Sleep apnea is a condition involving disordered breathing during sleep. While there are multiple kinds of sleep apnea, the most common is obstructive sleep apnea, or “OSA.” People who suffer from OSA experience blockage of the airflow during sleep, leading to intermittent breathing stops. Symptoms include snoring, daytime sleepiness, and gasping during sleep. People also suffer fatigue and depression, headaches and insomnia, as well concentration and memory issues. The VA has acknowledged that “OSA can disrupt sleep and decreased airflow can strain the heart, lungs, and other organs. The strain can lead to problems such as high blood pressure, heart attack and stroke.” In addition to obstructive sleep apnea, there is the less common diagnosis of central sleep apnea, where the breathing disruption caused at night is traced to a central nervous system disorder.
More than 20 million people in the United States suffer from sleep apnea. The VA will compensate veterans who suffer from sleep apnea if the veteran can show that the condition began in service, was related to service, or is secondary to another medical condition that is related to military service. The major hurdle veterans face in winning sleep apnea compensation is acquiring the sleep apnea diagnosis. This is accomplished by undergoing a sleep study in which medical professionals assess your breathing during sleep. Usually, the VA will provide the veterans with a sleep study, although a private one may also be obtained.
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We do not charge for an initial consultation, so if you have questions about your own case, please give us a call. What follows are just the basics on sleep apnea – we do not intend to provide any legal advice with this information. We do hope it assists you as much as it assists our attorneys and staff when tackling a VA compensation denial.
Sleep Apnea Ratings
What follows is a summary of the way the VA rates sleep apnea claims, which it rates as a respiratory condition. For an even deeper dive into the VA’s rating system, please refer to the VA’s ratings codes. Generally speaking, the VA will normally only rate your sleep apnea according to the symptoms listed in the VA’s Diagnostic Code. The VA’s formula for rating sleep apnea is found at the rating code DC 6847.
Diagnostic Code 8100 states:
100-percent Chronic respiratory failure with carbon dioxide retention or cor pulmonae, or: Requires tracheostomy.
50-percent Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine.
30-percent Persistent day-time hypersomnolence.
0-percent Asymptomatic but with documented sleep disorder breathing.
The 100-percent rating is rare. However, many veterans are prescribed CPAP therapy, which would rate a 50-percent rating under DC 6847. A CPAP machine is a device worn over the face at night that provides a constant level of air pressure to the upper airway.
“Hypersomnolence” essentially means excess sleepiness.
One issue to keep in mind for veterans seeking disability compensation for sleep apnea is that the VA will likely only compensate for one lung condition at a time. In other words, the VA will often not combine sleep apnea with any other respiratory condition, although there are some exceptions.
TDIU and Sleep Apnea
Veterans who have been diagnosed with sleep apnea and prescribed a CPAP machine can obtain a 50-percent rating. This rating can be a good stepping stone toward obtaining Individual Unemployability (a.k.a. TDIU) at the 100-percent level.
Sleep Apnea and Secondary Conditions
Veterans who suffer from sleep apnea may also suffer from other illnesses that are commonly related to or caused by sleep apnea. These can include heart disease, mental illnesses like depression and anxiety, diabetes, and hypertension.
Research indicates that sleep apnea can also be aggravated by PTSD and other mental illnesses, such as anxiety. Therefore, a veteran who suffers from PTSD may be able to win service connection by demonstrating that his PTSD is making his sleep apnea worse.