatever treatment or study of your sleep issues happens while you are still serving.
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How Do Proposed Va Disability Changes Affect My Claim
Your VA claims are about to get much more difficult. If successful, the VA will have successfully eliminated a large portion of many veterans disability claims. The proposed VA disability changes to the process are not being done to help you. They are being done so the VA can save money.
The VA claims they do not intend to reduce any current ratings. However, that is not completely accurate. The VA buried the truth inside the proposal. They admit that the new regulations apply to all veterans going forward. As a result, the VA will reevaluate veterans with a current sleep apnea rating under the new regulations anytime they file for an increase or additional claim.
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How Do Sleep Apnea Benefits Work
If you are a veteran diagnosed with sleep apnea, you may be eligible for the Veterans Disability. The VA benefits can help cover the costs of treatment and equipment.
If your sleep disorder causes difficulties in your daily life and work, this could be an ideal option. Read on to learn more about how these benefits work and what they entail!
Introduction To Sleep Apnea Va Claims
Sleep apnea is a common but serious condition that affects millions of Americans, but veterans disability filings show us that it impacts veterans at a higher rate and that theyre diagnosed at a higher rate than the general population.
Over the past decade, the VA has seen a spike in claims for sleep apnea and as a result, theres a greater awareness of this condition. If youve been diagnosed with sleep apnea, you may be entitled to veterans disability benefits. If the condition developed while you were in active service or was aggravated by your service, then you may have a path called direct service connection.
Sleep apnea impacts your ability to sleep, which impacts everything that comes after that your ability to function and your ability to work. As such, if determined to be service-connected, sleep apnea can be an important part of your path to Total Disability Individual Unemployability benefits.
Sleep apnea can cause you to stop breathing or your breathing becomes interrupted during the course of the night. Symptoms include snoring, choking, often breathing pauses for extended periods.
If you think that you may suffer from sleep apnea, for VA rating purposes, its really important that you go to a medical professional and you get a documented diagnosis by having a sleep study conducted. Without this diagnosis in writing it can be difficult to connect the condition to your time in service.
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Is There A Va Disability Compensation Form To File A Claim For Sleep Apnea Benefits
The answer is yes, but youll need to be prepared to take the initiative. You can download the form from the VA website or find it at most VA offices. If you prefer to fill it out online, theres an option on their website.
Once you have completed all necessary supporting documents are included. Also, keep in mind that if your claim requires further review by one of our staff members before being approved or denied, we may request additional information such as other diagnostic tests explicitly related to sleep apnea treatment options specific to each case being reviewed.
Was Your Sleep Apnea Va Claim Denied
If VA denied you VA disability for sleep apnea, there are still options for appealing the decision. The accredited claims agents and attorneys at Chisholm Chisholm & Kilpatrick may be able to help you secure the benefits you deserve. We have decades of experience representing veterans before VA, the Board of Veterans Appeals, and the Court of Appeals for Veterans Claims .
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Sleep Apnea Va Rating
As with most disabilities, the VA rating for sleep apnea depends on your particular situation. The military provides an extremely physically demanding environment that can lead to many conditions associated with sleep apnea, ranging from post traumatic stress disorder to various injuries that limit mobility, plus exposure to a wide variety of dust and fumes. Some indications are that one in five U.S. veterans has sleep apnea, and in one study, veterans of combat in Iraq were more than 45% more likely than non-combatants to develop sleep apnea.
Before considering your VA claim for a sleep apnea disability rating, the VA will insist that you provide the results of a sleep study, which can help define the severity of your condition. You can choose to undergo a polysomnogram that measures brain activity, blood pressure, eye movements, blood oxygen levels, heart rate, snoring, and chest movements throughout the night as you sleep. This type of sleep study typically takes place at a medical facility or specialized sleep lab.
You can choose to sleep with a home-based monitor that records much of the same information while allowing you to sleep in your own bed at home. Depending on the results of the home test, a sleep specialist may advise that you follow up with a more formal sleep study as part of your VA claim.
Obtaining Service Connection For Insomnia
When seeking service connection for insomnia, veterans should know that there must be an actual diagnosis of insomnia in the first place .
If youre interested in filing a VA disability claim, you will need to prove that your condition is connected to your time in military service. To successfully establish a service connection, youll need to include the following three elements in your claim:
There are a number of events that can lead to insomnia, including the loss of a fellow service member during combat or a sudden attack during a standard convoy mission. Please note that the in-service occurrence or incident does not necessarily need to have taken place while the veteran is officially on active duty. In other words, the VA does not consider whether you were on base or not when rating your disability.
Events that result in insomnia can be difficult to pinpoint, especially because years have often passed before the veteran experiences symptoms. A veteran may have discussed their sleep issues with a doctor for an extended period of time before discovering the root cause of the problem.
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Factors That Influence Sleep Apnea Disability Claims
In summary, you need to prove the following three factors to receive a disability rating for sleep apnea:
An in-service diagnosis of sleep apnea is the clearest path toward approval for VA disability.
However, most service members do not receive a diagnosis while in the military which makes proving that sleep apnea is service-connected much more difficult.
As a result, scheduling a sleep study through a certified clinic is the best means to getting an indisputable diagnosis.
Veterans And Sleep Apnea
Sleep Apnea is a potentially serious sleep disorder in which a persons breathing is repeatedly interrupted, or ceases, during the course of a nights sleep. These sleep disturbances can occur from tens to hundreds of times per night.
Typically, sleep apnea symptoms are at their worst during REM Sleep due to the bodys naturally-occurring reduced muscle tone in the bodys airway. REM sleep is also sometimes known as deep sleep. The causes of these disturbances may vary depending on which form of the condition you have: obstructive, central, or a mixed form of both.
This sleep-disordered breathing leads to poor sleep quality and is a risk factor for the poor quality of life.
Obstructive sleep apnea is one of the more common types of sleep apnea, which occurs when the upper airway repeatedly becomes blocked throughout the night. This blockage is caused when the back throat muscles relax, impairing the airflow.
Central sleep apnea occurs when the brain either does not send signals to the muscles that control breathing or those signals are interrupted. The VA refers to mixed sleep apnea as a combination of the obstructive and central forms of the condition.
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Va Proposes Changes To Sleep Apnea Ratings
Under the current rating schedule, VA issues ratings at 0, 30, 50, 100 percent for sleep apnea even if treatments are somewhat effective in dealing with the condition.
However, in February 2022, VA proposed changes that would reclassify sleep apnea ratings to 0 percent, 10 percent, 30 percent, or 50 percent, with 100 percent for sleep apnea seeming even harder to qualify for.
Asymptomatic sleep apnea would not be compensated under the tentative regulation. If treatment for sleep apnea provides only limited alleviation, you will only receive ten percent of your maximum compensation, even if a CPAP machine is required.
A 50% rating would be given if treatment was ineffective or you were unable to use therapies due to another condition. Finally, a 100% rating is available when sleep apnea is so severe that it involves organ damage.
So if this proposed change for sleep apnea ratings goes through, its possible that veterans may start getting lowballed ratings. For now, these ratings are merely a proposal so stay tuned to this page while we update.
Get Help With Your Va Sleep Apnea Rating
Think you need help with your sleep apnea disability claim? Havent applied and want assistance? Were you denied a VA sleep apnea rating and want to appeal? Just not sure what to do next? Give Woods & Woods a call.
Since 1985, we have successfully represented thousands of veterans and their families. We offer free legal consultations and free help filing your application. Our lawyers only charge if you hire us for an appeal and we win. Our law firm is here to answer any questions you have and make a recommendation for your claim. If you need help, reach out to us about your VA disability sleep apnea rating.
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Va Reconsiders Disability Ratings For Apnea
VA Looks to Tighten Sleep Apnea Rating Schedule
The Department of Veterans Affairs is studying changes to disability ratings for obstructive sleep apnea, particularly the 50-percent rating being awarded when VA physicians prescribe use of a CPAP, or continuous positive airway pressure machine, for sleep-deprived veterans.
“That’s definitely going to be the one they look at,” said Jonathan Hughes, a policy consultant for VA’s compensation service. “Because essentially there’s no functional impairment related to that” 50-percent rating for obstructive sleep apnea under the Veterans Affairs Schedule for Rating Disabilities .
The good news for more than 114,000 veterans already drawing compensation for sleep apnea is their ratings would not be reduced with broad change to the rating schedule, Hughes explained. Current law prohibits that. Indeed, claimants still awaiting favorable decisions might not be impacted either because VASRD changes don’t happen quickly.
The only date Hughes could quote with certainty is that an ongoing effort to modernize the entire VASRD is to be completed by January 2016.
When interviewed Tuesday at VA headquarters in Washington D.C., Hughes had just delivered a briefing on sleep apnea at a public hearing of VA Advisory Committee on Disability Compensation. The panel, established in 2010, counsels the VA secretary on maintaining or readjusting the VASRD.
Weight remains the most common cause of sleep apnea, Hughes said, even when diagnosed in service.
The Va Sleep Apnea Eligibility Criteria:
- 100%: Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or requires tracheostomy
- 50%: Requires use of breathing assistance device such as continuous airway pressure machine
- 30%: Persistent day-time hypersomnolence and
- 0%: Asymptomatic but with documented sleep disorder breathing.
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Sinusitis Secondary To Sleep Apnea
Sinusitis is a condition where a persons sinuses become swollen and inflamed for three months or longer, despite treatment. Symptoms of sinusitis often include:
- Nasal inflammation
Tinnitus is one of the most frequently claimed conditions for service connection. This is likely due to a variety of factors related to service, such as exposure to noise, possibility of traumatic brain injury, and exposure to explosive devices like IEDs.
Research has found that veterans who have chronic tinnitus also prevalently experience sleep apnea. As such, veterans who are service connected for tinnitus may be eligible for secondary service connection for sleep apnea, and vice-versa.
Other Conditions Linked Sleep Apnea
There are many conditions that have been linked to sleep apnea that veterans can receive benefits for through secondary service connection. Some of the following conditions can be secondary to sleep apnea, while others may be the primary condition to which sleep apnea is secondary.
- Allergic Rhinitis