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Sleep Apnea & VA Service-Connected Compensation

Picture of Man Sleeping in Bed with Sleep Apnea Mask

Sleep Apnea is a very complex medical issue that impacts many military veterans.  Unfortunately, it is not simple to prove that sleep apnea is related to your military service, and the VA denies many sleep apnea claims for service-connected disability compensation.  Any veteran pursuit a sleep apnea VA disability claim should be ready for the “long-game” when trying to prove to the VA that their sleep apena is service-connected.

What is Sleep Apnea?

Sleep apnea is a chronic disorder in which the person temporarily stops breathing or takes shallow breaths while they are asleep.  These pauses in breathing can last until the person’s brain becomes desperate for oxygen that they are jolted awake, gasping for air often after making a snorting or choking sound.

Graphic Showing Cause of Sleep Apnea

Blocked Airway Causes Sleep Apnea

According to VA’s Schedule of Ratings, there are 3 types of Sleep Apnea: “Obstructive”, “Central”, and “Mixed”.  In “Obstructive” sleep apnea (the most common type) the airway collapses or becomes blocked during sleep. The loud snoring sound that is often associated with sleep apnea is caused by the small amount of air that manages to pass the blockage.  In “central sleep apnea,” the area of the brain that controls breathing doesn’t send the correct signals to the breathing muscles. This type of sleep apnea can affect anyone but, it is most common in people who suffer from heart conditions/ stroke or in people who are on certain medications like opioids.  The “Mix” can occur when “Obstructive” and “Central” Sleep Apnea happen simultaneously.

If left untreated, sleep apnea can increase the risk of heart failure, heart attack, stroke, high blood pressure, obesity, diabetes, migraine head-aches and fatigue-related or driving accidents.  If that wasn’t enough, sleep apnea can create irregular heart-beats (arrhythmias). Symptoms range from feeling tired all day or dozing off during activities to drastic personality changes such as irritability, anxiety, or depression.

When Can Veterans Claim Service-Connected Sleep Apnea Disability?

There are a number of scenarios that veterans who have Sleep Apnea find themselves in: they may have been denied after being diagnosed in service, they may have been denied after being diagnosed years after their service ended, or they may have been denied because of a lack of diagnosis and may even have in-service medical records that documented sleeping problems.  With the right evidence and effort, veterans with similar situations to these may be granted service connection for Sleep Apnea.

In order to be awarded disability compensation, sleep apnea must be connected to a veteran’s military service. There are two paths one can take to service connection: Direct or Secondary.  In this article, we will discuss Direct Service Connection.

Direct Service-Connection for Sleep Apnea

It is more than a current problem – There are three things to prove to show service-connection:

It is a common and often frustrating misconception that veterans believe because they have been diagnosed with sleep apnea and wear a CPAP while sleeping, they are automatically entitled to a 50% compensation rating from VA.  While this belief may be well-founded, VA requires us to take a few more steps.  In order to be awarded VA compensation for any disability, veterans must show that is related to their service. To show direct service connection, veterans must prove (through medical and sometimes lay evidence) the following criteria:

  1. They have a current disability (Sleep Apnea);
  2. an in-service incurrence or aggravation of a disease or injury; and
  3. a nexus (connection) between the claimed in-service disease or injury and the present disability.

For more information on service-connection see the following cases from the U.S. court of Appeals for the Federal Circuit and the U.S. Court of Veterans Claims:  Davidson v. Shinseki, 581 F.3d 1313 (Fed.Cir.2009); Hickson v. West, 12 Vet.App. 247, 253 (1999); Caluza v. Brown, 7 Vet.App. 498, 506 (1995), aff’d per curiam, 78 F.3d 604 (Fed.Cir.1996) (table).

The nexus – or connection – can be the hardest part:

Perhaps the most common proof that veterans find themselves missing is the medical evidence of a link or nexus between the in-service event and the current disability.  A medical professional is needed to give an opinion, sometimes called a “nexus statement”, linking what occurred in service as the cause of the current condition.  However, Sleep Apnea can be difficult for doctors to detect without an actual sleep study. In fact, VA requires a sleep study in order to confirm a diagnosis of Sleep Apnea.

Proving a current condition:

If a veteran has not had a sleep study and therefore does not have any medical records from service that diagnose him/ her with Sleep Apnea, strong lay evidence, like buddy statements from old barracks or ship’s birthing roommates or even someone who slept near the veteran during their time in service, can set the groundwork for a veteran’s service-connected sleep apnea claim.  These statements should mention where the veteran and the “buddy” served during their time in the military and which symptoms of sleep apnea the “buddy” remembers the veteran having.  It may be even more difficult to detect if the veteran does not actually know they have the disorder.  Put it this way, if you don’t share your bedroom or housing situation with someone who can tell you that you are snoring/ choking during sleep, you might not know about it.

Take-Aways

  • Combining solid medical evidence with strong lay evidence, like buddy statements, may be crucial in helping prove service-connection for veterans who are suffering from Sleep Apnea.
  • VA requires a sleep study that confirms your Sleep Apnea diagnosis. It may not be necessary for your sleep study to have been done in the military but, you need one that confirms a Sleep Apnea diagnosis before you will be granted service-connection.
  • The most important piece of the puzzle is a medical nexus opinion that ties it all together by showing that the symptoms a veteran experienced while in service are connected to those he/she still experiences today were and diagnoses them as Sleep Apnea.

If you are a veteran suffering from Sleep Apnea and VA has denied your disability claim, you may still eligible for disability compensation.  Call us to speak to one of our experienced Veterans Disability attorneys.  Consultations are free.  We handle claims nationwide, and you can reach us toll-free from anywhere in the USA at (866) 282-5260.

 

Thanks to Kyle Short, a veteran of the USMC and 3L at Stetson University College of Law for his contributions to this article.

 

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    I’m James bratcher, I talked earlier with Lindsay about ap’lying for tdiu. I also have Sleep Apnea and have had a sleep study, been diagnosed with Sleep apnea, and use a CPA machine given from VA every night. With a nexus letter, i’m thinking about a filing claim with Sleep Apnea as a secondary to my PTSD.

    Mr. Bratcher, it is very common for sleep apnea to be tied to PTSD. Please note: For your privacy, I would suggest that you call us if you have any questions or would like to discuss a particular claim. You may reach us at (866) 282-5260 or (727) 572-5000.

    I am service connected for Agent Orange exposure with type2 Diabetes. Later diagnose with sleep apnea by the VA and prescribed a CPap device. What are my chances ?

    Without reading your SMRs, your current medical records, any nexus statements from doctors, and any buddy letters, an opinion you get from any attorney to answer that really is not worth much. I recommend that you put all of those things together, and if you have strong evidence, you will have a strong case. Read this article I wrote on how to prove service-connection in VA claims: VA Service Connected Disability: What Does a Veteran Have to Prove? Good luck!

    I’ve Just Hadn’t a recent Sleep study exam and The examiner told amen That i Have a positive sleep apnea What percentage Disability would a That Be a And How much will i be averting They Said They’re Gonna call me To get My CPAP Machine..

    If sleep apnea is service connected (and I don’t know if your is or will be, not can I tell you since I don’t have any of the facts about why it would be) and a veteran has to use a CPAP, it should be rated at 50%. Good luck!

    I have sleep apnea and was issued a cpap machine, and last year was told I now have type II diabetic, is there a link between the two, and should I file a claim

    Thomas: Thank you for your question. I do not have enough info to give you an opinion about whether you should file a claim. However, you know the specifics of your situation, so ask yourself if you can prove these 3 things:
    1. Did you have symptoms of either sleep apnea or diabetes while you were in service? Did you get medical care, or do you have friends that can write you a letter to explain the symptoms they observed (really bad snoring, for example)?
    2. Are you currently having symptoms from either or both of those conditions? (sounds like you are, so this is likely not going to be a problem), and
    3. Do you doctors say that either current medical condition is connected to the symptoms you had while you were in service (or have you consistently treated for those symptoms since you left service)?

    If you can prove all three of those things, then you should file a claim. Now, I think you were also asking if the diabetes would be linked to the sleep apnea. That is a question for your doctors. I am not aware of any link from one to the other, but that does not mean that a doctor might not give you an opinion that would say that, so ask them. Good luck!

    I underwent a VA Home sleep study and was diagnosed with moderate central and obstructed sleep apnea. Will a formal sleep test be required before filing a claim?

    You shouldn’t, but you will need evidence to prove that it was related to your service. Either a doctor’s opinion explaining why or medical records/witness statements explaining the symptoms of apnea that you had while you were in the service and then up to now. Just having a diagnosis is not enough to get service-connected compensation. See the 3 things you have to prove that I explain in the blog above. Good luck!

    I have had sleep apnea for awhile now and just went thru the VA protocol to be diagnosed and provided a CPAP, I am claiming thru the VA for the sleep apnea because of my broken jaw in the 80’s. The migranes that I currently get from the TMJ have grown more severe. Would this be direct connections/nexus for the sleep apnea? What are the chances I get the disability? I am currently at 90%, would that make a difference

    It certainly could be. I can’t tell you the chances of you winning based on a few sentences though. I would have to review your medical records, see what VA’s C&P said, and see what your doctors have to say. I expect you will certainly need a medical nexus opinion from a doctor explaining the service connection. Feel free to call us at (866) 282-5260 if your claim is (or was) denied. John Tucker

    Just recently be diagnosed with Sleep Apnea from the VA, I have also been diagnosed with migraine headaches back in 2003, and both wife and myself dated during my first duty station and she can recall me snoring constantly. Question, am I entitled to a claim.

    You certainly may be. On the sleep apnea: Did you snore before you went in the military? Did something happen to you in the military where you hurt your nose or jaw? Were you exposed to chemicals? These and other questions like them would be part of a thorough investigation into sleep apnea, and you should be sure to tell VA about anything like what I asked about if you apply. A statement from your wife about what she recalls of your symptoms (snoring, choking, etc.) while you were in service (and all the way through today) would be helpful….as long as you were not having those symptoms before you entered service. As for your migraines, you did not give me any reason to understand why those would be connected to your service. Remember, to prove service connection, you have to prove 3 things: 1) you have a current condition, 2) while you were in the military, you had an occurrence of the same problem, treatment, or something that could cause your current condition, and 3) a nexus – or proven connection – between the in-service event and the current condition.

    If you apply and receive a denial, give us a call to discuss your appeal options at (866) 282-5260. Hopefully, VA will pick up your claims when you apply. Good luck!

    I just got awarded 50% for adding OSA to my PTSD. My previous claims were denied, but I kept resubmitting and even sent them article after article of supporting literature. Dont give up.

    Congratulations! You are exactly right. Do not give up trying to your get your conditions service connected and get the compensation that VA should be paying you.

    Tried to apply for VA disability with sleep apnea issue. Was rejected as not an issue during service, even thought I had sent in 9 pages from my medical records with comments about sleeping issues annotated. My ex-wife used to complain about me stopping breathing while snoring. She was a RN.

    Thanks for your comment Paul. That is a very common problem that we see. Happy to help you with an appeal if you want representation. You may need to add documentation about a possible cause of your symptoms (facial impact, throat/lung chemical exposure, etc.). Please call us at (866) 282-5260 and ask for Victoria, and she will get you set up to talk with me.
    John

    I have multiple service connected issue, have had sinus surgery four times , have PTSD, and graves disease all of which are service connected, yet I continue to get denied sleep apnea as a secondary to any of these.

    I would not be surprised that it is because none of your doctors have explained to VA why your sleep apnea was caused by one of your service-connected conditions. Just because you have the condition is not enough. You need a nexus (a connection) explained by a doctor. See VA Service Connected Disability: What Does a Veteran Have to Prove? If you would like help with an appeal, call us at (866) 282-5260.

    please help I need a sleep study for my 40 yr old fiancé. He has a prescription but was denied the sleep study bc he has no insurance. They said they would be liable to provide his maching and tubing if he had it bc he has not insurance and no one will touch him. His feet are balloons and he needs help

    Thank you for your inquiry. We do not want to discuss the specifics of someone’s claim on the website, so I ask that you please call our office at (866) 282-5260 and ask to speak to Victoria. She will get some information from you, and we will see if it is something we can help with. John Tucker

    I have no military medical records for sleep apnea but now that I know what the symptoms are I know for a fact I had it while I was in. The VA had me do a sleep study and I do have sleep apnea. They issued me a CPAP machine. However, I did share a room with a 2 other soldiers and they complained and even woke me up when I was sleeping because it was so bad. Can I have them write statements and submit those as evidence to the VA?

    You certainly can. You should consider getting statements from anyone else that can help you prove you had those symptoms from the time you were in service until the time you had the sleep study. Basically, you want to fill in the holes in your paper record between the time when you were not treating for sleep apnea and the time when you finally started seeing a doctor for it. Also, if you had any trauma to your face or airway, make sure VA has those records. Keep in mind that VA may take the position that your snoring preexisted you going into the military, so if you can get statements from your family or anyone else to prove you did not have that problem before you entered service, that could help you as well. If you receive a denial, please feel free to call us to help you with the appeal. You can reach us toll-free from anywhere in the US at (866) 282-5260. Good luck!

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