Unless the veteran has a solid diagnosis of OSA while on active duty,
the condition may be impossible to claim as service connected.
Snoring may be a sign of OSA or it may not. OSA is a serious health
condition and more information is brought into our knowledge banks every
To be awarded a benefit for OSA will require a medical record that
supports your claim that you had OSA during your military service. A
statement from your spouse or a buddy isn't likely to carry any weight.
If your OSA has been diagnosed well after your military service has
ended but you've heard how lucrative the benefit is (50% if you use a
CPAP) you should think long and hard before you apply for the award.
If you were a chronic heavy snorer while on active duty, can you
document that? Did you ever make a sick call because of chronic daytime
sleepiness? Have you ever been at fault in an accident where you fell
asleep at the wheel of your vehicle? During any hospitalization or
surgical treatment, did a health care provider make a note to your
record about your airway obstruction or a breathing problem during
Once you're sure that you can prove your case, you may want to file that
claim. If you don't believe that you have the evidence you'll need,
consider delaying any action while you attempt to have a nexus letter written. That could require a formal IME that you'll pay for out of your own pocket.
If you're a heavy snorer today, whether or not you are able to make a
service connection and receive a VA benefit, get a sleep study done.
Sleep studies are now available for you to have it all done in the
privacy of your own bedroom. You no loner must spend a night in a sleep
lab...you can take a small piece of equipment home (a headband sort of
arrangement) and wear it to bed. When you return it to your doctor the
data gathered will be analyzed for a diagnosis.
Using a CPAP may reduce the incidence of adult onset diabetes, heart
disease, strokes and many other of the conditions that come to us as we
age. Not only that...the daytime sleepiness you experience from the lack
of a good nights sleep will be much less severe.
Medicare and most insurers will pay for the home sleep study and the CPAP you may need afterwards. It's well worth your time.
2001, the year U.S. forces invaded Afghanistan, 983 veterans began to
draw disability compensation from the Department of Veterans Affairs for
sleep apnea, a disorder linked to obesity and characterized by pauses
in breathing during sleep that can cause chronic drowsiness.
year, 25 times that number of veterans and military retirees (24,791)
were added to VA compensation rolls for service-connected sleep apnea,
raising the number of vets and retirees drawing apnea payments to
114,103, double the number VA reported just three years earlier.
Regrettably, this divorce lawyer doesn't note that the recent wars have
been cited for significant problems with breathing issues due to
exposure to toxic chemicals, burn pits and so on. Maybe that's the real
reason behind any rise in benefits claims. That and the fact that recent
medical science advances have shown us much more about the condition
and how to treat it.
OSA is a severe health hazard and a prescription for a CPAP is not a
cure. Rather, a CPAP is a complex medical device that a veteran patient
must deal with for the rest of his/her life.
To paint veterans as abusers of the benefits system with such a broad
brush isn't unusual when it's done by someone who isn't suffering from
The "I've got mine & screw you" syndrome is all too often seen by VAWatchdog.
Don't let this guy fool you. OSA is a serious health condition and it
lasts all your life. There's a reason that OSA may be rated as high as
50%...it can kill you.
Do you have a rating for PTSD? Do you also have a positive diagnosis of OSA? Do you use a CPAP?
You may be eligible for OSA service connected benefits as a secondary
condition even if you don't have a service medical record of OSA.
Consider that many of the medications that are used to treat sleep
disturbances or mental health conditions may have an effect on your
sleep patterns. If your OSA was diagnosed after you started taking
medicines to aid your sleep or to treat some mental health conditions,
you might want to consider filing for OSA as secondary to the service
Before you decide to do that, review the side effects of the medicines
and be ready to offer a sound reasoning for your claim. Once you're sure
that the medicines you take cause or aggravate your OSA, file for the
Heavy, oxygen depleting snoring may be something you knew about long
ago. Your spouse may have complained. Your buddies may have commented on
your heavy snoring while you were in your bunk.
You may have suffered overwhelming daytime sleepiness for years.
Now, how do you convince VA that the OSA had its origin while you were on active duty? Sometimes, you can't.
Maybe your OSA didn't manifest on active duty. Maybe the condition crept
up on you as you were treated for other maladies like diabetes or PTSD.
No matter what your history is, it's worth considering whether or not
you should file a claim for OSA. If you left the service 20 years ago
and you've been in relatively good health but gained weight over the
years and now you snore, you probably aren't service connected. If the
medicine you take for your PTSD or any other condition contributes to
your snoring and gasping for breath as you sleep, you may have a
No matter what the basis of the claim, service connection for OSA is
complex. You have to use precise language. For example, if you claim OSA
as secondary to PTSD, you'll probably lose. If you claim OSA as
secondary to the soporific effects of the medicines that doctors
prescribe for your PTSD and you provide evidence that the medicine you
take can cause, contribute to or aggravate OSA, you have a good claim.
Read the BVA appeals we'll list for you here. Learn from the mistakes
and triumphs of others. Avoid the errors and duplicate the good work of
those who have gone before you.
specialist Meir Kryger, MD, of the Yale University School of Medicine
and the VA Connecticut Health System, tells WebMD the findings highlight
the growing recognition that sleep disturbances play a significant role
in chronic disease. “It is now clear that patients with heart disease
or a metabolic disease like type 2 diabetes should be asked about their
sleep habits, and they should be treated if they have sleep apnea,” he
VAWatchdog "Eric" follows up the story below with even more data for you to use.
Your readers will be surprised to learn just how much has been
clinically connected to PTSD. For example, PTSD has been shown as being
tied to asthma. Click here for the link.
You might want to call veterans attention to the National Institute of Health research resources website.
There, a veteran can perform a search "Diagnosis "A" AND Diagnosis "B",
and get to see the very same journal articles that the VA examiner
-should- be looking at. Granted examiners rarely do the search
themselves, so the vet would be well served to do this on their own.
A "Meritorious" claim would be one that shows a direct link between
Diagnosis "A" AND Diagnosis "B". But when ever possible the veteran
should submit three such journal articles to show a secondary cause.
These should be cited on a VA From 21-3148 in proper APA or Blue Book
format, as the RO's are often told to discard journal articles submitted
by the veteran. This will protect the veteran's rights should the
examiner fail to address the journal article's in responding to the
BDQ's. Here the following case should also be cited, "Robinson v. Mansfield 21 Vet.App. 545 (2008)"
Where the court asserted that the Board MUST address every theory
reasonably raised by the record. Citation of a journal article on a VA
Form 21-4138 or within a NOD in support of a theory of secondary service
connection most certainly raises an issue in the record.
Then bring a copy of each article, or at least the abstract, to the exam
just in case you have a cooperative examiner. But CYA using the above
steps at some point before expiration of the NOD.
Many thanks to Eric & Sniper2!
VAWatchdog "Sniper2" writes to point out an important case he's discovered.
I was denied comp for my sleep apnea claim recently. The VA claimed I
had not been treated or asked to be treated for sleep apnea during my
active duty so no benefits. I have been diagnosed by the VA with
chronic apnea and issued a CPAP.
I found this appeals court case on the net and it rules in favor of a
vet who wanted his sleep apnea to be recognized as secondary to his PTSD
and/or PTSD meds. He never claimed to have been treated for sleep apnea
while on active duty nor did he claim he ever asked for treatment. The
BVA granted full benefits of his OSA secondary to his PTSD irregardless
of his past history showing he never asked for or received treatment
while in service.
I filed for sleep apnea as secondary to my PTSD after reading this
case. I have already been called in for a CP exam and handed the Dr. a
copy of this court case. She seemed to be very interested in it as I
watched her reading it. Point of this of course is that this case could
open a flood of sleep apnea claims that have been denied. I feel 100%
confident the VA will now award me 50% for sleep apnea as secondary to
my PTSD. The appeals court case does not distinguish between PTSD or
PTSD meds as being qualifiers but vets should be aware that the VA will
ask the vet which one he feels the apnea stems from. Tell them both.
Have a good day buddy.
Your message is an important one. Conditions that are either directly
caused by a primary service connected condition or may be aggravated by
the primary condition are often called "secondary" ratings. To establish a secondary cause can be tricky. Often enough, the nexus is routine...diabetes leading to PAD is a readily apparent cause and
effect relationship. Other cause and effect scenarios won't be as
obvious and will require a medical opinion in support of the hypotheses.
This case is a good example of how a veteran carefully crafted the
necessary documents in support of his claim. This is the sort of
patience and tenacity required when working with your VA.