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Blog

How Does the VA Rate Sleep Apnea?

September 22, 2019 By Bross & Frankel

How Does the VA Rate Sleep Apnea?

Millions of Americans suffer from sleep apnea. This condition is incredibly common: at least 9 percent of women and 24 percent of men suffer from sleep apnea. For veterans who struggle with sleep apnea, a common question that arises is whether they can receive benefits for sleep apnea related to their service.

The Department of Veterans Affairs (VA) provides benefits to veterans with service-connected disabilities — including sleep apnea. The level of benefits received will depend on the severity of the condition. This is determined through a somewhat complex process based on a rating system.

Learning how the rating system works can help you better understand your right to benefits. A Philadelphia veterans disability benefits attorney can work with you to help you find out more about the benefits that you may be eligible for based on your service to our country.

What Is Sleep Apnea?

Sleep apnea is a type of sleep disorder that can be serious. A person with sleep apnea will repeatedly stop breathing while asleep. There are three primary types of sleep apnea:

  • Obstructive sleep apnea: breathing stops when throat muscles relax
  • Central sleep apnea: breathing stops when the brain does not send the right signals to the muscles that control breathing
  • Complex sleep apnea: a combination of obstructive and central sleep apnea

There are a number of symptoms of sleep apnea, many of which are the same for both obstructive and central sleep apnea. They include:

  • Loud snoring:
  • Gasping for air during sleep
  • Waking with a dry mouth
  • Stopping breathing during sleep
  • Headache in the morning
  • Difficulty staying asleep
  • Excessive daytime sleepiness
  • Irritability
  • Difficulty concentrating

Any type of sleep apnea can cause serious complications, such as daytime fatigue, heart problems, high blood pressure, type two diabetes, metabolic syndrome, and liver problems. If an individual has any signs or symptoms of sleep apnea, they should seek medical attention. There are a number of treatments for sleep apnea, including machines to help you breathe while you sleep, oral appliances, and surgery.

The VA Disability Rating Schedule

The VA provides disability benefits for veterans who have a current illness or injury that either began during or was made worse during their service. This compensation is based on a Rating Schedule.

Under the Rating Schedule, benefits increase as a veteran’s level of disability increases (from 0 to 100%. If a veteran is deemed “totally disabled” exclusively due to service-connected impairments, then the benefits are paid at 100%. In some situations, veterans may receive additional compensation for very serious injuries.

The Rating Schedule groups disabilities into broad categories, such as “the musculoskeletal system,” “the skin,” and “mental disorders.” Each category contains a schedule of ratings for specific diagnoses, with specific symptoms that are required for various ratings of disability. An individual must suffer from those particular symptoms to qualify for a given rating.

To rate a disability, the VA will first look at the broad category and find your diagnosis — such as sleep apnea. From there, the VA will find the diagnostic code that best matches your symptoms, which will result in your rating.

VA Disability Ratings and Sleep Apnea

To qualify for VA benefits for sleep apnea, veterans must first be diagnosed with the condition. This is typically done through a sleep study, either at a clinic or at your home. In addition, there must be evidence that this diagnosis either began during active military service or was made worse during service.  In other words, there must be a current diagnosis, an onset, event or cause in service, and a link or “nexus” between those two.  

Even if Sleep Apnea did not specifically begin in service, other conditions may be related.  For example, some studies have found a link between Post-traumatic stress disorder and sleep apnea.  Other conditions may also be related, but ultimately, only a doctor can offer a medical opinion to link a separate service-connected condition with sleep apnea. 

An individual with sleep apnea may be eligible for VA benefits. Under the VA Ratings Schedule, a veteran with sleep apnea may be entitled to 0%, 30%, 50% or 100% benefits for sleep apnea, as follows:

  • 0% Sleep Apnea Rating: asymptomatic, but with documented sleep disorder breathing
  • 30% Sleep Apnea Rating: persistent daytime hypersomnolence (excessive daytime sleepiness)
  • 50% Sleep Apnea Rating: requires use of breathing assistance device such as continuous airway pressure (CPAP) machine
  • 100% Sleep Apnea Rating: respiratory failure with carbon dioxide retention or cor pulmonale (condition that causes the right side of the heart to fail) or requires tracheostomy.

Even individuals who have a 0% rating for sleep apnea may be eligible for other benefits, such as VA healthcare. An experienced Philadelphia veterans disability benefits attorney can work with you to determine if you may be entitled to benefits for sleep apnea or any other benefits.

Questions? We Can Help

The VA benefits system can be complex, particularly at the appeal level. While attorneys can only advocate for veterans after an initial ratings decision has been issued, the team at Bross & Frankel offers their knowledge to assist veterans with their new claims. We also represent veterans in the appeals process for denied service connections or inadequate rating awards.

Our firm is proud to help veterans in Pennsylvania and New Jersey. Our brave service members gave so much for our freedom, and we believe that every veteran with a disability should receive the benefits to which they are entitled. To learn more or to schedule a free claim review, contact our office today at 856-795-8880, or online.

Posted in VA Benefits

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