For many veterans, sleep apnea is not just a diagnosis, but a daily struggle that impacts their health, relationships, and work ability. Despite its prevalence, VA claims for sleep apnea are often denied. At Tabak Law, we have helped thousands of veterans navigate the VA disability system and understand why these claims face difficulties – and how to overcome them.
Why the VA Denies Sleep Apnea Claims
The Department of Veterans Affairs frequently denies claims of sleep apnea for three main reasons:
- Lack of In-Service Diagnosis: The VA requires evidence that your condition began during service or was caused by a service-related condition. Unfortunately, many veterans are not diagnosed with sleep apnea until after their discharge, making it difficult to directly link the condition to military service.
- Presumption of Non-Service Connection: Unlike conditions such as PTSD or tinnitus, sleep apnea is not considered a presumptive condition under 38 CFR § 3.309. This means that the burden rests entirely on the veteran to provide evidence of a connection between their military service and the condition.
- Weight or Lifestyle Factors: Unfortunately, some VA raters mistakenly assume that sleep apnea is only caused by weight gain or lifestyle changes after service. While obesity can increase the risk of sleep apnea, it does not automatically disqualify a claim, especially if an event that occurred during service (such as exposure to burn pits or a traumatic brain injury) may have contributed to the condition.
Building a Winning Sleep Apnea Claim
To win a VA sleep apnea claim, you need to establish a service connection – either directly, indirectly, or through an aggravation. Here’s how:
1. Direct Service Connection
If you have experienced symptoms such as loud snoring, daytime fatigue, or witnessed apnea episodes while serving but have never been officially diagnosed with sleep apnea, you may still be eligible for a buddy statement from another service member, entries in your service record (even if they don’t mention “sleep apnea” by name) or later medical opinion that links current diagnosis to in-service symptoms.
According to 38 CFR § 3.303, a service connection may be granted for any illness diagnosed after discharge if all the evidence indicates that the illness was caused by the service.
2. Secondary Service Connection
This is often the best option. If you are already receiving service-related benefits for conditions such as PTSD, TBI (traumatic brain injury), or respiratory problems, and these conditions have caused or worsened your sleep apnea, you may be able to file a secondary claim under 38 CFR § 3.310.
For example, studies have shown a strong link between PTSD and sleep-related breathing disorders. A medical expert’s letter explaining this relationship could make or break a case.
3. Nexus Evidence Is Key
A nexus letter, or medical opinion, connecting your current sleep apnea to your military service, is often the missing link in denied claims. This letter should be written by a doctor who is familiar with both sleep medicine and the VA’s requirements.
Common Pitfalls to Avoid
- Relying solely on a CPAP prescription: Using a CPAP machine indicates that you have sleep apnea, but it doesn’t prove the need for service.
- Failing to respond promptly: You only have one year from the date of the denial letter to file a Notice of Disagreement.
- Not submitting new evidence: If you’re appealing, be sure to include updated medical records, expert opinions, or other relevant information that wasn’t included in your original application.
How Tabak Law Can Help
At Tabak Law, we understand that every case involves a real person facing difficult circumstances, whether it’s due to a disability, an injury, or another life-altering challenge. Our goal is to help our clients move from hardship to hope, providing them with results that are compassionate, honest, and backed by unparalleled legal expertise.
We are experts in the VA system. Our team works closely with medical professionals to create compelling Nexus letters and gather crucial evidence. We represent veterans at every stage of the process, from initial claims to appeals before the Board of Veteran’s Appeals.
If your sleep apnea claim has been denied, or you’re planning to file for the first time, don’t do it alone. You’ve served your country and now it’s our turn to serve you.