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VA Rating Changes for Sleep Apnea Veterans Benefits Claims

Mar 3, 2023

Legal Help for Veterans is a law firm helping veterans get the benefits they deserve.

Northville, MI (Law Firm Newswire) June 29, 2022 – The VA plans to change its disability rating criteria for several conditions to ensure that veterans’ compensation benefits match their medical conditions. The VA explains that the proposed changes to 38 CFR 4.96 should clarify, simplify, and eliminate redundancies in the provisions covering respiratory illnesses in the federal registrar. The major overhaul will affect disability rating criteria for sleep apnea.

Sleep apnea is a potentially serious sleep disorder in which a person’s breathing repeatedly stops and starts. The three primary forms of sleep apnea are:

Obstructive Sleep Apnea
Central Sleep Apnea
Complex Sleep Apnea Syndrome

These conditions include symptoms of loud snoring, episodes of halted breathing, gasping for air during sleep, awakening with a dry mouth, morning headaches, and irritability. Those who suffer from this condition are more likely to experience a stroke.

According to the VA Office of Inspector General (“OIG”), since 2013, sleep apnea has become the most prevalent service-connected disability of all the respiratory conditions for which veterans seek benefits.

In response to these severe conditions, the VA ratings will be evaluated based on the effectiveness of treatment and the condition’s impact on a veteran’s earnings. The VA apportions higher ratings to veterans when their treatment provider prescribes more intensive therapies without considering whether the patient first tried conservative therapies. In light of the change, the VA will focus on the result of the treatment rather than the type. The VA reports that considering lost wages and productivity is necessary to ensure that the department compensates veterans appropriately.

The VA proposes to assign 0 percent evaluations to those with asymptomatic sleep apnea syndrome, regardless of treatment. The VA seeks to set a 10 percent rating when treatment yields “incomplete” relief. Ratings above 10 percent are appropriate only when treatment is ineffective because of the severity of the condition or complications because of the veteran’s comorbidities. Comorbidities refer to qualifying conditions that impede or prevent the use of sleep-apnea treatments in the opinion of a qualified medical provider. Finally, the VA proposes that a 100 percent evaluation is only appropriate if there is end-organ damage.

It is important to note that, according to the VA, no change to a veteran’s current rating will occur because of these proposed changes. However, if the proposed changes are finalized, veterans should consult with an attorney to determine whether applying for increased compensation is advisable.

Veterans interested in learning about how these recent changes may impact their military benefit eligibility should reach out to an experienced veterans’ benefits lawyer for immediate assistance. Legal Help for Veterans, PLLC, is a Michigan-based veteran benefit law firm that concentrates only on service-connected disability claims. The firm can be reached through its website at https://www.legalhelpforveterans.com/.

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