Va Disability Sleep Apnea Eligibility Criteria


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How Can I Prove My Sleep Apnea Resulted From An In

Sleep Apnea VA Disability Ratings and Benefits | What is the Highest Disability Rating?

Sleep apnea is not considered a presumptive condition for veterans exposed to Agent Orange or ionized radiation, or contaminated water at Camp Lejeune. However, veterans of the Persian Gulf War may be entitled to presumptive service connection for their sleep apnea. Under the VAs regulation concerning Persian Gulf War veterans, 38 § C.F.R. 3.17, sleep apnea falls under sleep disturbances as an undiagnosed illness and medically unexplained chronic multisymptom illness.

Veterans can also prove service connection for sleep apnea by showing that their sleep apnea began in service using service medical records, or by providing a nexus opinion from a medical professional that links their current diagnosis of sleep apnea to signs or symptoms they experienced in service.

Additionally, veterans can service connect their sleep apnea on a secondary basis. Establishing a secondary service connection involves proving that your sleep apnea is a secondary or residual effect of another condition one that does have a direct service connection such as chronic rhinitis, asthma, a deviated septum, or diabetes mellitus type 2.

What Evidence Do I Need With Veteran Disability Benefits For Sleep Apnea Claim

Since sleep apnea can be difficult to diagnose, it is essential that you document symptoms and evidence to submit. This includes having a sleep study done , a buddy letter from your spouse, and medical records from your doctor about your symptoms. Keeping a list of your symptoms and treatments can be beneficial evidence to submit.

In fact, even if you have been previously diagnosed with a form of sleep apnea it is highly likely the VA will ask you to have another study conducted.

Remember, you cannot expect the VA to take you just at your word. Many veterans have submitted claims without providing enough proof, resulting in most sleep apnea claims being rejected . This means that it is key to provide as much evidence as possible, leaving very little room for the VA to speculate about anything.

Sleep apnea has continued to be one of the harder disability claims for veterans to win, meaning you must do your due diligence to get the benefits you deserve for this condition.

While there is a preparation you need to do to get your claim approved, it is worth it!

Although sleep apnea claims have spiked considerably in recent years, especially with veterans of Iraq and Afghanistan, the VA does not consider sleep apnea presumptive to a service connection.

Even though sleep apnea has been a difficult claim for veterans to win in the past, with the right amount of evidence your sleep apnea claim could be an easy win with the right materials.

How Sleep Apnea Could Link To Military Service

There are a number of ways military service can lead to developing Sleep Apnea. It can also happen from routine injuries during the course of performing ones military duties. This can include: broken legs, ankles, back injuries, and the list goes on. The military is a very physically demanding work environment, and sometimes injuries happen.

Sleep Apnea in the workplace injuries can lead to a loss of mobility and activity, which can lead to a person developing risk factors for Sleep Apnea, such as weight gain due to decreased mobility. Its a VA requirement that a veteran demonstrates the disability claim for Sleep Apnea be the result of military service, so its important for the link to be demonstrated as part of the VA disability claim.

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How Does The Va Diagnose Sleep Apnea

Sleep apnea is a difficult condition to diagnosis for a variety of reasons.

For starters, the symptoms for Obstructive Sleep Apnea and Central Sleep Apnea are similar and may overlap.

Therefore, receiving a diagnosis that covers the correct form of sleep apnea is not always apparent at first.

Furthermore, the patient may have Complex Sleep Apnea Syndrome which includes both forms.

Sleep apnea is difficult to diagnose unless you sleep with a partner .

Consequently, the military traditionally orders a sleep study when sleep apnea is suspected.

The sleep study enables medical professionals to study a patient while they are resting to confirm a diagnosis.

A sleep study can serve as medical evidence of a diagnosis.

Moreover, the VA has an expected duty to assist veterans in scheduling the sleep study examination.

Thus, do not be afraid to contact your local veterans clinic or hospital to set up a new examination.

What if you have already been diagnosed with sleep apnea?

The VA will likely still have you undergo a sleep study done by the military to confirm the diagnosis.

Sleep Apnea Va Rating

Highest Va Rating For Sleep Apnea

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.

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C& p Exam For Sleep Apnea And Sleep Studies

The VA will usually order a sleep study to be performed in order to confirm a current diagnosis of sleep apnea. As a part of the VAs duty to assist veterans in obtaining evidence to help prove their claim, the VA has a duty to assist veterans in scheduling the examination for a sleep study and helping them realize the VA disability claim that they are entitled to.

This study will serve as medical evidence for the veterans case and can help to prove the medical condition or medical conditions that go into a total rating.

Getting A Secondary Service Connection For Sleep Apnea

It is possible to establish a connection on a secondary basis. In which case the link must be established between a previously accepted service-connected condition. A couple of conditions sleep apnea has been secondarily rated for are PTSD and asthma, for example. There are quite a few conditions that have been proven to lead to the development of sleep apnea, so this might be a good course for you to choose.

Studies have shown that there is an especially significant link between PTSD and sleep apnea. Many factors overlap in both disorders that can aggravate each other. Some of these may have begun during active duty, such as excessive sleep deprivation, hyperarousal, and chronic stress.

These studies have shown that if PTSD increases in severity, the chances of sleep apnea increase as well. So if you have PTSD, it is recommended that you get screened for sleep apnea.

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How Does The Va Rate Sleep Apnea

Currently the VA assigns the following ratings for veterans based on the severity of their sleep apnea:

  • 0 % – The veterans condition does not produce any symptoms but has a documented sleep disorder. This rating is a non-compensable rating, however, a veteran may be entitled to other benefits, such as VA health care.
  • 30% – The veteran is experiencing hypersomnia, or excessive daytime sleepiness, that does not improve with sufficient sleep or even with naps during the day
  • 50% – The veteran requires the use of a breathing device, such as a CPAP machine.
  • 100% -chronic respiratory failure with carbon dioxide retention, the need for a tracheostomy or the enlargement or failure of the right side of the heart due to lung disease. This is the most severe and the highest rating available.

How Does The Va Currently Rate Sleep Apnea

How to WIN Your Sleep Apnea VA Disability Claim

The VA currently rates sleep apnea at 0%, 30%, 50%, or 100% depending on severity. However, the VA rates sleep apnea needing a CPAP at a minimum of 50%. As a result, this is a high value VA claim. Many veterans rely on sleep apnea to help them achieve an overall 100% rating. However, that means it is also expensive from a VA stand point. These VA disability changes are a way to save a few bucks.

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Va Disability Changes To Sleep Apnea

The Department of Veterans Affairs has proposed a series of changes to the disability compensation program. These VA disability changes would affect veterans in several ways, and it is important that all veterans are aware of them. In this blog post, we will discuss the proposed changes and what they could mean for veterans. We will also provide information on how veterans can voice their opinion on the proposed changes.

The VA wants to modernize the current rating for sleep apnea. This is a politically correct way to say that they want to eliminate the sleep apnea rating. The VA hides this under the veil of modernization. It is nothing more than a way for the VA to refuse to pay veterans benefits. The VA is not considering the real-world implications of these changes.

Tdiu For Sleep Disturbances

Getting a 100 percent schedular rating for sleep conditions can be very difficult to do. Total disability based on individual unemployability provides an alternative avenue for receiving a 100 percent total rating. If you are unable to secure and maintain substantially gainful employment as a result of your service-connected sleep condition, you may be entitled to TDIU.

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To Prove Sleep Apnea You Need Medical Evidence

Only medical evidence can satisfy the eligibility criteria for these ratings. It is not enough for the veteran to say I meet the criteria for a 50% rating. Fortunately, VAs website provides rating tools such as Disability Benefits Questionnaires . Specifically, VA provides a Sleep Apnea DBQ that focuses on the symptoms described in the Schedule. Veterans seeking a higher rating for sleep apnea should have their doctors complete the DBQ. If the criteria for a 100% rating for Sleep Apnea is noted on the DBQ, then VA will likely grant that rating.

A Veterans Case For Sleep Apnea Disability Benefits

Va Compensation For Sleep Apnea

VA recognizes the three types of sleep apnea, all of which may seriously damage a veterans ability to maintain gainful employment and disrupt normal, everyday functions:

  • Obstructive sleep apnea throat muscles relax during sleep, causing partial or complete blockage of the airways. This is the most common form.
  • Central sleep apnea the airway is not blocked instead, the brain fails to transmit the signals that tell the muscles to breathe. This type may be caused by heart disorders, conditions of the cervical spine, obesity, stroke, and
  • Complex, or mixed, sleep apnea a combination of both obstructive and central sleep apnea symptoms.

Apnea means temporary cessation of breathing. Also involved in diagnosis are episodes of hypopnea which is unusually slow or shallow breathing.

For some veterans, the disorder may be very mild, and for others, sleep apnea is a seriously disabling and possibly fatal condition. Victims may continuously stop breathing up to hundreds of times overnight and for various lengths of time per apnea episode. The result is the veterans body and brain suffer a great deficiency of oxygen.

Serious and potentially fatal impairments that may arise secondary to the sleep apnea include stroke, heart disease, insulin resistance, and brain damage.

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Is Sleep Apnea A Disability A Guide For Veterans

Is Sleep Apnea a disability? What are the new VA rules regarding disability claims? How have the rules changed? This article has helpful information about new VA regulations regarding Sleep Apnea as a disability, and also includes a section with information about how PTSD can impact Sleep Apnea. The article also covers how the Social Security Administration views Sleep Apnea disability claims.

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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Is Sleep Apnea A Permanent Va Disability

Generally, sleep apnea is not automatically rated a permanent disability by VA, but if a veteran meets certain qualifications, they may be able to secure lifelong compensation.

For example, if your sleep apnea VA rating has been in place for a certain period of time, VA may assume based on medical evidence that the level of impairment will continue for the rest of your life. It is also generally more difficult for younger veterans to be considered permanently disabled, as VA is allowed to take age into account.

If VA considers your sleep apnea permanent in nature, meaning they are reasonably certain that the condition will continue with zero or close to zero chance of improvement, you will not be scheduled for a re-examination. If this is the case, VA cannot propose a rating reduction.

What To Know Before Filing A Sleep Apnea Claim As A Veteran

How The VA Rates Sleep Apnea for VA Disability

If you are a veteran suffering from any form of sleep apnea as a direct result of your active-duty military service, you may be entitled to compensation from the Department of Veterans Affairs . Understanding whether your sleep apnea qualifies for VA disability benefits and how to get the information needed to prove entitlement to service-connection can be challenging.

For information on what you need to know before filing a sleep apnea claim as a veteran, do not hesitate to contact our firm. Our VA disability attorneys can help you better understand what you could be entitled to for service-connected sleep apnea.

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Where Are These Changes To Va Sleep Apnea Rules

If you have been through the VA disability process before, you probably know that VA decision making seems random with different VA personnel deciding the same types of claims very differently. The process is often filled with delays and errors that could be avoided.

It may surprise you to learn that the VA actually has a series of written policies on how to decide VA disability claims. This huge document is a playbook for VA personnel to use in deciding every type of VA claim.

That playbook is M21-1MR Adjudication Procedures Manual. The M21-1MR is constantly being updated in a piecemeal fashion. One of those most recent updates was the section dealing with the adjudication of VA sleep apnea disability claims.

Hypothyroidism Secondary To Sleep Apnea

Hypothyroidism, or an underactive thyroid, occurs when the thyroid gland does not produce sufficient thyroid hormone. Symptoms can include:

  • Heavy or irregular menstrual cycles
  • Slowed heart rate

Hypothyroidism can cause changes to the upper airway, which can lead to or aggravate sleep apnea. As such, veterans can establish secondary service connection for hypothyroidism relating to sleep apnea.

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Receiving A Secondary Service Connection

In some cases, sleep apnea may be the result of a secondary service connection. To establish a link, the Veteran will need to prove that their sleep apnea was secondary to their direct service connection. Some conditions that are related to sleep apnea are type 2 diabetes, asthma, or chronic rhinitis. Sleep apnea can also result from taking certain medications.

Studies have suggested that those with PTSD are at an increased risk for sleep disorders such as sleep apnea. There is also a link between traumatic brain injuries and sleep apnea.

If a Veteran has an established service connection for PTSD and has a secondary-service connection for sleep apnea, they may qualify for Total Disability Individual Unemployability . If they qualify for TDIU, they can receive a 100 percent disability rating.

How Va Rates Sleep Apnea

Successful Sleep Apnea Va Claims

Once service connection is established, VA will rate sleep apnea under 38 CFR § 4.97, Diagnostic Code 6847 Sleep Apnea Syndromes. Veterans are assigned either a 0, 30, 50, or 100 percent rating depending on the severity of their condition.

  • A non-compensable, 0percent rating indicates the veteran has a diagnosis of sleep apnea, but the condition is asymptomatic.
  • A 30percent rating is awarded when a veteran experiences chronic daytime sleepiness .
  • A 50percent rating tends to be the most common evaluation assigned as it is consistent with the veterans use of a CPAP machine.
  • A total disability rating for sleep apnea requires chronic respiratory failure with carbon dioxide retention or cor pulmonale, or requires tracheostomy.

Importantly, veterans will not receive separate disability ratings for multiple types of sleep conditions. Instead, they will only receive a single combined disability rating for the condition that takes into account all of their symptoms.

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Was Your Va Disability Claim Denied

The veterans benefits attorneys and advocates have decades of experience successfully representing veterans and their families before the Department of Veterans Affairs, the Court of Appeals for Veterans Claims, and the Federal Circuit. If your VA claim has been denied, we may be able to help. Contact us today at 800-544-9144.

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