While more veterans are filing VA Sleep Apnea claims, more are being denied: between 2013 and 2014, over 75% of Sleep Apnea appeals to the BVA were denied. And there are still a lot of OSA claims submitted on a direct basis with zero evidence of any sleep issues in service. Generally, to establish service connection, the veteran needs to submit three things to VA: A current diagnosis of sleep apnea, as confirmed by a sleep study; An in-service event, injury, or illness; and. I study how sleep is affected by common conditions among Veterans, including traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), Parkinson's disease and Alzheimer's . #3. I recently received word back from the VA that my sleep apnea claim was denied. Diagnosis of Sleep Apnea Veterans that wish to obtain a VA sleep apnea rating should first get a diagnosis from the appropriate medical professional. That means that 3 out of every 4 Veterans are spending years in the VA Hamster Wheel trying to . Found medical records after 17 years all claims were denied in 2018 re-filed in 2021 partial claim just confirmed via VA phone call and on VA app 20% for my ankles and I've got mental health C&P next week don't give up there's always hope! 13 posts Supplemental Claim Denied - Sleep Apnea Supplemental Claim Denied - Sleep Apnea. VA Claims Forums > Appeals > Supplemental Claim Denied - Sleep Apnea. The major causes appear to be sleep deprivation and chronic stress. 24:23 Understanding why your sleep apnea claim was denied Veterans with Sleep Apnea will be subject to their Sleep Study results; if Veterans claim they have Sleep Apnea and do not see a Sleep Specialist and get tested for Sleep Apnea, it is unlikely they will win a sleep apnea VA disability rating. Here's what the 38CFR lists for sleep apnea: 6847 Sleep Apnea Syndromes (Obstructive, Central, Mixed): The military utilizes VA disability ratings to determine the severity of the Obstructive, Central, or Mixed Sleep Apnea. Aug 11, 2021 #1. This is always a denial. Gulf War veterans are eligible for disability benefits through the VA, but they must prove that their symptoms are caused by their military service. 13 posts Supplemental Claim Denied - Sleep Apnea Supplemental Claim Denied - Sleep Apnea. Veterans NEED Information and Education to Improve their VA Sleep Apnea Appeals. Sleep apnea has become the most prevalent service-connected respiratory disability for military personnel. VA claim for sleep apnea denied? Been where your at, and was awarded sleep apnea secondary to tinnitus. A medical nexus (i.e., link) between their sleep apnea and the in-service event, injury, or illness. The most documented VA percentages for sleep apnea are as follows: 0% Sleep apnea with documented sleep disorder breathing that is currently asymptomatic. 4) Narrow air passages in the nose and throat. They deny most claims. One common scenario is when a veteran tries to claim sleep apnea as a primary condition when there was no diagnosis during active-duty service. Why would a VA claim for sleep apnea be denied? My name is Jay. A VA claim for sleep apnea can be denied for many reasons. . Share. I had a claim in for Sleep Apnea, as I have been diagnosed and prescribed a CPAP. So, many veterans wonder why they do not . The purpose of this article is to give tips on how to win your Sleep Apnea VA disability benefits claim, aka Sleep Apnea VA claim, so you can get the rating and compensation you deserve. 76% were Denied or Remanded for more evidence. If you were denied sleep apnea VA disability benefits within the last year, you should consider talking to a VA disability appeal lawyer. Many veterans attempt to service-connect sleep apnea as a primary disability condition and can't seem to figure our "why" the VA keeps denying your sleep apnea claim. 4 2. Hello All, The appeals board found that the veteran met the criteria for a 70 percent disability rating for depressive disorder, and reopened the claim. No current medical diagnosis (within the last 12 months), or improper diagnosis #3. You submit a supplemental claim with a good IMO/NEXUS letter from a qualified physician. . (866) 232-5777 or fill . A provided a NEXUS statement that stated the apnea was more than 52% likely to be the cause. Allow us to help you get the compensation you deserve. Jim's Reply: The VA is scrutinizing Obstructive Sleep Apnea (OSA) claims very carefully these days. The number of VA disability ratings that are awarded for sleep apnea is on the rise, however, it still fails to address the entire issue. I study how sleep is affected by common conditions among Veterans, including traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), Parkinson's disease and Alzheimer's . Three Elements of a Successful VA Sleep Apnea Rating Claim. According to the VBA , there were over 282,300 service-connected sleep apnea claims that were awarded in 2017. 5) A large tongue that can block the airway when you sleep. I had a sleep study completed and the study indicated that I had obstructed sleep apnea and required a CPAP. It pays for itself with first back pay check. Your odds of getting SC are a whole lot better. No current sleep study within the last 12 months #2. I had a sleep study completed and the study indicated that I had obstructed sleep apnea and required a CPAP. If you are submitting a secondary OSA claim, consult with a VA accredited agent or attorney. hello, biggest reason sleep apnea gets denied is it was not diagnosed in service, symptoms are related to another disability, or no current actual sleep apnea diagnosis. In order to establish direct service connection for sleep apnea, a claimant must show that they have a current, diagnosis of sleep apnea, an in-service event or illness/injury, and a medical nexus or link that shows the veteran's sleep apnea is related to their in-service event, injury/illness. The VA reports that nearly 1 in 4 respiratory claims for VA disability benefits is linked to sleep apnea. Beware This Pitfall in VA Sleep Apnea Claims One of the two changes makes it a little easier for the Regional Office to deny your VA sleep apnea claim at the 50% disability rating level. Here is a fairly common situation. No body wants to pay out a little $$ for a good IMO/NEXUS letter. VA Claims and Appeals Process; Has Your Claim Been Denied? The symptoms have disappeared or are not severe enough to cause any issues. No current medical diagnosis (within the last 12 months), or improper diagnosis. These claims can be wrongly denied, especially if VA does not consider all the evidence. What made the difference was that the veteran inVA sleep apnea claim #1 lacked ANY lay evidence of sleep apnea symptomatology from service to diagnosis. I suppose the reason is obvious; many veterans apply because of the relatively high 50% rating. C:\USCAVC_Docs\SINGLE.CVA\EdwardsPD_20-5533.pdf EdwardsPD_20-5533.pdf I thought that anything within 1 year of separation was considered service connection. FREE Guide Books. To confirm a sleep apnea diagnosis for VA disability compensation purposes, . If you use a CPAP machine, then this should warrant a 50% rating. * The 5 Reasons that 76% of VA Sleep Apnea claims are denied - and how to fix the problem in YOUR case. be scrutinizing VA disability claims for Sleep Apnea more closely than they did in the past. The nexus letter i review on a daily basis lack painting the picture of the veteran and focus more on the studies on other individuals. Many Veterans are denied VA benefits for Sleep Apnea due to a lack of medical evidence with no in-service diagnosis of Sleep Apnea, and no sleep study. In July 2012, the Veteran filed his claim for a sleep disorder. By subscribing to the Veterans Law Blog you get a free copy of the eBook version - along with many more training manuals and instructional videos. That means that 3 out of every 4 Veterans are spending years in the VA Hamster Wheel trying to prove their Sleep Apnea service connection claims and appeals! 76% were Denied or Remanded for more evidence. The VA erred in finding a lack of a medical nexus between the PTSD and sleep apnea, despite the fact that sleep apnea was one of the rated conditions. Aug 11, 2021 #1 I was recently denied my claim for sleep apnea. Qualifying for VA disability benefits for sleep apnea 3) Abnormal facial features, such as a recessed lower jaw (called an advanced velopharyngeal insufficiency). 2) Chronic lung diseases, such as asthma or emphysema. Sleep disordered breathing, as well as the myriad of symptoms linked with it (such as sleepiness and fatigue), can all exacerbate the relationship between sleep apnea and PTSD. Free Case Evaluation. Yes, but there are many things to consider when filing a VA claim. VA Claims Forums > Appeals > Supplemental Claim Denied - Sleep Apnea. In some. The VA seems to . The most documented VA percentages for sleep apnea are as follows: 0% Sleep apnea with documented sleep disorder breathing that is currently asymptomatic. Check out the VA Sleep Apnea Field Manual. Share with: Link: Copy link. 855-855-8992. No proof of service connection (missing a nexus letter) A doctor at a VA medical center recommends a sleep study for a veteran. Though there are some conditions that can be granted service connection if they are diagnosed to a compensable degree within one year of leaving active duty, sleep apnea is not one of them. I had a claim in for Sleep Apnea, as I have been diagnosed and prescribed a CPAP. September 18, 2018, Washington, DC - Bergmann & Moore attorneys prevailed on behalf of a peacetime Veteran who originally sought disability compensation benefits for his sleep apnea from the U.S. Department of Veterans Affairs (VA) more than six years ago. To properly comment on your situation I'd have to know the date (month/year) you were discharged. Veterans can submit a claim for service . 24% of those Veterans Sleep Apnea appeals were Granted. After first reading these examples, the obvious answer is that the private examiner's opinion in VA sleep apnea claim #2 was what made the difference. #2. The VA uses two options for rating most sleep apnea claims. #1: Veterans Don't Often Know How to File a VA Sleep Apnea Claim. Post Aug 15, 2019 #1 2019-08-15T22:01. Sleep apnea VA disability claims account for nearly 1 in 4 respiratory claims. 3) Abnormal facial features, such as a recessed lower jaw (called an advanced velopharyngeal insufficiency). The diagnostic criteria for a VA sleep apnea claim, found in the Code of Federal Regulations, have not changed. Post Aug 15, 2019 #1 2019-08-15T22:01. But, VA does not assign a rating. One common scenario is when a veteran tries to claim sleep apnea as a primary condition when there was no diagnosis during active-duty service. . 4 2. 6) Poorly fitting upper teeth, which may collapse the airway when you sleep. The obvious answer is the wrong answer. If you have a service connected sleep apnea disability, then a CPAP would usually entitle you to a 50% rating. I filed the claim as as secondary to GERD a pre-existing already disability. A provided a NEXUS statement that stated the apnea was more than 52% likely to be the . 4 2. captamericao9. In our experience, OSA denials are almost always due to one or more of these five gaps: #1. Hello All, Check out the VA Sleep Apnea Field Manual. Without a CPAP machine, the VA assigns a 30% rating. I submitted lay statements from my ex-boss and wife along with my sleep study from my doctor. The VA can not deny the claim. FAQs; Contact Us; Blog; CALL US TO GET STARTED. Many of them have been diagnosed with the condition many years after leaving active duty service . In our experience, OSA denials are almost always due to one or more of these five gaps: #1. In fact, the va has put together a list of conditions associated with sleep apnea as follows: 1) Heartburn or acid reflux disease.