Sleep Apnea VA Claim Field Manual

Mission Brief

Suspect the VA underrated (or denied) your obstructive sleep apnea? This mission brief walks you through proving the diagnosis, tying it to service, and showing CPAP compliance so raters have to award the correct percentage.

Whether you are filing direct, secondary to another condition, or appealing a denial, start with the sleep study. Show when symptoms began, which duty assignments triggered them, and how treatment affects your daily life.

Keep this brief next to the Claim Prep Checklist, pull every STR, line-of-duty report, and treatment plan you can find, and prep for the C&P exam like it is an inspection on your rack time.

• Map the timeline: line up snoring, choking, and fatigue complaints in service records, post-deployment health assessments, or lay statements.
• Prove the diagnosis: include the full sleep study (polysomnography or home test), apnea-hypopnea index (AHI), and durable medical equipment prescription.
• Document the prescribed therapy: download CPAP usage reports, note pressure settings, and capture if a doctor ordered BPAP, oxygen, or additional devices.
• Align to CFR §4.97: quote diagnostic code 6847 so the rater can see whether you meet 30%, 50%, or 100% criteria.

Situation Brief

Sleep apnea remains one of the most common service-connected respiratory disabilities—VA’s FY 2024 Annual Benefits Report lists 659,335 veterans with sleep apnea syndromes.¹ Approvals still hinge on linking the diagnosis to service and showing that treatment (such as a CPAP) is medically required under 38 C.F.R. § 4.97, Diagnostic Code 6847.² Bring the complete sleep study, a credible nexus, and documentation that proves the prescribed therapy keeps you mission capable.

Diagnostic code 6847 reminder: 50% requires a breathing assistance device such as CPAP; 100% requires chronic respiratory failure with carbon dioxide retention, cor pulmonale, or tracheostomy. Quote the language that matches your records and cite 38 C.F.R. § 4.97, DC 6847 so the rater can follow along.²

Prep Checklist

Before you submit, make sure every exhibit ties the diagnosis to service and proves the treatment burden today.

• File an Intent to File (VA Form 21-0966) to protect your effective date while you gather medical evidence.
• Collect STRs, deployment health questionnaires, or medical board findings that mention snoring, fatigue, or airway issues.
• Secure the complete sleep study report and the physician interpretation recommending CPAP, BPAP, or other devices.
• Download CPAP compliance logs (90-day and 12-month snapshots) from the manufacturer portal or DME provider.
• Ask a treating physician or sleep specialist for a nexus opinion that links your condition to service or to a service-connected disability.
• Prepare lay statements from bunkmates or family outlining how the condition presented during or immediately after service.

Label each exhibit with the veteran’s name, file number, and the CFR element it supports—diagnosis, nexus, or current severity.

Step-by-Step Playbook

1. Lock in your effective date: Submit or confirm your intent to file so you have one year to finish the sleep apnea evidence pack.
2. Assemble the medical core: Gather the full sleep study, CPAP prescription, and compliance logs that show ongoing treatment.
3. Prove service connection: Compile STRs, lay statements, and medical literature or nexus opinions connecting the apnea to service or a service-connected disability.
4. Challenge the rating criteria: Quote Diagnostic Code 6847 and explain in your cover letter how each exhibit satisfies 30%, 50%, or 100% requirements.

Evidence Arsenal

Build a three-part packet: diagnosis, nexus, and functional impact. The rater should be able to review it like a maintenance checklist.

Reminder: If the VA only scanned the one-page sleep study summary, submit the full report with an indexed cover letter so the examiner cannot claim it was missing.

Intel & Tools

Sleep apnea claims live or die on details. Treat every upload like a log entry the rater must act on.

• CPAP data pulls: schedule monthly downloads from ResMed AirView, DreamMapper, or your DME portal. Highlight nights below four hours to show treatment burden and that the device is more than optional.
• Weight and lifestyle notes: if weight gain, PTSD medications, or nasal conditions worsened apnea, document each change with provider notes to support a secondary theory.
• C&P rehearsal: practice describing daytime fatigue, workplace safety issues, and how you manage the CPAP (travel, maintenance, skin irritation). Bring the machine or usage report to the exam.
• Monitor rating changes: VA proposed updates to respiratory ratings in February 2022, but they are not final as of September 2025—track the Federal Register so you can adjust evidence if Diagnostic Code 6847 evolves.³

Update the file anytime you change machines, adjust pressure settings, or add a new secondary condition tied to the apnea, and note any VA rule changes in your tracker.

Next Actions & Support