SKIP TO
CONTENT
Allergic rhinitis is a common condition among veterans, often resulting from exposure to toxic substances such as airborne burn pit toxins and Agent Orange. Many veterans diagnosed with allergic rhinitis may subsequently develop sleep apnea.
When allergic rhinitis triggers or aggravates sleep apnea, the resulting conditions can severely impact productivity, leading to chronic fatigue, difficulty concentrating, and additional challenges that hinder daily tasks and employment outlook.
For this reason, the VA offers disability compensation for sleep apnea secondary to allergic rhinitis. However, veterans must be able to demonstrate a connection between these conditions and military service. For more information on sleep apnea VA ratings—including eligibility, nexus letters, and securing secondary service connection—download our free eBook: VA Disability Ratings for Sleep Apnea: An Essential Guide for U.S. Veterans.
Rhinitis Among US Veterans
Allergic rhinitis impacts approximately 10% to 30% of the adult population in the United States. Rhinitis is even more common among veterans. Nearly 40% of participants in the VA Airborne Hazards and Open Burn Pit Registry reported symptoms of allergic rhinitis.
Rhinitis can originate from various sources: natural environmental allergens such as pollen; common household irritants like dust or animal dander; and exposure to particulate matter, smoke, smog, or chemicals. For veterans, a leading cause of rhinitis is exposure to burn pits commonly used by military operations for waste disposal.
In general, allergic rhinitis refers to an inflammation of the nose and nasal cavity triggered by environmental allergens. Common symptoms of rhinitis include:
- Coughing
- Dry, itchy skin
- Excessive fatigue
- Frequent headaches
- Hives
- Postnasal drainage
- Itchy or watery eyes
- Runny or stuffy nose
- Sneezing
- Sore or scratchy throat
Prolonged exposure to specific allergens or inhaled toxins may cause or aggravate various forms of rhinitis, including seasonal allergic rhinitis, perennial allergic rhinitis, infectious rhinitis, and non-allergic rhinitis.
Treatment options are available for both chronic and non-chronic forms of rhinitis that can significantly reduce or even eliminate symptoms. Medications prescribed may include antihistamines, decongestants, corticosteroids, allergy shots, and sublingual immunotherapy treatments.
Can Rhinitis Cause Sleep Apnea?
Sleep apnea is another common condition among veterans. It is characterized by periodic interruptions in breathing while asleep that can last from seconds to over one minute. The most common type—obstructive sleep apnea (OSA)—occurs when the throat muscles relax to cause airway obstruction.
Obstructive sleep apnea not only causes disrupted sleep and snoring but also diminished oxygen intake, potentially resulting in more severe health issues like heart disease, stroke, diabetes, and hypertension.
Research indicates that allergic rhinitis significantly increases the likelihood of developing OSA. Allergic rhinitis reduces pharyngeal diameter and heightens airway resistance. Nasal passage constriction causes a sleeping person to breathe through their mouth instead of their nose, contributing to the onset of sleep apnea.
Veterans with service-connected allergic rhinitis who subsequently develop sleep apnea may, therefore be, eligible for additional disability benefits via secondary service connection.
Sleep Apnea VA Rating That’s Secondary to Rhinitis
Veterans with service-connected allergic rhinitis who are diagnosed with sleep apnea may qualify for an increased disability rating by claiming sleep apnea secondary to allergic rhinitis.
To qualify for VA benefits for sleep apnea secondary to rhinitis, veterans must establish the following criteria:
- Current service connection for allergic rhinitis.
- A confirmed diagnosis of sleep apnea was obtained through a VA-approved sleep study and other pertinent diagnostic measures.
- A nexus letter for sleep apnea that includes scientific evidence and a medical expert opinion linking the service-connected rhinitis to the development of sleep apnea.
Secondary service connection ratings can substantially impact a veteran’s overall combined disability rating. For example, a veteran with a primary service connection for rhinitis rated at 50 percent and a secondary service connection for sleep apnea rated at 30 percent would be eligible for Total Disability Individual Unemployability (TDIU).
Moreover, veterans who do not meet schedular TDIU criteria may still be considered for extraschedular TDIU if they can demonstrate that their conditions specifically hinder their ability to maintain employment.
Sleep Apnea VA Ratings
Sleep apnea VA ratings are covered under 38 CFR § 4.97, Diagnostic Code 6847 Schedule of Ratings – Sleep Apnea Syndromes. These ratings range from 0% to 100%, depending on symptom severity, frequency, and duration. Most veterans are assigned a 50% rating for obstructive sleep apnea.
Rhinitis VA Ratings
Allergic rhinitis VA ratings are covered under 38 CFR § 4.97 – Schedule of Ratings, Respiratory System, Diagnostic Code (DC) 6522 as follows:
- 30% Rating: Assigned for allergic rhinitis when polyps are present.
- 10% Rating: Assigned for allergic rhinitis without polyps, but with more than a 50 percent nasal passage obstruction on both sides or complete obstruction on one side.
Veterans experiencing unique or severe symptoms related to allergic rhinitis may be eligible for an extraschedular rating under VA regulation 38 CFR § 3.321(b)(1).
Additionally, veterans diagnosed with rhinitis due to particulate matter exposure during military service could qualify for presumptive service connection under the PACT Act. Eligibility criteria for presumptive service connection for allergic rhinitis under the PACT Act include service in the following locations and periods:
- Served on or after August 2, 1990, engaging in active military duties and stationed in (or operating within airspace above) the United Arab Emirates, Saudi Arabia, Somalia, Qatar, Kuwait, Oman, Bahrain, or Iraq.
- Served on or after September 11, 2001, while fulfilling active military duties and stationed in (or operating within airspace above) Syria, Jordan, Lebanon, Egypt, Afghanistan, or Djibouti.
Sleep Apnea Secondary to Rhinitis Nexus Letters
A nexus letter establishing the connection between sleep apnea and rhinitis is indispensable documentation when seeking VA benefits. To substantiate this link to the VA, veterans must present a medical expert opinion or nexus letter that scientifically correlates rhinitis and sleep apnea.
The nexus letter should clarify the relationship between service-connected rhinitis and the onset or exacerbation of sleep apnea through a healthcare provider’s detailed medical rationale and professional assessment. It must clearly state that it is “as likely as not” that the veteran’s sleep apnea was caused or aggravated by their service-connected rhinitis.
Establishing a secondary service connection for sleep apnea due to rhinitis can be challenging. A VA disability lawyer with expertise in secondary service connection claims can assist in obtaining a comprehensive nexus letter, preparing an effective claim, or appealing a denied claim. For more information about VA ratings for sleep apnea—including eligibility, nexus letters related to sleep apnea, and securing secondary-service connections—download our free eBook: VA Disability Ratings for Sleep Apnea: An Essential Guide for U.S. Veterans.