Sleep Apnea

Proposed Changes to the Ratings of the Respiratory System

On February 15th, 2022, the VA published proposed changes to the ratings of the Respiratory System.

The VA is proposing huge changes for sleep apnea. Currently, it is rated on the treatments required for management. However, the purpose of the ratings is to compensate veterans for loss of earning capacity. The VA therefore proposes instead to rate sleep apnea on any symptoms that remain after treatment. This does put these ratings more in line with the ratings for other conditions but will make it harder to receive a higher rating under this code. 

NOTE: These changes are PROPOSED and not approved. Changes like this can take years to be incorporated if they are approved at all. 

If you have a current rating for sleep apnea, you will not lose your rating. 

-Current- Code 6847: Any sleep apnea syndrome is rated under this code. Sleep apnea is a disorder that occurs while asleep. There is either a pause when breathing that can last up to a few minutes or there is very shallow, low breathing. Central sleep apnea is caused by a decrease in the “action” of breathing—the body doesn’t try as hard to breathe properly. Obstructive sleep apnea is caused by a block in the airways, like a narrowing of the airway passages or an excess of mucus. This causes severe snoring. Mixed sleep apnea is a combination of both central and obstructive.

Sleep apnea can cause a significant impairment of the heart and respiratory system by limiting the amount of air that is taken in during the hours of sleep.

If the condition continues over a long period of time and causes respiratory failure with right heart ventricle failure or with too much carbon dioxide in the blood stream, or if it requires a Tracheotomy, it is rated 100%.

If it requires the use of breathing machines like a continuous positive airway pressure (CPAP) machine during sleep, it is rated 50%.

If it causes serious sleepiness during the daytime or not feeling rested after sleeping, it is rated 30%.

If it is diagnosed by a sleep test, but it doesn’t cause any significant symptoms, it is rated 0%.

-Proposed- Code 6847: Any sleep apnea syndrome is rated under this code. Sleep apnea is a disorder that occurs while asleep. There is either a pause when breathing that can last up to a few minutes or there is very shallow, low breathing. 

Central sleep apnea is caused by a decrease in the “action” of breathing—the body doesn’t try as hard to breathe properly. Obstructive sleep apnea is caused by a block in the airways, like a narrowing of the airway passages or an excess of mucus. This causes severe snoring. Mixed sleep apnea is a combination of both central and obstructive.

Sleep apnea can cause a significant impairment of the heart and respiratory system by limiting the amount of air that is taken in during the hours of sleep.

100% - If there is end-organ damage (damage of the heart, kidneys, brain, or eyes) and the condition does not respond to treatment or cannot be treated.

50% - If the condition does not respond to treatment or cannot be treated.

10% - If the symptoms are only partially resolved with treatment.

0% - If the symptoms are fully resolved with or without treatment.