Sleep Apnea (Obstructive, Central, or Mixed)
Sleep apnea is a disorder where breathing repeatedly stops during sleep. VA rates it on how it is treated and how severe the effects are, from documented-but-asymptomatic up to chronic respiratory failure.
How the VA rates it
Sleep apnea is rated under diagnostic code 6847 with four tiers: 0, 30, 50, and 100 percent. The single biggest driver is treatment: if a doctor has prescribed a breathing assistance device such as a CPAP machine, the rating is 50 percent. Daytime sleepiness without a required device is 30 percent, and the 100 percent level is reserved for chronic respiratory failure or a tracheostomy.
Rating criteria by percentage
Rated up to 100%Chronic respiratory failure with carbon dioxide retention or cor pulmonale (right-sided heart failure), or the condition requires a tracheostomy.
Requires use of a breathing assistance device such as a CPAP (continuous positive airway pressure) machine.
Persistent daytime hypersomnolence (excessive daytime sleepiness) without requiring a breathing assistance device.
Asymptomatic, but with documented sleep-disordered breathing on a sleep study.
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Hypertension — High blood pressure is sometimes claimed secondary to untreated obstructive sleep apnea, which is medically linked to cardiovascular strain.
- Major Depressive Disorder — Chronic sleep disruption and fatigue from sleep apnea can aggravate or contribute to depression.
This is often secondary to
If you already have one of these service-connected, it may support connecting this condition.
- PTSD — Sleep apnea is one of the most commonly claimed secondaries to PTSD, via weight gain from psychiatric medications, hyperarousal, and disrupted sleep architecture. A medical nexus opinion is essential.
- GERD — Nighttime reflux can aggravate obstructive sleep apnea, and the two conditions are frequently linked in medical literature.
- Allergic Rhinitis — Chronic nasal obstruction from rhinitis can contribute to or aggravate obstructive sleep apnea.
- Deviated Septum — A service-connected deviated septum causing nasal obstruction can contribute to or aggravate obstructive sleep apnea.
Evidence that strengthens this claim
- A sleep study (polysomnography or an approved home sleep test) with a formal diagnosis is effectively required — a self-reported snoring history alone will not support the claim.
- If you use a CPAP, get the prescription and medical-necessity documentation in the record; prescribed CPAP use is what supports the 50 percent level.
- For secondary claims (for example, to PTSD or rhinitis), obtain a medical nexus opinion that explains the connection — VA rarely concedes these links without one.
- Buddy or spouse statements describing in-service or long-standing snoring, gasping, and daytime sleepiness help establish onset.
Rating rules to know
Under 38 CFR 4.96(a), ratings for respiratory codes 6600-6817 and 6822-6847 cannot be combined with each other. If you have sleep apnea plus another rated lung condition (asthma, COPD, bronchitis), VA assigns a single rating under the code reflecting the predominant disability, elevating to the next higher level if overall severity warrants.
More respiratory conditions
Asthma (Bronchial Asthma)
Asthma is a chronic airway disease causing wheezing, coughing, and shortness of breath. VA rates it on pulmonary function test (PFT) results or on how much medication and medical care it requires, whichever applies.
Rated up to 100%
Allergic Rhinitis
Allergic rhinitis is chronic nasal inflammation causing congestion, runny nose, and sneezing. VA rates it on whether nasal polyps are present and how blocked the nasal passages are, with a maximum of 30 percent.
Rated up to 30%
Chronic Sinusitis
Chronic sinusitis is long-term inflammation and infection of the sinus cavities causing headaches, facial pain, and discharge. VA rates all forms on one shared formula based on how many sinusitis episodes you have per year and how severe they are.
Rated up to 50%
Chronic Obstructive Pulmonary Disease (COPD)
COPD is a progressive lung disease that obstructs airflow and makes breathing difficult. VA rates it almost entirely on objective pulmonary function test results, with higher ratings for oxygen therapy or heart complications.
Rated up to 100%
Chronic Bronchitis
Chronic bronchitis is long-term inflammation of the bronchial tubes with a persistent productive cough. VA rates it on the same pulmonary function test criteria used for COPD.
Rated up to 100%
Deviated Nasal Septum (Traumatic)
A deviated septum is a displacement of the wall between the nostrils that blocks airflow. VA rates it under a single 10 percent tier, and only when the deviation is traumatic (caused by injury).
Rated up to 10%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.