How To Service Connect Sleep Apnea

Top 5 Reasons for Obstructive Sleep Apnea Claim Denials (Plus OSA Service Connection Tips)

Was your obstructive sleep apnea (OSA) VA claim denied? OSA is a common deprival veterans receive when pursuing a VA claim, but it doesn't have to exist—if you lot empathize the condition and what your merits must include in lodge to be successful.

In this article, we'll help you understand the tiptop 5 reasons OSA claims are denied—and even improve, what to exercise almost information technology if you've received a denial for your OSA merits. We share our top tips and a footstep-by-step guide to a successful claim for obstructive sleep apnea!

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What is obstructive sleep apnea?

First of all, let's explore a little most this common inability in veterans, so you understand the condition and why information technology's important you pursue your claim and get the benefits you lot deserve.

Sleep apnea is a sleep disorder in which breathing is repeatedly interrupted during the course of slumber. Broadly, it'south defined every bit the occurrence of five or more than breathing-related "events" per hour, measured by polysomnography (sleep study).

These temporary breathing disruptions or lapses can occur from dozens to hundreds of times per nighttime. The resulting reduction in sleep quality and in the torso'south supply of oxygen can have serious consequences on health and quality of life.

Obstructive sleep apnea (OSA) is the most common blazon of slumber apnea. It occurs when airflow is impaired repeatedly during slumber due to blockage in the upper airway. The blockage is believed to occur when the muscles in the back of the pharynx go overly relaxed.

Some of the about mutual symptoms of slumber apnea include:

Disrupted breathing in which a person'due south respiration can get labored or even terminate for upwardly to a minute at a time
Excessive daytime sleepiness
Morning headaches
Irritability
Limited attending span or difficulty thinking clearly
Snoring, including snoring that is specially loud and involves gasping, choking, or snorting that may cause a person to briefly wake up
Morning sore throat or dry mouth

People who suffer from sleep apnea are often unaware of the animate disturbances, finding out virtually them from a bed partner or roommate. Excessive daytime sleepiness is the most noticeable signal for those who alive alone.

Left untreated, sleep apnea tin can lead to cardiovascular diseases (high blood force per unit area, center failure, arrhythmias, stroke), diabetes, low, and headaches, among others.

Obstructive sleep apnea is estimated to affect between 2-9% of adults (virtually 15 1000000 Americans) simply is believed to be frequently undiagnosed.

Slumber apnea is extremely common among veterans, every bit the disorder is frequently caused or exacerbated by fourth dimension in service. (In one report, 69.2% of veterans were assessed as existence at high risk for OSA.)

If you're experiencing any of the symptoms listed above, and doubtable your sleep apnea arose from your fourth dimension on agile duty (or was or aggravated by a currently service-connected disability), yous should consider seeking a diagnosis and pursuing bounty for this inability.

Even if you've been denied before, it'due south not likewise belatedly!

The Top 5 Reasons OSA Claims Are Denied

VA merits for sleep apnea denied? In our experience, OSA denials are about always due to ane or more of these five gaps:

#1. No current sleep study within the terminal 12 months
#2. No electric current medical diagnosis (within the last 12 months), or improper diagnosis
#3. No proof of service connection (missing a nexus letter)
#iv Lack of agile-duty documentation and medical prove
#5 Filing for direct service connection vs secondary service-connection (secondary to an already service-connected disability)

Fortunately, in that location are elementary strategies yous tin can employ to accost these factors—even if the VA has already denied your VA merits for sleep apnea.

Steps and Strategies: How to Evidence Service Connexion for Slumber Apnea

Follow the steps beneath to remedy the above-listed typical reasons for deprival, and you'll be much closer to a winning claim!

Stride #one: Get a NEW sleep study (if yours was not in the last 12 months)
Pace #2: Confirm a medical diagnosis of sleep apnea with a sleep specialist (or your primary care provider)

Stride #iii: Obtain a nexus letter for sleep apnea
Footstep #4: Pursue filing for OSA or SA as secondary to an already service-connected disability (if a diagnosis of OSA or SA was non documented in your service treatment records while on agile duty)

Footstep #1: Go a NEW Slumber Study (within the past 12 months)

If you take symptoms of OSA, consider obtaining a sleep study, also known as polysomnography.

Even if you've had a sleep study before, it's important to become 1 washed within the 12 months prior to your VA claim. This will confirm a medical diagnosis and current symptoms, especially if they've become more astringent over time.

A slumber report is critical to confirming whether you meet the clinical diagnostic criteria for sleep apnea.

The polysomnography study records your brain waves, the oxygen levels in your blood, your centre rate and breathing, and eye and leg movements, amid other criteria.

At that place are three chief means for veterans to get a sleep study:

Discuss your sleep bug with your master care VA doc and enquire for a referral to a slumber specialist at the VA.
Enquire your private doctor for a referral to a sleep specialist in your area (a good option if y'all have private wellness insurance).
Order a sleep apnea at-dwelling examination kit.

Step #ii: Obtain a medical diagnosis of sleep apnea from a sleep specialist

Once you lot've finished your slumber written report, it'southward important to review your results with a sleep specialist to confirm whether you lot accept a medical diagnosis of sleep apnea.

You only need to found that your sleep apnea is "at least as likely as not":

caused or made worse by your agile duty military service OR
aggravated beyond its natural progression by another service-connected status (for secondary service connection).

va rating for sleep apnea secondary to tinnitus

Pace #three: Become a nexus alphabetic character for sleep apnea from a credible contained medical professional

A nexus letter of the alphabet is an bear witness-based document prepared by a medical professional person that helps to plant a connection betwixt the veteran's current disability and either military service (for direct service connection) or some other rated disability (for secondary service connectedness).

A nexus letter is oft the missing link in a VA claim. It'south an essential slice of show. In our experience, most VA disability claims are won or lost based on medical bear witness.

Lack of Medical Show is the #1 Reason VA Claims are Denied

Therefore, a well-crafted nexus alphabetic character for sleep apnea is the single near crucial document a veteran can provide the VA adjudicator to aid prove service connection on an "at least as likely as not" footing.

A apparent nexus letter fulfills i of the requirements for secondary service connection for slumber apnea: medical nexus show establishing a connection between the service-connected inability and the current disability (sleep apnea).

The contained opinion of a private medical professional can also influence the C&P examiner'due south medical opinion, as well as the VA rating official's final disability decision.

See our tips on how to obtain a apparent nexus letter.

Step #4: Consider secondary service connection instead of direct service connection

You'll need to make the call on direct service connection versus secondary service connection.

In our opinion, the merely time a veteran should pursue direct service connection for sleep apnea is if you had a sleep report performed while on active duty, which confirmed the presence of a sleep apnea condition (medically diagnosed) during agile-duty service.

Straight Service Connection Requirements

At that place are three components to proving direct service connection for any VA disability merits:

A current disability (medical diagnosis in medical records)
An in-service event, injury, disease, or aggravation; and
A link or nexus establishing that the electric current inability had its onset, inception, or aggaravation in service, which may be established past
- evidence of chronicity and continuity in your service handling records and private handling records, or
- a medical nexus opinion.

For the legal principles of direct service connection, encounter 38 CFR 3.303. Besides see our post What is a Service-Connected Disability?

Secondary Service Connection Requirements

In our feel, if y'all did NOT have a sleep study while on active duty and you lot did non get a medical diagnosis of sleep apnea in the military, y'all should only try to service-connect your slumber apnea VA claim SECONDARY to another service-continued inability.

Service connexion on a secondary basis requires evidence of aggravation or causation.This requires that the secondary inability be shown to be "proximately due to" or "proximately aggravated by" another service-continued disability.

By law, there are three evidentiary elements that must be satisfied for slumber apnea secondary conditions to prove secondary service connection:

A medical diagnosis of sleep apnea confirmed by a sleep study in VA medical records or private records (sleep study in past 12 months)
Bear witness of a service-connected primary inability (such equally PTSD, depression, anxiety, sinusitis, rhinitis), AND
Medical nexus show establishing a connection between the service-connected disability and the current disability

The first part tin can exist satisfied with any existing medical evidence— service treatment records, VA medical records, or any private medical records, bold you practice have a diagnosis of slumber apnea.

The second part can be satisfied with your existing service-continued disability rated at 0 percent or higher.

The third part tin can exist satisfied with a nexus Letter from a qualified medical professional, equally noted above.

Which principal disabilities brand the best claims for secondary service connexion of sleep apnea?

OSA and Upper Respiratory Weather

In our experience, an upper respiratory inability is 1 of the easiest choices for claiming OSA secondary to another service-connected disability.

Both sinusitis and rhinitis are linked to slumber apnea. If you have slumber apnea and sinusitis/rhinitis, your next step would exist to get a doctor'due south medical opinion supporting that your service-connected sinusitis/rhinitis caused or aggravates your sleep apnea.

This may be even easier for you now because of a new VA new rule as of Baronial 2, 2021. Thanks to additions to the VA presumptive list, you may be able to presumptively service-connect rhinitis, sinusitis, rhinosinusitis or asthma if you served in particular theaters during specified time periods. This opens doors for many veterans who were unable to service-connect these respiratory conditions previously. Run into our commodity Burn down Pit Presumptive Weather.

OSA and PTSD

OSA secondary to PTSD (or other mental health claim) is a more than challenging claim to make, but information technology is nevertheless a acme candidate for secondary service connection of sleep apnea. This is because the fact is that many veterans suffer from PTSD—and sleep problems are a common symptom of PTSD.

Emerging research indicates a strong association betwixt PTSD and slumber apnea.The link between sleep apnea and PTSD is probable due to the fact that many factors that beal PTSD likewise aggravate sleep apnea—including sleep impecuniousness, insomnia, hyperarousal, and daytime sleepiness.

In a study of veterans, PTSD symptom severity increased the risk of screening positive for OSA.

Both anxiety and low can as well exist linked to sleep apnea. Anxiety and depression tin can interfere with sleep patterns. People with sleep apnea are iv times more likely to take depression than people without a sleeping disorder.

While an OSA disability claim secondary to sinusitis/rhinitis is an easier path, veterans who are service-connected for PTSD (or other mental health conditions) are eligible for secondary service connection for their slumber apnea, and information technology's possible to achieve an OSA disability claim secondary to PTSD with the correct strategy and credible medical evidence.

Need more help?

You can too cheque out our 2022 Facebook alive video on the Top 5 Causes for OSA Denials and How to Gear up Them!

For all nigh getting a VA rating for sleep apnea, come across our post Your Sleep Apnea VA Rating — A Guide to Getting a VA Inability Rating for Sleep Apnea.

Every bit you've seen, claims for obstructive sleep apnea can be tricky—all the same important to pursue if you're suffering from this disability, and then you lot tin go the benefits you deserve and intendance yous need. Nosotros can help—reach out and then we can show you how.

Get the compensation you lot deserve.

Regardless of whether y'all are dealing with OSA, it'southward of import to pursue all the benefits available to yous equally a veteran. Most veterans are underrated for their disabilities and therefore non getting the compensation they're due.

At VA Claims Insider, we help you understand and accept control of the claims process, so you can go the rating and bounty you're owed by police force.

Our procedure takes the guesswork out of filing a VA inability merits and supports yous every pace of the manner in building a fully-developed claim (FDC)—and so you can increase your rating faster!

If you've filed your VA disability claim and take been denied or have received a depression rating—or yous're unsure how to become started—reach out to united states of america! Take advantage of a Complimentary VA Claim Discovery Call. Learn what you've been missing—then you tin can FINALLY go the disability rating and compensation you lot deserve!

We've supported more than 15,000 veterans to win their claims and increase their ratings. NOW IT'S YOUR TURN.

Brian Reese

Founder & CEO

Brian Reese is VA benefits proficient, author of the #one Amazon Bestseller Y'all Deserve It: The Definitive Guide to Getting the Veteran Benefits You've Earned, and founder of VA Claims Insider –"The Virtually Trusted Proper name in Education-Based Resources for Veterans."

His frustration with the8-pace VA disability claims procedure led him to create"VA Claims Insider," which provides U.Due south. armed forces veterans with tips, strategies, and lessons learned for successfully submitting or re-submitting a winning VA disability compensation claim.

Brian isas well the CEO ofMilitary Disability Made Piece of cake, which is the world'due south largest free searchable database for all things related to DoD disability and VA disability claims and has served more than than iv,600,000 military members and veterans since its founding in 2013.

His eBook, the"9 Secrets Strategies for Winning Your VA Disability Merits" has been downloaded more than than 300,000 times in the past three years and is the #1 rated free VA disability claims guide for veterans.

He is aquondam agile duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a gainsay tour to Transitional islamic state of afghanistan in 2011 supporting Operation ENDURING Liberty.

Brian is a Distinguished Graduate of Management from theUnited States Air Forcefulness Academy, Colorado Springs, CO and he holds an MBA from Oklahoma State University'southward Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Summit i% of Graduate School class).