Sleep Apnea VA Disability Claims – Understanding Your Rights

Roughly22 million Americans suffer from sleep apnea. Stripes reports that about 25,000 veterans made sleep apnea VA disability claims in 2015 alone. This is up from less than 1,000 in 2001. Therefore, the U.S. Department of Veterans Affairs has been looking at ways to reduce the volume of claims and, in turn, reduce payments for sleep apnea claims. As such, it’s important for veterans seeking compensation to act quickly to preserve their rights, if they believe they have a service-connected claim for sleep apnea.

What Is Sleep Apnea?

Sleep apnea is a medical condition that can either be caused by a physical obstruction of the airway during sleep (Obstructive Sleep Apnea or “OSA”), a neurological interruption during sleep (Central Sleep Apnea or “CSA”), or a combination of both (mixed or complex apnea).

What Are The Symptoms And Effects?

Veterans who suffer from sleep apnea often suffer from short-term memory loss, daytime drowsiness and fatigue, and other health problems relating to interrupted sleep.

What Are The Treatments For Sleep Apnea?

For those with mild to moderate OSA, weight loss and reductions in caffeine and alcohol intake, as well as tobacco cessation, can make a big difference. For those with moderate to severe OSA, these remedies alone will probably not correct the problem. In those cases, a C-PAP (continuous positive airway pressure) device can be effective in treating OSA. For those who cannot tolerate a C-PAP, doctors may recommend an oral appliance that a veteran can wear at night. These devices help keep the airway open during sleep.

What VA Rating Is Assigned For Sleep Apnea?

VA has made a lot of changes in recent years in response toreports that sleep apnea VA disability claims were costing over $1 Billion per year. This is now leading to more denials for veterans seeking compensation for sleep apnea. In general, the VA considers sleep apnea as falling into four categories based on rating:

  • 100% Rating. Severe Sleep Apnea, contributing to or causing chronic respiratory failure with carbon dioxide retention or cor pulmonale; or requires tracheostomy. Treatments include C-PAP, Surgery, Respiratory Therapy.
  • 50% Rating. Moderate to Severe Sleep Apnea, requiring a C-PAP. Treatments include C-PAP.
  • 30% Rating. Mild to Moderate Sleep Apnea, leading to daytime drowsiness. No treatments involved.
  • 0% Rating. Documented sleep problems but asymptomatic. No treatments involved.

In order to qualify for a rating of 50 percent or higher, a veteran must have (1) a diagnosis of sleep apnea, (2) a medical need for C-PAP as prescribed by a physician, and (3) evidence that sleep apnea was incurred during military service. The last of these is generally the hardest to prove, as sleep apnea is often greatly affected by other factors, such as alcohol, caffeine, weight and tobacco. Nevertheless, there are other ways to service-connect sleep apnea.

Sleep Apnea As A Secondary Diagnosis

Veterans can make claims for disabilities incurred on active duty. These are called primary claims. However, if a service-connected condition ultimately leads to or contributes to other medical problems, those problems can be claimed as “secondary” to the service-connected disability. Here is how it works:

  • Veteran is diagnosed with a deviated septum caused by a traumatic impact during military service. If proven and a rating is awarded for this condition (even if just 0%), and this condition leads to scar tissue or obstruction of the airway, the veteran may develop sleep apnea.
  • If the apnea is diagnosed, the veteran then must prove the “nexus” between the initial disability (deviated septum) and the secondary diagnosis (sleep apnea). If successful in proving that the initial condition at least in part contributed to the sleep apnea (or aggravated it), then the veteran qualifies for compensation for the secondary condition of sleep apnea.

Proving A Secondary Condition

Proving that a previously diagnosed service-connected disability has caused or aggravated a newly diagnosed condition can be very difficult. However, some small conditions such as hearing loss, tinnitus, minor ankle and knee injuries, and respiratory problems developed on active duty can lead to long-term severe health complications later in life. Sadly, the Social Security Administration has abolished compensation for sleep apnea directly. It may not be long before the VA does the same thing.

Get Help With A VA Sleep Apnea Claim

To prove the connection, you will need to prove the nexus between the two conditions. An experienced VA Accredited Attorney can assist with gathering the evidence and making the arguments necessary to prove your claim.

For a free consultation and to discuss your VA claims, contact the Klok Law Firm, LLC. The laws are changing, so you can’t afford to wait.

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