Being rated for sleep apnea

dptrck89

Registered Member
Hey everyone,

I am new to all this, but I was hoping to get help and some clarification.

I was recently diagnosed with sleep apnea and have been given a CRAP machine by the VA. Is this still ratable at 50%?

Also, does it have to be linked to a specific thing that happened in military service like PTSD or do I just have to have been diagnosed to put in the claim. I never had any problems before the service, but now I need this machine. I am just confused because there is alot of conflicting information out there.

Thanks!
 

gsfowler

Staff Member
PEB Forum Veteran
Yes, sleep apnea requiring the use of a CPAP is rated at 50%. The VA will determine the service connection when you file the C&P claim.


The rating criteria is below:

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

Chronic respiratory failure with carbon dioxide retention or corpulmonale, or; requires tracheostomy.............................................................. 100

Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine...................................................................... 50

Persistent day-time hypersomnolence .................................................................... 30

Asymptomatic but with documented sleep disorder breathing.................................. 0
 

Warrior644

Staff Member
PEB Forum Lifetime Supporter
PEB Forum Veteran
Registered Member
Hey everyone,

I am new to all this, but I was hoping to get help and some clarification.

I was recently diagnosed with sleep apnea and have been given a CRAP machine by the VA. Is this still ratable at 50%?

Also, does it have to be linked to a specific thing that happened in military service like PTSD or do I just have to have been diagnosed to put in the claim. I never had any problems before the service, but now I need this machine. I am just confused because there is alot of conflicting information out there.

Thanks!
Welcome to the PEB Forum! :)

Hmm, indeed, a very good question...

It seems many military veterans are unaware that if you are military service-connected for PTSD, you can also file a DoVA claim for veterans disability compensation on sleep apnea as secondary to PTSD. If you are claiming sleep apnea as secondary to PTSD, then you should already be rated as military service-connected for PTSD. If not, then you must organize and word your DoVA claim carefully, so it is very clear to the VA rating officer that he/she must first determine your claim for PTSD, and only then consider your sleep apnea.

Once you are military service-connected for PTSD, you need to show that it is "as likely as not" that your sleep apnea is somehow related to your PTSD. There have been numerous journal studies performed which determined a strong correlation of comorbidity between PTSD (or any other anxiety/mood disorder) and sleep apnea.

To that extent, one piece of evidence that will help your DoVA claim is having your doctor write a letter saying exactly what the journal study states: based on the science, "it appears to be as likely as not that your sleep apnea and your PTSD are related conditions." Remember that since this is a VA claim for a secondary condition, you are trying to prove the connection between sleep apnea and your military service-connected PTSD, not the direct link between sleep apnea and your military service.

As such, the doctor's examination is critical to your VA claim for a secondary condition. If the doctor who examines you believes it is at least "as likely as not" that your sleep apnea is related to your PTSD (and he/she will put that in writing), then you shall have a strong VA claim that is likely to be granted.

Bottom line is that if you have PTSD and Sleep Apnea, then you can now file a DoVA claim for the sleep apnea as a secondary to your PTSD if applicable.

In retrospect, I have been diagnosed with PTSD and Obstructive Sleep Apnea with CPAP while still on active duty in the U.S. Army with both medical impairments being designated as related conditions and military service-connected by the DoVA D-RAS. That said, I am currently generating a DoVA claim inclusive of sleep apnea as secondary to PTSD in the forthcoming submission of a new VA disability compensation claim. More to follow upon receipt of updated VA claim information.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 
Last edited:

scoutCC

PEB Forum Veteran
Registered Member
have to be linked to a specific thing that happened in military service like PTSD
All VA claims need service connection.

Primary service connection is linked to a specific thing. Maybe an event, maybe early showing of symptoms, etc.
Secondary service connection is by linking it to an already service connection condition, such as PTSD as Warrior64 talks about.
Presumptive service connection is by linking it to when and/or where you served, generally this won't apply for sleep apnea, but maybe if diagnosed within one year of discharge.

Generally this link is provided by a doctor. As long as your claim includes a basically plausible theory, the VA should help you investigate that link with a C&P exam.
 

fair_warning66

Registered Member
How did your sleep apnea claim related to PTSD work out? I am diagnosed with PTSD service connected and have been diagnosed with sleep apnea. I would love to see that you were successful.
 

SPCMILTON52D

Registered Member
Welcome to the PEB Forum! :)

Hmm, indeed, a very good question...

It seems many military veterans are unaware that if you are military service-connected for PTSD, you can also file a DoVA claim for veterans disability compensation on sleep apnea as secondary to PTSD. If you are claiming sleep apnea as secondary to PTSD, then you should already be rated as military service-connected for PTSD. If not, then you must organize and word your DoVA claim carefully, so it is very clear to the VA rating officer that he/she must first determine your claim for PTSD, and only then consider your sleep apnea.

Once you are military service-connected for PTSD, you need to show that it is "as likely as not" that your sleep apnea is somehow related to your PTSD. There have been numerous journal studies performed which determined a strong correlation of comorbidity between PTSD (or any other anxiety/mood disorder) and sleep apnea.

To that extent, one piece of evidence that will help your DoVA claim is having your doctor write a letter saying exactly what the journal study states: based on the science, "it appears to be as likely as not that your sleep apnea and your PTSD are related conditions." Remember that since this is a VA claim for a secondary condition, you are trying to prove the connection between sleep apnea and your military service-connected PTSD, not the direct link between sleep apnea and your military service.

As such, the doctor's examination is critical to your VA claim for a secondary condition. If the doctor who examines you believes it is at least "as likely as not" that your sleep apnea is related to your PTSD (and he/she will put that in writing), then you shall have a strong VA claim that is likely to be granted.

Bottom line is that if you have PTSD and Sleep Apnea, then you can now file a DoVA claim for the sleep apnea as a secondary to your PTSD if applicable.

In retrospect, I have been diagnosed with PTSD and Obstructive Sleep Apnea with CPAP while still on active duty in the U.S. Army with both medical impairments being designated as related conditions and military service-connected by the DoVA D-RAS. That said, I am currently generating a DoVA claim inclusive of sleep apnea as secondary to PTSD in the forthcoming submission of a new VA disability compensation claim. More to follow upon receipt of updated VA claim information.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
So do you happen to know where I can find a medical journal connecting the two? Thank you!
 

gsfowler

Staff Member
PEB Forum Veteran
So do you happen to know where I can find a medical journal connecting the two? Thank you!
scholar.google.com

In the search bar type in "PTSD and Obstructive Sleep Apnea" A lot of times medical journal articles are behind a paywall, therefore it may take a bit before you find one that contains evidence that is of use to support your claim.

Here is a pretty good article from the Journal of Sleep Clinic Medicine.

http://jcsm.aasm.org/ViewAbstract.aspx?pid=29881
 

Warrior644

Staff Member
PEB Forum Lifetime Supporter
PEB Forum Veteran
Registered Member
So do you happen to know where I can find a medical journal connecting the two? Thank you!
Indeed, and in addition to @gsfowler's insightful feedback, please reference the below studies to assist with medically validating the relationship for Sleep Apnea as secondary to PTSD:

The National Veteran Sleep Disorder Study: Descriptive Epidemiology and Secular Trends, 2000–2010.
https://academic.oup.com/sleep/article/39/7/1399/2453971?searchresult=1

Association of Psychiatric Disorders and Sleep Apnea in a Large Cohort (2005).
https://www.researchgate.net/publication/7434993_Association_of_Psychiatric_Disorders_and_Sleep_Apnea_in_a_Large_Cohort

Sleep Disorders and Associated Medical Comorbidities in Active Duty Military Personnel.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543057/

Sleep disorder in US military personnel: a high rate of comorbid insomnia and obstructive sleep apnea.
http://www.ncbi.nlm.nih.gov/pubmed/23681455

Sleep disorders and associated medical comorbidities in active duty military personnel.
http://www.ncbi.nlm.nih.gov/pubmed/23372263

Again, please be mindful of it's highly imperative that a medical doctor's examination is critical to any DoVA disability claim for a secondary condition. If the medical doctor believes it is at least "as likely as not" that the sleep apnea is related to PTSD (and he/she officially documents that belief in writing), then you shall have a strong DoVA claim that is likely to be granted by the DoVA Rating Agency. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

SPCMILTON52D

Registered Member
Man, I sure do appreciate your information! It's going to be quite helpful when I see my PCP this Friday and ask him to write a nexus letter or put it in his notes. The reason I'm asking him is that I don't see my sleep doctor again until November.
 

Warrior644

Staff Member
PEB Forum Lifetime Supporter
PEB Forum Veteran
Registered Member
Man, I sure do appreciate your information! It's going to be quite helpful when I see my PCP this Friday and ask him to write a nexus letter or put it in his notes. The reason I'm asking him is that I don't see my sleep doctor again until November.
Great! No worries and you are quite welcome!

Indeed, get that nexus letter from either your PCP or sleep doctor with the minimum "at least as likely as not" verbiage that the sleep apnea is related to PTSD.

For historical knowledge, reference the entire expressions in which the medical doctor's opinion for nexus should be based upon as shown below:

#1. “is due to” (e.g., 100% sure)
#2. “more likely than not” (e.g., greater than 50%)
#3. “at least as likely as not” (e.g., equal to or greater than 50%)
#4. “not at least as likely as not” (e.g., less than 50%)
#5. “is not due to” (e.g., 0%)

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

chaplaincharlie

Staff Member
PEB Forum Lifetime Supporter
PEB Forum Veteran
Registered Member
OSA is also linked to heart disease. My suggestion is always file a claim and let the VA do its thing. The concept of linked diseases is NOT news to them.
 

wilnel

Registered Member
i'm in this same boat too, i got diagnosed by civilian doc with sleep apnea. I am still in the guard. I am trying to get setup with the va to get tested for ptsd. I was going to file a claim for sleep apnea first but I am glad I stumbled onto this thread. I don't know if i'll get diagnosed with the ptsd or not, I was in oifII and it was pretty traumatic but I sleep well, and I never thought about suicide. I know they want to know how it has affect your life and I am trying to figure that out.
 

Bobmoran

Registered Member
CPAP machines and masks require a doctor's prescription to purchase, so he'll need a sleep study performed before he can buy one.

Have the clinic refer your dad to the specialist for a sleep study. From there, they can best advise on his options.

They are also significantly overpriced in Singapore. I bought a new ResMed S9 AutoSet from secondwindcpap, and it was about 35% cheaper than buying locally. You could save even more if you're willing to buy a used unit.

While I do sleep better with it, it does take some getting used to, and not everyone can accept it. There are nights where I can't sleep with my mask on, but having a night of poor sleep was still better than no sleep.

The main complaint that I have, is that it is quite bulky and not travel friendly.

Also that info will be useful for you as for a newbie: http://healthyhowardmd.org/cpap-machines/
 
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