Unfortunately, VA’s disability rules are not easy to understand. This often means that veterans are not sure whether VA is handling their claim correctly or not.
Many veterans have questions about VA’s rules, and I try to answer many of those in the articles I write on this blog. In this article, I would like to discuss an issue that pops up quite frequently when I talk to veterans about sleep apnea.
Here is a fairly common situation. A doctor at a VA medical center recommends a sleep study for a veteran. After the sleep study, the doctor prescribes a CPAP. But, VA does not assign a rating.
If you have a service connected sleep apnea disability, then a CPAP would usually entitle you to a 50% rating. So, many veterans wonder why they do not necessarily get that rating when a VA medical center prescribes a CPAP. They also wonder why VA denies them when they file their claim for sleep apnea.
Why don’t I automatically get a 50% rating when VA diagnoses me with sleep apnea and prescribes a CPAP?
What’s wrong here? Unfortunately, receiving medical treatment for your sleep apnea at a VA medical center does not automatically entitle you to VA disability compensation benefits for your sleep apnea.
Here is why. Sleep apnea is no different than any other VA disability compensation claim. A veteran must prove three things to win a VA disability claim.
A current diagnosis.
A current diagnosis means you currently have the condition for which you are seeking benefits. In the example which we are discussing, the current diagnosis is present.
VA diagnosed the veteran with sleep apnea and prescribe a CPAP. So ,the veteran should have satisfied that element of proof.
But, the current diagnosis is not the only part that you have to prove to VA. You also have to prove two additional elements.
An incurrence or aggravation of sleep apnea during your active duty military service
Your sleep apnea either had to start or worsen during your military service. This is part of the idea of service connection. It is a connection between your service and the condition for which you are claiming compensation.
The incurrence or aggravation is like the starting point on a line. Your current diagnosis is the ending point. Then, you need to have a line connecting those two points which is the third thing you must prove to VA:
The nexus is the link that connects your in service event to your current diagnosis. This is what creates the service connection between what happened to you in service and the condition/disability which you currently have.
Usually, nexus is going to be in the form of medical evidence. Often, it could be an opinion from a doctor who has treated you for the condition.
Can I still get a VA sleep apnea rating if my sleep apnea is not service connected yet?
You have to get your sleep apnea service connected before VA will grant you a rating. So, the first thing you need to do is file to try to get your sleep apnea service connected.
If you have an ongoing VA claim for sleep apnea, you need to make sure you can prove all three elements to VA. If you do not have an ongoing claim, you will need to file a claim for your sleep apnea.