Sleep apnea is a potentially debilitating condition that is unfortunately often undiagnosed, especially among military veterans. This disorder can profoundly affect their overall well-being and is a crucial factor in determining the level of disability benefits they may qualify for through the Department of Veterans Affairs (VA). Veterans diagnosed with sleep apnea need to have a comprehensive understanding of the Sleep Apnea VA rating process to accurately assess the level of support they may be entitled to receive.
What is Sleep Apnea?
Sleep apnea is a significant sleeping disorder that is characterized by repetitive pauses in the respiration. These pauses occur due to an obstruction in the airway or due to a fault in the signal from the brain to the muscles that control breathing. There are three types of sleep apneas:
- Obstructive sleep apnea, or OSA.
- Central sleep apnea, or CSA.
- Mixed sleep apnea, which is a combination of both OSA and CSA.
Other symptoms of sleep apnea include snoring, fatigue, morning headaches, sleep disturbances, and difficulty concentrating. Most patients with sleep apnea are often not aware of their problem and may mistake their daytime sleepiness for the natural effects of aging or lack of sleep. If left untreated, sleep apnea can lead to serious health issues such as hypertension, heart disease, stroke, diabetes, and liver conditions. This condition is usually diagnosed through a sleep study to determine its presence and severity.
How to Understand the VA Ratings System for Sleep Apnea
The Veteran Affairs (VA) disability rating system was put into place after World War I to provide compensation to veterans for disabilities due to injuries or illnesses incurred in or aggravated by military service. The VA’s individual disability ratings are determined in 10% increments, with 100% being total disability. Every individual rating has a corresponding monthly compensation amount, and veterans with multiple disabilities can be granted a combined rating reflective of all the health deviations they are encountering.
The VA typically grants ratings of a symptom depending on the belief in sleep apnea, based on the severity of symptoms and the limitation to daily life that a veteran is experiencing. Discussion of the rating system is very much in order as veterans with sleep apnea need to know about it to ensure they wind up with the proper VA disability benefits.
Sleep Apnea in Veterans
An audit conducted by the U.S. Department of Veterans Affairs Office of Inspector General (VA OIG) in 2019 reported that over 1.3 million veterans were receiving disability compensation for sleep apnea – “an increase of about 384,000 veterans from FY 2015.”
Further aggravating the high prevalence of this condition among veterans, all these risk factors—smoking, aging, and mental health conditions—are associated with military service. Studies have also found that veterans with post-traumatic stress disorder are markedly more likely to develop sleep apnea, further complicating their mental health treatments.
The VA considers the severity of sleep apnea to rate it on a criterion-based system between 0% and 100% disabled.
- 0% Rating: Sleep apnea is diagnosed, but symptoms do not significantly impair daily life. Veterans with this rating are recognized as having a service-connected condition but do not receive monetary compensation.
- 30% Rating: This rating is typically awarded to veterans who experience persistent daytime hypersomnolence (excessive sleepiness) due to sleep apnea.
- 50% Rating: Veterans who require a Continuous Positive Airway Pressure (CPAP) machine or another breathing assistance device receive this rating. The VA considers the need for such a device as indicative of moderate to severe impairment.
- 100% Rating: This rating is given when sleep apnea causes total occupational and social impairment. This could be due to complications like heart disease or other severe health conditions directly related to sleep apnea.
The Sleep Apnea VA Rating Process: The steps to take to be rated by the VA for your sleep apnea
- Filing a VA Disability Claim: Veterans must first file a claim through the VA. The claim must include evidence of the condition and its connection to military service. This typically involves submitting medical records, sleep study results, and service records documenting incidents or conditions that could have led to sleep apnea.
- Establishing a Service Connection: To establish a direct service connection, a veteran must provide medical evidence linking their sleep apnea to their time in service. This often requires a nexus letter from a medical professional who can explicitly state that the condition is “at least as likely as not” related to service.
- VA Medical Examination: The VA may require the veteran to undergo a Compensation & Pension (C&P) exam after filing the claim. During this exam, a VA-sanctioned physician evaluates the severity of the sleep apnea and its impact on the veteran’s daily life.
- VA Decision: The VA reviews the claim, the evidence provided, and the results of the C&P exam to determine the appropriate rating. This rating then dictates the amount of monthly compensation the veteran will receive.
Tips that May Help you Secure Sleep Apnea VA Rating Successfully
Below are a few steps veterans may take to strengthen VA sleep apnea claims.
- Keep Detailed Records: Document all symptoms, treatments, and medical evaluations related to sleep apnea. Maintaining a comprehensive record can be crucial in proving the severity of the condition.
- Get a Nexus Letter: A nexus letter from a medical professional that clearly links sleep apnea to military service can significantly strengthen a claim. This letter should state that the condition is “at least as likely as not” related to service.
- Consult Experts: Veterans should consider consulting with VA claims experts or legal professionals specializing in veteran disability claims. These professionals can provide guidance on gathering evidence, filing claims, and navigating the VA system.
It is important to note that obtaining a VA rating for sleep apnea goes a long way toward achieving disability benefits. Veterans who are informed, organized, and proactive will be better positioned to receive their benefits successfully. To those suffering from sleep apnea, do not hesitate to demand the earned entitlements through your service.
Remember, veterans deserve the support they’ve earned. Trajector Medical’s medical evidence development helps you secure the benefits you legally and medically deserve, enhancing your overall well-being. Additionally, if your claim is initially denied, there are organizations who can help you through the appeals process.
