Veterans Disability Info Blog

Unveiling the Truth: Your Sleep Apnea VA Rating FAQs Answered by a Seasoned Lawyer

Sleep apnea is a sleep disorder in which there are frequent episodes during which an individual’s breathing stops and starts again while they are sleeping. These disturbances result in poor-quality sleep and reduced oxygen flow to the brain, in turn leading to symptoms that can impact their day-to-day lives and ability to work. Persons with sleep apnea often do not realize that they have the condition, as the sleep disturbances may not be sufficient to cause them to fully awaken. 

Symptoms of sleep apnea include:

  • Loud snoring
  • Gasping for air while sleeping can result in low oxygen intake
  • Periods during which breathing stops while sleeping
  • Waking up with a dry mouth
  • Headaches in the morning upon awakening
  • Experiencing difficulty staying asleep, a condition known as insomnia 
  • Experiencing excessive sleepiness during the day, a condition known as hypersomnia

Many of the symptoms of sleep apnea can be difficult to identify on your own. 

Working with an experienced VA disability lawyer is helpful in the following situations: 

  • if you are adding your sleep apnea to an existing VA disability rating through a supplemental claim, 
  • When you are appealing a denial, 
  • If you are seeking to upgrade your existing sleep apnea VA disability rating

The following are some frequently asked questions about sleep apnea that we hear from our veteran clients to help you consider your best options. 

Is it hard to claim sleep apnea with the VA?

To collect VA disability benefits for your sleep apnea, you must first meet the following base conditions: 

  • You have a current diagnosis of sleep apnea, proven through the results of a sleep study
  • Your current diagnosis of sleep apnea is connected to your qualifying active service in the U.S. Armed Forces or other covered organization.
  • You have a current medical opinion that identifies a connection between your current diagnosis of sleep apnea and your qualifying active service.

The origin of your sleep apnea could be a direct event, injury, or illness experienced during active service or the result of another service-connected condition. In such a situation, you would have sleep apnea as a secondary condition and can file for a VA rating for sleep apnea through a supplemental claim. For example, sleep apnea can be caused by certain injuries to the septum or throat or can result from obesity. Specific injuries or medications can increase the risk of obesity, and if sleep apnea were to develop it would be a secondary condition covered by VA disability. 

Is it mandatory 50% if the VA issues a CPAP?

If you are a veteran diagnosed with service-connected sleep apnea and you require the use of a breathing assistance device, including a CPAP, you should be assigned a 50 percent sleep apnea VA rating. At this particular VA disability rating, the individual suffering from sleep apnea is unable to maintain steady, gainful employment as a result of their condition. Given the impact on your ability to work, a 50 percent VA rating entitles you to a tax-free monthly payment of $1,041.82. 

When you have a VA disability rating that does not accurately reflect your current disability, you may have a right to file a supplemental claim. A supplemental claim allows you to submit new evidence linked to your service-connected condition to allow the VA to generate a new rating for your condition. For example, if you received a 30 percent sleep apnea VA rating initially, but since that time, your condition has worsened, and you now require the assistance of a CPAP, you could be eligible for an upgrade to a 50 percent rating. 

Identifying when your condition has worsened to the point that your VA disability rating should be upgraded can be difficult to determine without an expert opinion. If you believe that your condition may have worsened, contact a local VA disability benefits attorney to explore options. While lawyers cannot assist you in filing your initial claim, our VA disability attorneys can help you process an appeal or file a supplemental claim to have your VA disability rating upgraded to accurately reflect your current condition.  

What is the average VA rating for sleep apnea?

The VA disability rating assigned to a condition ranges on a percentage scale from 0 to 100 percent. At 0 percent, a veteran has a diagnosis for the condition, but it does not impact their day-to-day life or ability to work. VA healthcare coverage is available for a VA disability rating of 0 for your condition, although tax-free VA disability payments are not available until your VA disability rating reaches 10 percent. 

At 30 percent, the disability is impacting the day-to-day life of the sufferer in a significant way and may require medication to manage. The purpose of disability payments is to replace lost earnings due to the condition, with those receiving a 50 percent, 70 percent, or 100 percent disability rating significantly impacting the ability of the veteran to engage in steady, gainful employment. The only way to receive an accurate diagnosis for your condition is to make sure that you visit a healthcare expert capable of accurately diagnosing your condition. 

It is important to receive the coverage and rating that you deserve to address the resulting symptoms and impact on your ability to work. Some common risk factors for sleep apnea include excessive weight, nasal congestion, certain medical conditions, and the use of sedatives and other medications. Veterans with PTSD and other conditions have been found to be more likely to develop sleep apnea. While these are some of the most common risk factors, there are also 3 main types of sleep apnea to consider. 

There are three common types of sleep apnea, as follows: 

  • Obstructive sleep apnea – Generally referred to as OSA, this type of sleep apnea happens when the muscles in the throat that support the soft palate relax, resulting in the blocking of your airway, leading to the brain sensing that you cannot breathe, causing a brief waking period so that you can reopen your airway
  • Central sleep apnea – This type of sleep apnea happens when your brain does not effectively signal the muscles in your chest that control your breathing
  • Complex sleep apnea – Sometimes referred to as mixed sleep apnea, this is when an individual experiences both OSA and central sleep apnea, which can magnify the resulting symptoms from the condition 

An accurate diagnosis of your sleep apnea will ensure that you receive an accurate VA disability rating for your condition. While it could be said that it is common for a veteran to receive a sleep apnea VA rating of 30 percent, that rating is also often added to other conditions leading to a total disability rating. It is essential to get the help you need with your initial application, which is available for free from the VA, or to work with an experienced attorney for your supplemental claim or appeal. 

What are the new VA rules for sleep apnea?

Proposed changes in the rules that impact your VA disability rating for sleep apnea are being considered. For persons with asymptomatic sleep apnea, in which there is a diagnosis but no meaningful impact on life or the ability to work, the VA would assign a rating of 0 percent. For those who are only able to receive partial relief from medical treatment would be assigned a rating of 10 percent. A 50 percent rating would be available to veterans for whom sleep apnea treatment was not effective or because other conditions prevent the veteran from taking advantage of treatment. Finally, a 100 percent rating would be assigned to those veterans for whom treatment is ineffective or impossible, and the veteran has organ damage as a result of the condition. 

These potential changes could impact veterans in a negative way, with those who presently have a 50 percent rating potentially being downgraded to a 0 or 10 percent rating under the new system. To ensure that you receive the benefits you deserve, working with a knowledgeable attorney and getting your application under the more veteran-friendly current rules is helpful. 

Connect with a Local VA Disability Lawyer for Assistance

Reach out to a local VA disability benefits attorney for help ensuring that you have an accurate present sleep apnea VA rating or if you may be entitled to file a supplemental claim. We can help you effectively process a supplemental claim or appeal to ensure that your sleep apnea VA rating and overall VA disability rating are accurate and complete so that you can collect the full benefits you deserve.

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If you are having trouble obtaining benefits, contact us online or at 888.878.9350 to discuss your case.