Sleep Disorders The Va Covers
There are three basic classes of sleep disorders the VA covers for disability compensation: sleep apnea, insomnia, and narcolepsy. Well talk more in-depth about each of these conditions in a moment. But it is important to note that a wide variety of more specific conditions can fall under these three categories.
You can get three different kinds of service connections for sleep disorders. These include direct service connections, secondary service connections, and presumptive service conditions. Which kind you get will determine how much evidence you need to provide for your disability claim.
The Inability To Sleep Due To Severe Sleep Apnea May Affect Your Work Activity Causing Disability
The Social Security Administration evaluates sleep apnea under the Respiratory Disorders section of the Blue Book listing of impairments. The complications of sleep-related breathing disorders are evaluated under the listing for the body system that is affected. For example, if your sleep apnea has caused chronic pulmonary hypertension, it will be evaluated under 3.09: Chronic pulmonary hypertension due to any cause. According to Omaha disability lawyers at Cuddigan Law, this listing is seldom met by applicants because of its significant requirements. However, many applicants are awarded benefits who have severe sleep apnea as one of their impairments, along with a showing that sleep apnea in combination with the other impairments, such as a heart condition or obesity prevents or significantly limits their ability to work.
For more information about this disorder and Social Security contact us. For our free brochure Give Yourself the Best Chance of Winning Your Social Security Disability Case contact Omaha Disability Lawyerby calling or email us at
How The Social Security Administration Determines Residual Functional Capacity
The SSA determines your level of residual functional capacity by examining your medical records. They will look at any relevant exams or tests that have been performed by one of your physicians. The SSA also may have one of their physicians examine you to determine your capacity for work.
The SSA will assign you a rating that describes the work you are capable of doing. These ratings include sedentary, light, medium, and heavy work. The higher the RFC rating, the more jobs you could possibly do. This is why it is harder to get approved for benefits if you have an RFC rating of medium or heavy.
You May Like: How To Calculate Disability Retirement Pay
Most Applicants Will Find It Difficult To Qualify For Social Security Disability Benefits Automatically With A Diagnosis Of Sleep Apnea Unless They Can Prove Their Disability Is Related To Heart Failure Chronic Pulmonary Hypertension Or A Neurocognitive Disorder
If you have sleep apnea, but your disability does not match one of Social Securitys impairment listings, you may still be eligible for Social Security Disability benefits if you have another impairment for example, high blood pressure or diabetes. Applicants often have more than one illness or injury that prevents them from working full time. By itself one disorder may not meet the requirements of an impairment as stated in Social Securitys Blue Book. However, if an applicant has multiple medical conditions, Social Security must consider how those health issues, combined together, limit an applicants ability to hold a job and perform necessary daily tasks. In any case, you must have an actual diagnosis confirmed by a polysomnogram and statements by medical providers detailing your capabilities and limitations. For example, because of sleepiness during the day, you may not be able to operate machinery. Social Security will also evaluate how your limitations affect your ability to work , taking into account whether or not you are able to drive, your age, and level of education. They will test your residual functional capacity which is a measure of how the disease affects your everyday job performance. The fatigue associated with sleep apnea, particularly chronic or severe sleep apnea, can lead to physical and cognitive impairment.
The first category is the Work Requirements which has two tests.
The second category is the Medical Eligibility Requirement.
Veterans Affairs 50% Disability Rating Is Harder To Get
The new rules made it so that a prescription for a CPAP machine alone is not enough evidence to demonstrate a 50% disability. Now, the need for a CPAP machine is considered to be a medical question, which can only be answered by a physician. In addition to the prescription for the machine, the physician needs to present documentation of how Sleep Apnea impacts your life, and how it was caused by military service.
The added requirement may surprise veterans who are looking to get a 50% VA disability rating for Sleep Apnea. With the rule changes, a veteran who applies for VA disability for Sleep Apnea could get their claim denied if they do not prove medical necessity that requires further documentation from your doctor.
And even then, its not a guarantee that youd get approval from the VA. The VA seems to be scrutinizing VA disability claims for Sleep Apnea more closely than they did in the past. Is Sleep Apnea a disability? Yes, but there are many things to consider when filing a VA claim.
Don’t Miss: Best Rv For Disabled
Sleep Apnea And Secondary Service Connection
Many veterans with Sleep Apnea, especially those who were diagnosed long after leaving the military, might still be eligible if medical evidence shows your Sleep Apnea is proximately due to or aggravated by another service-connected disability such as musculoskeletal conditions and/or mental health conditions.
Service connection on a secondary basis requires a showing of causation.
A showing of causation requires that the secondary disability be shown to be proximately due to, or the result of, a service-connected disability.
The first part can be satisfied with any existing medical evidence in service treatment records, VA medical records, or any private medical records.
The second part can be satisfied with a veterans existing service-connected disability rated at 0 percent or higher.
The third part can be satisfied with a Medical Nexus Letter, aka, Independent Medical Opinion from a qualified medical professional.
Did you know there are more than 50 conditions that can be medically linked to cause or aggravate sleep apnea?
Also Check: Can You Get Disability For Degenerative Disc Disease
What Are The Most Effective Home
Sleep apnea is a common problem. It is identified by episodes of breathing cessation during sleep, which can last anywhere from a couple of seconds to mins.
One of the most typical therapy for sleep apnea is the use of a dental device or CPAP device. These gadgets are put right into the mouth to open up the air passage, lessening any obstruction to aid with breathing.
VitalSleep is just one of the most preferred at-home treatments for sleep apnea, with hundreds of favorable customer reviews on Amazon.com with an average score of 4 stars out of 5 celebrities. Va Disability For Sleep Apnea With Oral Device
Recommended Reading: How To Calculate Disability Retirement Pay
Va Disability Benefits For Sleep Apnea
Winning a VA disability claim for sleep apnea is an uphill battle, but it isnt impossible. With the information presented here, you can work with your VA disability attorney to evaluate the strength of your sleep apnea disability claim and decide whether applying for VA disability compensation is the best path for you.
Links Between Asthma And Sleep Apnea
Many studies have now shown that people who have asthma are more likely to develop obstructive sleep apnea. This risk is almost 40% greater for them than for people with no asthma. Some of this is due to the use of systemic steroids in treating asthma. Long-term use of these steroids can cause upper airway muscles to weaken which may result in impaired function. This issue is directly related to obstructive sleep apnea. When throat muscles have weakened because of asthma, the tendency for the throat to collapse and obstruct the airway increases.
Because of this the longer a veteran has asthma the higher the likelihood is that they will develop sleep apnea.
Don’t Miss: How Much Is Ssdi In California
How Does The Va Evaluate Sleep Apnea
The VA evaluates sleep apnea under 38 C.F.R. § 4.97-13, Code 6847 as Sleep Apnea Syndromes . The lowest possible rating, 0 percent, does not qualify you for any monthly compensation, but it makes you eligible for other benefits, such as healthcare. The highest rating, 100 percent, signifies total disability and makes you eligible for the highest schedular amount of monthly compensation.
Per 38 C.F.R. § 4.97-13, Code 6847, the ratings for obstructive, central, or mixed sleep apnea are as follows:
- 100 percent rating for chronic respiratory failure with carbon dioxide retention or cor pulmonare, or requires tracheostomy.
- 50 percent rating requires the use of a breathing assistance device such as a CPAP machine.
- 30 percent rating requires persistent day-time hypersomnolence.
- 0 percent rating for asymptomatic sleep apnea with documented sleep disorder breathing.
As of December 1st, 2020 the VA disability rate benefit amounts are as follows:
- 30 percent disability rating: $441.35 per month
- 50 percent disability rating: $905.04 per month
- 100 percent disability rating: $3,146.42 per month
A rating of at least 30 percent or higher qualifies you for additional compensation if you have a spouse, dependent children, or dependent parents living in your home.
There Are Three Types Of Sleep Apnea: Obstructive Sleep Apnea Central Sleep Apnea And Mixed Or Complex Sleep Apnea
Obstruction sleep apnea, or OSA, is the most common and is caused by a blockage of the airway when soft tissue at the back of the throat collapses during sleep. When the muscles relax, the airway narrows or closes and the person cant get enough air. The brain senses this inability to breathe and wakes the person so they can begin breathing normally again. These occurrences are so brief the person doesnt even remember them.
You May Like: How To Calculate Disability Retirement Pay
How Can You Receive Va Disability For Sleep Apnea
Sleep apnea is a common condition that affects about 22 million people nationwide. If you are among the former military service members living with sleep apnea, you may be eligible for veterans disability compensation. This guide will outline the basics of sleep apnea, how the VA disability rating works for this condition, and how qualifying veterans can prove service connection.
Will Social Security Approve My Disability Claim Based On Sleep Apnea
Sleep apnea must be considered severe for SSA to approve the claim
Will SSA approve my claim based on sleep apnea?
How does SSA determine if my sleep apnea qualifies for Social Security Disability or SSI benefits?
Step 1: Non-Medical CriteriaStep 2: Severe ImpairmentStep 3: Medical ListingsStep 4: Past WorkStep 5: Other Work
Wondering If You Qualify?
Find out if you qualify for Social Security Disability benefits in just seconds with our free evaluation.
You May Like: How Do You Change Your Va Disability Direct Deposit
Higher/more Severe Va Ratings
50% Rating
The VA rates sleep apnea at a 50% rating if you need a breathing device to assist with your sleeping habits.
Military personnel or veterans that rely on a CPAP machine for breathing assistance fall under this distinction.
Under this rating, you have a 50/50 chance of receiving approval for disability benefits.
You should do your research when submitting the claim to make sure you submit any evidence of sleep apnea .
100% Rating
The VA rates sleep apnea at a 100% rating when chronic respiratory failure is evident through carbon dioxide retention.
Furthermore, the 100% rating for sleep apnea includes the need for a tracheostomy.
Additionally, veterans can file a claim if the right side of the heart is enlarged or experienced failure as a result of lung disease.
Under this rating, military personnel has the strongest likelihood of gaining acceptance for VA disability benefits.
The VA generally approves claims at this rating because it is considered the most severe form of sleep apnea.
Preparation & Medical Appointments
Step 1: Schedule an appointment with a medical professional to discuss your sleep problems and symptoms.
Step 2: Request that the VA schedule a sleep study examination for sleep apnea. Make sure the sleep test is performed at an approved clinic.
Step 3: Obtain the test results from the sleep study along with a nexus letter from a medical professional. The nexus letter contains the professional opinion that sleep apnea is related to your military service and therefore service-connected. This process is referred to as a direct service connection.
Step 4: Consider making your case more persuasive by adding a secondary basis . The secondary service connection, such as linking PTSD to sleep apnea helps add value to the claim that you deserve VA disability benefits. There are several conditions linked to sleep apnea in the military such as asthma, hypertension, type 2 diabetes, and mental health conditions.
Also Check: How Much Is The Average Disability Check
Facts About Sleep Apnea And Filing For Disability
Facts about the conditionQualifying for disability benefits with this condition
Why are so many disability cases lost at the disability application and reconsideration appeal levels?obtained and submittedMost popular topics on SSDRC.com
Tdiu Benefits For Sleep Apnea
Certain symptoms of sleep apnea, such as excessive daytime sleepiness, fatigue, and difficulty concentrating, may impact a veterans ability to work. Veterans unable to find and keep substantially gainful employment due to their service-connected conditions may be entitled to total disability based on individual unemployability .
Veterans can qualify for TDIU under 38 CFR § 4.16, provided they meet the following schedular requirements:
- A veteran must have one service-connected disability rated at 60 percent disabling or higher or
- More than one service-connected disability, with one disability rated at least 40 percent, and a combined rating of 70 percent or higher.
You May Like: How To Apply For Disability In Texas
Is Sleep Apnea A Permanent Va Disability
Generally, sleep apnea is not automatically rated a permanent disability by VA, but if a veteran meets certain qualifications, they may be able to secure lifelong compensation.
If VA considers your sleep apnea permanent in nature, meaning they are reasonably certain that the condition will continue with zero or close to zero chance of improvement, veterans will not be scheduled for a re-examination. If this is the case, VA cannot propose a rating reduction.
What Are One Of The Most Usual Causes Of Obstructive Sleep Apnea
Sleep apnea is a common sleep condition that affects a lot of individuals at least once in their lifetime. The condition is composed of cessation of breathing for 10 secs or more.
Obstructive sleep apnea is triggered when something obstructs air from flowing with your respiratory tracts when you are sleeping. There are several reasons this may happen, consisting of obesity, age, and also alcohol usage.
One of the most usual reason for obstructive sleep apnea is bigger tonsils and adenoids. This typically happens when these cells obstruct your throat when you attempt to inhale throughout sleep.
Also Check: Va Rating Schedule For Sciatica
Diagnosis Of Sleep Apnea
Sleep apnea often goes undiagnosed. There is no available blood test, and it usually is undetectable during periodic office checkups. Since the condition only occurs during sleep, many sufferers are unaware they even have the disorder. Typically, it is a spouse or family member that notices the disturbances in sleep and the accompanying signs.
The diagnose of sleep apnea is based on family and medical histories, sleep study results, and a physical exam. The primary care physician normally evaluates symptoms before deciding to send you to a sleep specialist.
Va Ratings For Disability
The VA is responsible for compensating veterans for disabilities earned during their time in the service. To determine how much money an individual will receive, they use a percentage-based rating system ranging from 0-100 using increments of 10 . VA ratings depend on the severity of a disability, which part of the body is affected, and how much of a hindrance the disability is to an individuals daily duties.
Don’t Miss: How To Calculate Disability Retirement Pay
The Winning Method For Disability Benefits Claims
Whether applying for disability benefits under the CPP or through an insurance plan, you will be doing the bare minimum method. This entails going through the whole application process as prescribed by the benefits providers. You submit a complete application with all the requirements and do as you are told. Everyone does this, and they are usually denied. In contrast, you should make your application stand out by going beyond doing the bare minimum to increase your chances of getting your claim approved. We call this the winning method.For CPP disability benefits claims, the Blueprint Strategy by Resolute Legal identifies the six key elements that your application must contain. You can read more about this in our free guide. Essentially, you must be able to tell a comprehensive and persuasive story of your disability and its effect on your life. You can also use the strategy for appeals to both Service Canada and the Social Security TribunalFor disability insurance benefits, Resolute Legal also has a free guide that even beginners can follow. It contains proven techniques for preparing a winning claim. The book also explains why insurance companies deny those who are legitimately disabled and how you can counteract their practices.