How VA Rates Sleep Apnea
CCK Law: Our Vital Role in Veterans Law
If you developed sleep apnea as a result of your military service, you may be eligible to receive disability benefits from the Department of Veterans Affairs (VA). In this article, we will discuss how VA goes about rating veterans with sleep apnea, as well as the most relevant mistakes and issues that we encounter with these types of disability claims.
Key takeaways of this article include:
- To earn a sleep apnea VA rating and disability compensation, veterans first have to establish service connection. This is when a veteran proves to VA that their sleep apnea was caused by their military service.
- Once service connection is established, VA will assign the veteran a disability rating of 0, 30, 50, or 100 percent disabled. As of 2025, if a veteran is forced to use a CPAP machine to treat their apnea, they will earn an automatic 50 percent rating.
- VA has proposed significant changes to the rating criteria for sleep apnea. These changes would make it more difficult for veterans to earn sleep apnea VA ratings higher than 0 percent. Though these changes have not yet taken effect, it is possible they will be implemented sometime in 2026. Claims started before the changes can use the earlier rating criteria if more favorable.
What Is Sleep Apnea?
“Sleep apnea is a potentially serious sleep disorder in which a person’s breathing is repeatedly interrupted throughout the night,” says Michael Lostritto, a managing attorney at CCK Law. “There are three main types of sleep apnea: obstructive sleep apnea, central sleep apnea, and also what’s known as complex or ‘mixed’ sleep apnea.”
- Obstructive sleep apnea (OSA) — The most common form of this condition. If you have OSA, then the airflow into your lungs is disrupted due to an issue with your throat muscles.
- Central sleep apnea (CSA) — If you have CSA, then it means your brain is not sending the right signals to the muscles that control your breathing.
- Treatment-emergent central sleep apnea, or “complex sleep apnea” — Occurs when a person who suffers simultaneously from OSA and CSA. Also known as “mixed sleep apnea.”
Symptoms can include loud snoring, gasping for air while sleeping, difficulty remaining asleep (i.e., insomnia), irritability, dry mouth upon waking, and more. These symptoms can greatly impact your daily life, so treatment is necessary.
Treatment often includes the use of a device called “CPAP,” or “continuous positive airway pressure.”
How Do Veterans Prove Their Sleep Apnea Is Service Connected?
A service-connected condition is one that a veteran can prove resulted from their military service, whether due to an in-service illness, injury, or event. There are several different types of service connection, including direct, secondary, and presumptive.
How Do Veterans Prove Direct Service Connection for Sleep Apnea?
Direct service connection for sleep apnea is when a veteran can prove that their condition was directly caused or aggravated by their military service. To prove a direct service connection, veterans must show evidence of the following:
- A current diagnosis of their condition, as confirmed by a sleep study;
- An in-service event, injury, or illness (often demonstrated with service records, medical records from during service, and/or lay statements from fellow service members, family members, etc.); and
- A medical nexus, or link, between their diagnosed condition and the in-service event, injury, or illness (provided by a medical professional).
Step 1: What Qualifies as a “Current Diagnosis” of Sleep Apnea for VA Purposes?
VA generally requires a formal sleep study (polysomnography) to recognize a current diagnosis of obstructive, central, or mixed sleep apnea.
- Without a sleep study, VA and the CAVC have repeatedly noted that symptoms like snoring or fatigue are not sufficient to establish a diagnosis.
- See 38 C.F.R. §§ 3.159(a)(1) (competent medical evidence) and Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (laypersons are competent to report observable symptoms but not complex medical diagnoses).
Step 2: What Qualifies as an “In-Service Event, Injury, or Illness” for VA Purposes?
To win a sleep apnea VA claim, a veteran must identify something that occurred during service that can plausibly be linked to the current diagnosis. Common examples:
Documented in-service symptoms or treatment
- Loud snoring
- Witnessed apneas
- Frequent awakenings
- Excessive daytime sleepiness
- Non-restorative sleep
- Weight gain or changes in physical condition during service
- Exposure to environmental hazards that caused upper airway inflammation (dust, burn pits, chemicals)
- Nasal trauma, facial injuries, or respiratory issues documented during service
These symptoms or incidents are often not diagnosed as sleep apnea during service, but they are still usable evidence if mentioned in service treatment records or described by “lay evidence.”
Step 3: What Does VA Consider a Sleep Apnea “Nexus” (a medical opinion connecting service and current sleep apnea)?
A nexus requires competent medical evidence explaining why the veteran’s current sleep apnea is at least as likely as not related to service. We find that this is usually the hardest element for veterans to prove to VA.
- How to avoid flaws in the medical opinion about service-connected sleep apnea
A strong nexus opinion typically:
- Reviews the claims file
- Addresses lay reports of in-service symptoms (Dalton v. Nicholson, 21 Vet. App. 23 (2007))
- Explains why in-service snoring, gasping, or sleep disturbance are medically consistent with undiagnosed sleep apnea
- Cites medical literature (upper airway anatomy, weight gain, trauma, environmental exposures)
- How to identify problems with VA C&P exams related to sleep apnea
VA usually uses a Compensation & Pension (C&P) exam to evaluate veterans’ claims. However, VA may make errors in C&P claims related to sleep apnea. Common VA examiner mistakes that can make an exam inadequate under Barr v. Nicholson, 21 Vet. App. 303 (2007):
- Rejecting lay observations because symptoms were “not documented” (Buchanan)
- Claiming sleep apnea must be diagnosed in service (legally incorrect; see Hampton v. Gober, 10 Vet. App. 481 (1997), and chronicity/continuity rules)
- Not addressing whether in-service snoring is an early sign
- Ignoring pertinent medical literature
- Failing to address in-service weight changes or injuries
Veterans can challenge an inadequate C&P exam with an appeal.
- How to prove that sleep apnea is an active disability
Although sleep apnea is not a chronic condition under 38 C.F.R. § 3.309(a), continuity can still support nexus as part of a medical rationale. Evidence may include:
- Statements from spouse, roommates, or fellow service members
- A sleep disturbance documented shortly after service
- Post-service sleep studies showing longstanding symptoms
What Is Secondary Service Connection for Sleep Apnea?
Frequently, a veteran’s sleep apnea is not caused by military service but is a secondary or residual effect of a separate condition that VA has already deemed service connected. This is called secondary service connection and is eligible for compensation.
Veterans seeking secondary service connection for sleep apnea must provide a medical nexus opinion linking their sleep apnea to this already-service-connected disability.
For example:
- Say a veteran was exposed to toxic smoke from a military burn pit while they were deployed overseas. After being discharged, the veteran still experiences regular congestion and inflammation in their nasal lining, which sometimes makes it difficult to breathe.
- Eventually, a doctor diagnoses the veteran with chronic rhinitis. Subsequently, VA recognizes that the veteran’s rhinitis is directly related to their burn pit exposure and assigns them a VA rating and compensation for this condition.
- Over time, the veteran finds that their chronic rhinitis has worsened, and they suddenly develop trouble sleeping. Their doctor confirms that the veteran has developed sleep apnea, likely as a result of their rhinitis.
- In this case, the veteran would be able to file a disability claim for sleep apnea secondary to chronic rhinitis. This is because their rhinitis (an already service-connected condition) seems to now have caused a secondary condition to develop (sleep apnea).
- If the veteran’s secondary claim is successful, VA will assign them a disability rating for sleep apnea and compensate them accordingly.
Other examples of service-connected conditions that may lead to sleep apnea include asthma, a deviated septum, or diabetes mellitus type 2.
What Is Presumptive Service Connection for Sleep Apnea?
Presumptive service connection is when VA automatically presumes that a disability was caused by a veteran’s military service. This eases much of the burden on the veteran, as it eliminates the need for them to gather evidence that their sleep apnea is connected to their service.
Veterans of the Persian Gulf War may be entitled to presumptive service connection for their sleep apnea. Under VA’s regulation concerning Persian Gulf War veterans, 38 CFR § 3.17, sleep apnea falls under “sleep disturbances” as an undiagnosed illness or medically unexplained chronic multisymptom illness. This means veterans of the Gulf War may have an easier time getting their sleep apnea recognized by VA.
How Does VA Rate Sleep Apnea?
VA rates service-connected conditions by severity, which then determines benefits like compensation. VA rates sleep apnea under 38 CFR § 4.97-13, Diagnostic Code 6847 — Sleep Apnea Syndromes (Obstructive, Central, Mixed).
Under this code, veterans are assigned a 0, 30, 50, or 100 percent sleep apnea VA rating based on the severity of their condition:
- 100 percent — The veteran has chronic respiratory failure with carbon dioxide retention, requires a tracheostomy, or has cor pulmonale (i.e., the enlargement or failure of the right side of the heart due to lung disease).
- 50 percent — The veteran requires the use of a breathing assistance device, such as a CPAP machine.
- 30 percent — The veteran is experiencing persistent daytime hypersomnolence (i.e., a condition characterized by chronic daytime sleepiness that does not improve even with sufficient sleep).
- 0 percent — The veteran has a documented sleep disorder, but their condition is currently asymptomatic (i.e., not producing symptoms). Although considered noncompensable, the veteran may still qualify for other benefits, such as VA health care.
As of 2025, the VA disability rate benefit amounts are as follows:
- 30 percent disability rating: $537.42 per month
- 50 percent disability rating: $1,102.04 per month
- 100 percent disability rating: $3,831.30 per month
A rating of at least 30 percent or higher qualifies you for additional compensation if you have a spouse, dependent children, or dependent parents living in your home.
Are the Rating Criteria for Sleep Apnea Going to Change Soon?
Yes, it is possible that the rating criteria for sleep apnea are going to change in the near future. This is because VA has proposed updates to these rating criteria, as well as the criteria for tinnitus and mental health disorders.
Under VA’s proposed new criteria, disability ratings for sleep apnea would be determined based partly on how symptomatic a veteran’s apnea remains after receiving treatment. In other words, the usage of a CPAP machine would no longer guarantee that a veteran receives an automatic 50 percent rating for their condition.
These proposed rating criteria are as follows:
- 100 percent – Treatment ineffective (as determined by sleep study) or unable to use treatment due to comorbid conditions; and end-organ damage
- 50 percent – Treatment ineffective (as determined by sleep study) or unable to use treatment due to comorbid conditions; and without end-organ damage
- 10 percent – Incomplete relief (as determined by sleep study) with treatment
- 0 percent – Asymptomatic with or without treatment
Based on these criteria, it may actually become harder for veterans to earn a sleep apnea rating of 10 percent or higher, as those ratings would be reserved for veterans whose sleep apnea does not respond effectively to treatment like CPAP, or who have comorbid conditions that prevent treatment in the first place.
It is important to note, however, that these changes were first proposed in February 2022 and have still not been implemented. While it is possible that these updated criteria will come into effect sometime in 2026, VA may also rework or even dispense with them based on internal priorities.
“One thing we do know is that if and when these implementations take place, there will be a 60-day notification window,” says Alyse Phillips, Supervising Attorney at CCK Law. “So that’s going to be a grace period where veterans will have time to get anything filed they want to file before the implementations take place. And that’s super important because if you do file a claim before these implementations take place, then the more favorable version of the law will apply to you.”
Frequently Asked Questions About Sleep Apnea
How common is it for veterans to get a VA rating for sleep apnea?
According to a 2025 study, sleep apnea rates were more than twice as high amongst veterans as nonveterans. Additionally, VA’s 2024 Annual Benefits Report lists sleep apnea as the second most common respiratory condition among disabled veterans, with more than 659,000 veterans receiving disability compensation for the disorder.
However, this does not mean it is easy to obtain a VA rating for sleep apnea. Many veterans find proving service connection to be difficult: obtaining a sleep apnea diagnosis, participating in a sleep study, and submitting evidence to VA establishing that the disorder is “at least as likely as not” a result of the veteran’s time in service.
Is it an automatic 50 percent VA rating if issued a CPAP for service-connected sleep apnea?
Yes, as of December 2025, if a veteran has sleep apnea serious enough to require treatment via a CPAP machine (or another breathing assistance device), they will earn an automatic 50 percent disability rating for their condition.
Per VA’s current rating criteria for sleep apnea:
- 100 percent —The veteran has chronic respiratory failure with carbon dioxide retention, requires a tracheostomy, or has cor pulmonale(i.e., the enlargement or failure of the right side of the heart due to lung disease).
- 50 percent —The veteran requires the use of a breathing assistance device, such as a CPAP machine.
- 30 percent — The veteran is experiencing persistent daytime hypersomnolence (i.e., a condition characterized by chronic daytime sleepiness that does not improve even with sufficient sleep).
- 0 percent — The veteran has a documented sleep disorder, but their condition is currently asymptomatic (i.e., not producing symptoms). Although considered noncompensable, the veteran may still qualify for other benefits, such as VA health care.
What evidence does VA need for sleep apnea?
To prove service connection and earn a disability rating for sleep apnea, veterans can submit a variety of different evidence to VA, including:
- Official service records (e.g., personnel records, in-service medical records)
- Medical records (e.g., VA medical records, private medical records)
- Medical or “nexus” opinions from a private doctor
- Employment records (e.g., performance evaluations, disciplinary reports)
- Lay statements (i.e., personal statements from family or friends testifying to the severity of the veteran’s sleep apnea)
Notably, VA will also likely require veterans to take part in a sleep study to confirm their sleep apnea diagnosis.
Why would a VA claim for sleep apnea be denied?
In our experience, here are some of the most common reasons that a sleep apnea claim is denied by VA:
- Insufficient evidence supporting in-service symptoms
- The lack of a current sleep apnea diagnosis via a sleep study
- No supporting medical nexus opinion from a doctor
- A veteran is missing their compensation and pension (C&P) exam
- A veteran submitting the wrong form or submitting it past the deadline
VA Claim Denied or Underrated? Call CCK Law
Appealing a sleep apnea claim denial is a complex process. It is valid and understandable to become overwhelmed while handling a case on your own. If this happens to you, consider asking for help.
- The veterans and advocates at Chisholm Chisholm & Kilpatrick LTD have decades of experience successfully appealing over 36,000 cases.
- CCK Law has a 99 percent win rate before VA and a 91 percent win rate before the U.S. Court of Appeals for Veterans Claims (CAVC) (note that we cannot legally promise results).
- We may also be able to help you identify other benefits that you are eligible for, such as compensation for additional disabilities through secondary service connection.
- And as VA-accredited advocates, we have a number of resources unavailable to veterans, such as backend access to VA’s case-tracking system.
If you filed a VA claim for sleep apnea but were denied, CCK Law may be able to help get you the benefits you deserve.
Call CCK Law today at (401) 566-9285 or online to discuss your case.
