For individuals with sleep apnea, every day can be a struggle. A lack of sleep can make it difficult to focus or to complete basic tasks. If you have sleep apnea that is either the result of your military service or was caused by a different service-connected disability, you may be eligible for disability benefits from the Department of Veterans Affairs (VA).
The VA provides benefits to veterans with a range of service-connected disabilities. The amount of benefits that you may receive is based on your level of disability, as determined by the VA rating system. Individuals with multiple disabilities related to their service may receive a combined rating.
If you have been diagnosed with sleep apnea as a veteran, you may be entitled to VA benefits. An experienced New Jersey veterans disability attorney can help you understand your right to benefits.
What Is Sleep Apnea?
Sleep apnea is a common medical condition that affects millions of Americans. It is a type of sleep disorder where an individual repeatedly stops breathing during sleep. There are three main types of sleep apnea: obstructive, central, and complex.
Sleep apnea makes it difficult for a person to have a restful sleep. A person with sleep apnea may experience excessive daytime sleepiness, difficulty concentrating, irritability, and headaches as a result of the condition. They may also suffer other complications, like heart problems, high blood pressure, and type two diabetes.
A veteran may be eligible for disability benefits if they can demonstrate that their sleep apnea is connected to their service. Under the VA Ratings Schedule, a veteran with sleep apnea may be entitled to between 0% and 100% benefits based on their condition.
The Connection Between Sleep Apnea and Other Medical Conditions
While a veteran with sleep apnea may qualify for disability benefits solely on the basis of their service-connected disability, in some cases, sleep apnea is a result of another condition. In these situations, a veteran may be able to claim sleep apnea on a secondary basis if the underlying health issue is service-connected.
There is a range of health problems that are connected to sleep apnea. For example, a 2015 study found that Iraq and Afghanistan veterans with post-traumatic stress disorder (PTSD) had a high risk of developing sleep apnea. The severity of PTSD symptoms increased the risk of screening positive for sleep apnea symptoms.
There are a number of medical conditions that are associated with sleep apnea, including:
- Hypothyroidism (low levels of thyroid hormone)
- Acromegaly (excessive secretion of growth hormone due to tumors on the pituitary gland)
- Muscle diseases
- Post-traumatic stress disorder (PTSD)
In addition, sleep apnea (particularly obstructive sleep apnea) may be caused by:
- Excess weight or obesity
- Deviated septum
- High blood pressure
- Chronic nasal congestion
- Alcohol consumption
- Some medications, including narcotic pain medications, sleep medicines, and sedative
If you have developed sleep apnea as a result of a medical condition that is related to your service, you may be able to claim sleep apnea as a secondary disability. Doing so requires that you submit evidence that shows (1) you have been diagnosed with sleep apnea; and (2) your sleep apnea was either directly caused by or related to a service-connected disability. A sleep apnea diagnosis alone will not qualify for VA benefits unless you can prove that it was connected in some way to your service. This almost always requires a strong medical opinion. Providing copies of research alone will not give VA decision-makers what they need. A trained medical professional must analyze the research, review your personal condition, and make a determination that it is at least as likely as not that your sleep apnea is caused by or aggravated by a service-connected condition.
For example, assume that you were diagnosed with asthma as a result of your service, and were awarded a VA rating for benefits as a result. If you then developed sleep apnea, you could seek an updated VA rating based on your combined disabilities. To do so, you will need to submit evidence of your sleep apnea diagnosis as well as a nexus (in other words, a connection) between your asthma and sleep apnea.
In other cases, a veteran may be diagnosed with obesity, which is a risk factor for sleep apnea. While obesity itself is not a service-connected disability, if the obesity was caused by a service-connected disability (such as an injury that prevents a person from exercising), it can be used as an “intermediate step” to demonstrate a secondary disability. In this way, you can demonstrate that a service-connected disability led to obesity, which then caused your sleep apnea.
Proving that your sleep apnea was caused by a service-connected disability (such as asthma) can be challenging. However, you may submit evidence such as an opinion from your treating physician that states their opinion that you developed sleep apnea because of the primary disability. An experienced New Jersey veterans disability benefits attorney can help you establish the evidence necessary to prove this type of claim.
The VA Disability 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.
Getting a Combined Disability Rating
If you have more than one disability connected to your service, you will receive a combined rating. The VA uses the Combined Ratings Table to calculate a combined rating for veterans with multiple service-connected disabilities.
Disability ratings are not added to each other. Instead, the VA uses the rating table to determine a combined rating. This involves listing each disability in order of severity and then using the chart to find a combined rating.
For example, assume that you have already received a rating of 60% for your service-connected asthma. You are then given a 20% disability rating for your sleep apnea. Based on the chart, the combined rating would be 68%; this rating is then rounded to the nearest 10, giving you a combined disability rating of 70%.
Applying for veteran’s disability benefits to include a disability that was obtained on a secondary basis can be complicated. A seasoned New Jersey veterans disability benefits attorney can help you with the process, from filing the paperwork to gathering evidence in support of your claim.
Filing for VA Disability Benefits? We Can Help.
Sleep apnea can affect every aspect of your life, from your ability to work to your overall health. Even if your sleep apnea was not directly caused by your military service, you may still be able to receive benefits for this condition if it is linked to a service-related disability. Working with a New Jersey veterans disability benefits attorney can increase the chances of being approved for a combined rating based on your primary condition and sleep apnea.
At Bross & Frankel, we are proud to help the men and women who have served our country. We offer a range of legal services for veterans, including assistance with filing for VA disability benefits. Contact us today at 856-795-8880, or online to schedule a free initial consultation.
Rich Frankel is the managing partner of Bross & Frankel. He is a member of the New Jersey and Pennsylvania bars. He has focused exclusively on disability and social security benefits since 2005.
Mr. Frankel joined what is now Bross & Frankel after having watched his father struggle with disability, fighting a lengthy illness. Mr. Frankel founded the firm’s veteran’s law practice and substantially grew the social security disability practice, focusing Bross & Frankel’s ability to fight for all of the disability benefits available to his clients.
Mr. Frankel additionally fights for clients in court, obtaining frequent victories in Social Security appeals and against insurance companies in Federal court.