Sleep apnea is one of the most commonly claimed service-connected disabilities among veterans, and the VA recognizes its serious impact. If you’ve been diagnosed with sleep apnea and plan to file for VA disability benefits, understanding the proposed changes to the rating system is essential.
Based on the VA’s 2022 proposed rule updates, new criteria for sleep apnea ratings are expected to take effect by the end of 2025. These changes will shift the focus from prescribed devices to how the condition affects your health and daily functioning.
Let’s break down each rating level so you can better understand where you might fall and what steps to take next.
What Is Sleep Apnea?
Sleep apnea is a disorder that causes breathing to repeatedly stop and start during sleep. There are three main types:
- Obstructive Sleep Apnea (OSA): The most common type, caused by throat muscles relaxing too much.
- Central Sleep Apnea: A brain-related issue where your brain doesn’t send proper signals to the muscles that control breathing.
- Mixed Sleep Apnea: A combination of obstructive and central sleep apnea.
Veterans are at higher risk due to factors like PTSD, burn pit exposure, and weight changes post-deployment.
Proposed VA Rating Changes for Sleep Apnea by the End of 2025
The VA uses its Schedule for Rating Disabilities to determine how severe your condition is and how it affects your ability to function. Here’s how the proposed new rating scale breaks down:
0% Rating: Diagnosis Without Functional Limitation
You have a confirmed diagnosis of sleep apnea (typically through a sleep study), but it doesn’t cause significant symptoms that impact your ability to function or perform daily activities. You may not have daytime fatigue or any need for treatment like a CPAP machine. No monthly disability compensation, but your condition is documented in your record. This can be helpful if symptoms worsen in the future.
10% Rating: Symptoms Present but Treatment Only Partially Effective
This is a new proposed rating. If your provider prescribes a breathing device like a CPAP machine, but the treatment is only partially effective, you may qualify for a 10% rating. Compensation is minimal, but it acknowledges that the condition affects your health, even if it’s not fully disabling.
50% Rating: Prescribed Use of a Breathing Assistance Device
You may qualify for this rating if treatment like CPAP or another breathing device is either:
- Not effective, meaning you continue to experience significant symptoms despite using it.
- Not tolerated, meaning you cannot use the device due to side effects such as nosebleeds, anxiety, or other complications
This level comes with substantial monthly compensation and broader access to VA healthcare and services.
100% Rating: Severe Symptoms That Limit Function
This is the highest level and applies when sleep apnea leads to:
- Chronic respiratory failure,
- The need for a tracheostomy,
- Or serious heart complications.
Veterans at this level are entitled to full disability benefits and priority access to expanded medical support.
Why the Proposed Changes Matter
These new rules shift the focus from simply having a CPAP prescription to how well the treatment works and how the condition affects your body. Here’s a summary of the key proposed changes:
- Eliminating the current 30% rating, which many veterans currently qualify for based on daytime fatigue and mild symptoms.
- Introducing a 10% rating for veterans whose treatment is only partially effective.
- Making the 50% rating harder to obtain, only applying to cases where treatment fails or cannot be tolerated.
If these changes go into effect as expected, many veterans may receive lower ratings or find it harder to qualify. That’s why filing your claim under the current criteria could help you secure a higher rating before the new rules are enforced.
How Your Rating Is Determined
Your VA sleep apnea rating depends on:
- A confirmed diagnosis through a sleep study
- Medical treatment records, including prescription of breathing devices
- How your condition is linked to your service (the “nexus”)
- The severity of symptoms and whether treatment is effective
Even with a CPAP prescription, these policy changes may affect how your claim is reviewed in the future.
Whether you’re newly diagnosed or already managing your condition, understanding how the VA evaluates sleep apnea is essential to protecting your health and benefits. If you’ve been denied or believe your current rating is too low, you have options to appeal or request a reevaluation.
Unsure what rating you might qualify for or if your claim is strong enough? J.C. Healthcare & Associates can help you through the process. We specialize in veteran disability evaluations, and we’ll guide you through the necessary steps to ensure your condition is properly reviewed.
Ready to take control of your health and benefits? Schedule your consultation with J.C. Healthcare & Associates today.
Head over to our website to check out our veteran disability claim services and book your appointment today. Take control of your health—with us by your side, you are never alone in this journey.