VA Disability Rating For Sleep Apnea | The 4 Rating Values

What is Sleep Apnea (SA)?

SA is a severe sleeping disorder that may negatively impact your overall well-being. People who have SA stop breathing regularly at night. VA has identified three different types of apneas. Disturbances in sleep can cause difficulty in concentration and sleeplessness at work, making achieving tasks very difficult.

Types of Sleep Apnea

• Obstructive sleep apnea (OSA)
• Central sleep apnea (CSA)
• Mixed sleep apnea (MSA)

Causes of OSA In Veterans

The most common form of apneas, OSA, is caused by muscles in the back of your throat relaxing and blocking your airway while you sleep. When this happens, your brain wakes you up to reopen the airway. Unfortunately, this ‘wake session’ is commonly not remembered.

• Excess weight
• Older age
• Narrowed airway
• High blood pressure (hypertension)
• Chronic nasal congestion
• Smoking
• Diabetes
• Sex
• Family history 
• Asthma

Causes of CSA In Veterans

Central SA occurs when your brain does not send proper neurological signals to your muscles that control breathing. CSA is common after a brain injury or heart disorder.

• Heart disorders. Veterans with irregular heartbeats (atrial fibrillation) & (congestive heart failure)
• Stroke, brain tumor, or a structural brainstem lesion (Includes Traumatic Brain Injury)
• High altitude – (Acute)
• Opioid use 
• CPAP
• Gender
• Age

Causes of MSA In Veterans

Mixed or “hybrid” apnea combines Central and OSA. As a result, your brain does not send proper signals to breathe correctly, causing your body not to provide the appropriate effort to inhale or exhale, AND you have an obstructed airway during breathing.

Veterans and Sleep Problems

SAs are an unavoidable sleeping condition that causes breathing interruptions in one’s sleep or if they occur repeatedly. 

Often, this sleep disturbance happens atnight. Typical apneic sleep symptoms occur in REM Sleep because of the natural muscle tone in the airway. REM (Rapid Eye Movements) is commonly called Deep Sleep. These disturbances may vary in how they occur – in obstructions or central and mixed forms of both.

Do Central, Obstructive, or Mixed Apneas Rate Differently?

No, central, obstructive, and MSA all rate the same. They are all rated under 38 CFR part 4 sleep apnea; specifically:  38 CFR 4.97 Code 6847. You can only have 1 rating for SA syndromes due to pyramiding.

What are the Sleep Apnea VA Ratings in 2023?

Code 6847 Sleep Apnea Syndromes (Obstructive Sleep Apnea, Central Sleep Apnea, Mixed Sleep Apnea):

1. Chronic respiratory failure with carbon dioxide retention or cor pulmonale or; requires tracheostomy – 100%
2. Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine – 50%
3. Persistent day-time hypersomnolence – 30%
4. Asymptomatic but with documented sleep disorder breathing – 0%

The average rating for SA is 50%, as most people diagnosed with this disability require a CPAP machine. On rare occasions, the VA raters award hypersomnolence for this condition.

How to Service-Connect OSA, CSA, or MSA?

There are quite a few ways to service connect sleep apnea conditions. Direct and Secondary are the most common ways. However, there are some presumptive conditions for Gulf War Veterans as well. Our article outlines the: Top 5 Ways to Service Connect OSA, CSA, or MSA to understand how to connect your condition.

Writing A Lay Statement for Apnea Conditions

When applying for VA benefits sleep apnea claim, you must write an effective lay statement for your sleep apnea diagnosis. We have assembled ways to write an effective lay statement to connect your condition under our article: How To Write A Lay Statement For Sleep Apnea.

Is Sleep Apnea the same as Insomnia (Chronic Sleep Impairment)?

No.  The VA rates insomnia (chronic sleep impairment) under mental health at the 30% level:

The VA rates Obstructive Sleep Apnea, Central Sleep Apnea, and Mixed Sleep Apnea under 38 CFR part 4.97.

(source ecfr.gov, 38 CFR 4.130)

Conclusion

• There are three types of Apneas
• The 4 rating levels for Sleep Syndromes are:

1. 1. Chronic respiratory failure with carbon dioxide retention or cor pulmonale or; requires tracheostomy – 100%
   2. Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine – 50%
   3. Persistent day-time hypersomnolence – 30%
   4. Asymptomatic but with documented sleep disorder breathing – 0%

• Understand your causes for the condition

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Need More Help?

We offer free, no-obligation 30-minute strategy sessions to thank you for your service. In addition, the Blue Cord Patriots will be happy to hear about the issues you face with service-connecting your condition and will provide your next steps and strategies to provide better success for you.  We can help determine if you require any nexus letters for your condition.

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