Sleep apnea is a disorder that causes a person's breathing to be repeatedly interrupted during the course of a typical night. Sufferers experience symptoms such as loud snoring, gasping for air during sleep, and waking up with a dry mouth. They may also struggle with headaches, daytime sleepiness, and difficulty concentrating. If a Veteran's sleep apnea is severe enough to interfere with their ability to hold substantially gainful employment, they may qualify for Total Disability Individual Unemployability (TDIU) benefits.
VA Ratings for Sleep Apnea
Sleep apnea is rated by the VA under 38 CFR § 4.97, Diagnostic Code 6847 – Sleep Apnea Syndromes (Obstructive, Central, Mixed). Possible ratings for sleep apnea are 0%, 30%, 50%, or 100%. The following is a brief overview:
- 0%. A Veteran will receive a 0% rating if their condition is asymptomatic but properly documented with an established service connection.
- 30%. Veterans can receive a 30% rating when they experience persistent daytime sleepiness that does not improve even with sufficient rest.
- 50%. A Veteran who requires the use of a CPAP machine can receive a 50% rating.
- 100%. A Veteran experiencing chronic respiratory failure with carbon dioxide retention, the need for a tracheostomy, or cor pulmonale can receive a 100% rating.
Veterans who suffer from sleep apnea often have other service-connected disabilities, such as hypertension, heart disease, GERD, PTSD, and depression. When a Veteran has multiple service-connected disabilities, VA math is used to assign a total disability rating that reflects the cumulative effect of all conditions but is never more than 100%.
Eligibility for TDIU Benefits
When fatigue, difficulty concentrating, and excessive daytime sleepiness affect a Veteran's ability to work, they may be eligible to receive TDIU benefits. These benefits provide compensation at the 100% disability level, even if the Veteran does not qualify for a 100% rating based on schedular criteria. Receiving benefits is an acknowledgment that the service-connected disability or disabilities are serious enough to prevent a Veteran from working.
Veterans with sleep apnea who want to apply for TDIU with two or more service-connected disabilities must have a combined rating of 70% or higher with one disability that is rated 40% or more unless their condition requires frequent and extended hospital stays. To be approved for TDIU benefits, you must submit evidence that your condition leaves you unable to maintain substantially gainful employment that is suited to your education and professional skills. For example, accounting work that requires attention to detail would be difficult to perform if a lack of sleep leaves you unable to concentrate for extended periods of time.
Let Us Help You Access the Benefits You Deserve
The office of Sean Kendall, Attorney-at-Law, works to help Veterans access the benefits they need to provide for themselves and their families. Contact us today to schedule a free, no-obligation initial consultation with an experienced Veterans benefits lawyer.