VA Sleep Apnea Rating Changes in 2025

Sleep apnea is one of the most commonly claimed disabilities among veterans, and in 2025, significant changes are coming to the way the Department of Veterans Affairs (VA) rates this condition. Many veterans rely on their VA disability ratings for financial support, and these changes may impact future claims. Below, we will break down the current rating system, explain the VA sleep apnea rating changes in 2025 and provide guidance noted by accredited VA attorney Rebecca Deming of ProVet Legal on how veterans can protect their benefits.

What is Sleep Apnea in Veterans?

Sleep apnea is a serious sleep disorder in which breathing repeatedly stops and starts during sleep. It is a prevalent condition among veterans, often linked to PTSD, traumatic brain injuries, and exposure to hazardous environments during service. The three main types are Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA), and Complex Sleep Apnea. 

Common sleep apnea symptoms include loud snoring, choking or gasping for air, excessive daytime sleepiness, and difficulty concentrating. If untreated, sleep apnea can lead to high blood pressure, heart disease, and other severe health complications.

A study published in the American Journal of Health Promotion found that obstructive sleep apnea (OSA) was diagnosed in 21% of veterans, more than double the 9% prevalence observed in nonveterans.

Current VA Sleep Apnea Disability Ratings

Under the current system, the VA rates sleep apnea under Diagnostic Code 6847 based on severity and prescribed treatment. The ratings range from 0% to 100%:

• 0% Rating: A veteran has a diagnosed condition but does not experience significant symptoms or require treatment.
• 30% Rating: The veteran has persistent daytime hypersomnolence (excessive sleepiness during the day).
• 50% Rating: The veteran requires a CPAP (Continuous Positive Airway Pressure) machine or another breathing assistance device.
• 100% Rating: The veteran has chronic respiratory failure, requires around-the-clock oxygen, or has undergone a tracheostomy.

The 50% rating is the most common because many veterans receive a CPAP prescription. However, this is changing in 2025.

Why Is the VA Changing Sleep Apnea Ratings?

Advancements in medical research and treatment have significantly improved the management of sleep apnea. The VA argues that the current rating system that requires a CPAP machine to receive a 50% disability rating, does not accurately reflect the functional impairment caused by sleep apnea. Many veterans receive a CPAP machine and experience significant improvement in their symptoms. The new changes aim to align disability ratings with the actual impact the condition has on a veteran’s daily life. While these changes could reduce benefits for some veterans, the VA believes they will better reflect the true level of disability caused by sleep apnea. 

The previous VA rating system sometimes led to disparities, where veterans with well-managed symptoms received the same ratings as those with more severe, treatment-resistant sleep apnea. The new system aims to create a fairer assessment by considering how well the treatment works for each veteran and whether other health conditions make their sleep apnea worse or prevent effective treatment.

However, many veteran advocacy groups argue that these changes unfairly penalize veterans who rely on CPAP therapy, as it fails to acknowledge the long-term health challenges they still face despite using the device. 

Major Changes to VA Sleep Apnea Ratings in 2025

One of the most significant changes in the 2025 rating system is that a CPAP machine alone will no longer guarantee a 50% disability rating. Instead, the VA will assess sleep apnea based on how effective treatment is and the level of impairment experienced by the veteran.

New Sleep Apnea Ratings in 2025

• 0% Rating: The veteran is asymptomatic with or without treatment.
• 10% or 30% Rating: The veteran has sleep apnea but experiences incomplete relief from symptoms despite treatment, as determined by a sleep study.
• 50% Rating: The veteran has ineffective treatment or is unable to use prescribed treatment due to comorbid conditions such as PTSD, claustrophobia, or other physical disabilities, and without end-organ damage.
• 100% Rating: The veteran has ineffective or unusable treatment due to comorbid conditions and suffers from end-organ damage (significant damage to organs like the heart or lungs caused by sleep apnea).

Comorbid Conditions and Their Impact on Sleep Apnea Ratings

Comorbid conditions, other health issues that exist alongside sleep apnea, can significantly impact a veteran’s VA disability rating. These conditions can worsen sleep apnea symptoms or make standard treatments like CPAP machines ineffective. The VA takes comorbid conditions into account, particularly when determining eligibility for a 50% or 100% rating.

Comorbidities that affect sleep apnea ratings include:

• Post-Traumatic Stress Disorder (PTSD): Veterans with PTSD may struggle with CPAP use due to anxiety, claustrophobia, or other mental health concerns. If PTSD prevents effective CPAP use, it may contribute to a higher rating.
• Chronic Obstructive Pulmonary Disease (COPD): Veterans with COPD and sleep apnea may experience respiratory problems which makes CPAP or other treatments less effective.
• Obesity and Metabolic Disorders: Conditions like obesity, diabetes, and metabolic syndrome increase the severity of sleep apnea and may reduce treatment effectiveness.
• Cardiovascular Disease: Untreated sleep apnea can contribute to or worsen cardiovascular conditions (e.g. hypertension, arrhythmia, heart failure, or stroke), leading to end-organ damage, which is a criterion for a 100% rating.
• Neuromuscular Disorders: Conditions such as ALS, multiple sclerosis (MS), or myasthenia gravis can impair breathing and prevent the use of standard sleep apnea treatments.
• Chronic Pain Conditions: Veterans with conditions like fibromyalgia or severe arthritis may struggle to sleep in positions that allow CPAP use, reducing treatment effectiveness and justifying a higher disability rating.
• Gastroesophageal Reflux Disease (GERD): GERD can be worsened by sleep apnea and may interfere with comfortable breathing during sleep, making it harder for veterans to tolerate CPAP therapy.
• Asthma: Asthma may lead to airway inflammation and obstruction, which can worsen sleep apnea symptoms and reduce CPAP effectiveness.

Proving a Comorbid Condition for a Higher Rating

In recent years, manufacturers have estimated that around 8 million people across the United States rely on CPAP machines. To secure a 50% or 100% rating, veterans should consider providing:

1. Medical evidence of a secondary comorbid condition (doctor’s diagnosis, treatment records).
2. A nexus letter linking the comorbid condition to sleep apnea or military service. While never required these can at times be helpful. 
3. Sleep studies showing that CPAP is ineffective or unusable.

If treatment is ineffective or unusable due to comorbidities and leads to organ damage, a veteran may qualify for a 100% disability rating.

How Will These Changes Impact Veterans?

Veterans Already Receiving a Sleep Apnea Rating

If you are already rated for sleep apnea, you will be grandfathered into the old system. This means your current rating will not be affected by the changes as long as you do not request an increase in benefits.

Veterans Filing New Claims After April 2025

Veterans who file new sleep apnea claims after April 2025 will be evaluated under the new criteria. This means that simply receiving a CPAP prescription will not be enough to secure a 50% rating. Veterans will need additional medical evidence to demonstrate that their treatment is ineffective or that they cannot use the prescribed treatment due to other comorbid conditions. 

If a veteran has secondary conditions such as PTSD, asthma, GERD, or cardiovascular disease that worsen sleep apnea or make CPAP use impractical, they must provide comprehensive medical documentation proving how these conditions impact their ability to receive effective treatment.

Veterans Requesting an Increased Rating

If you are currently rated for sleep apnea and request an increase after April 2025, your claim will be reviewed under the new criteria. While your rating should remain protected, there is a risk that the VA may attempt to lower your rating if they determine your treatment is effective. This is why many legal experts advise veterans to be cautious when requesting increases.

Should You File a Claim Before April 2025?

Many veteran advocates like Ms. Deming recommend that if you suspect you have sleep apnea, you should file a claim before the new regulations take effect. Even if you are still gathering medical evidence, filing before April 2025 ensures that your claim is evaluated under the current, more favorable rating system. Filing early can also maximize back pay by securing the earliest possible effective date for your benefits.

To maximize your chances of approval, you should:

• Submit an Intent to File (ITF) – This locks in your effective date while you gather medical evidence.
• Obtain a VA-Approved Sleep Study Diagnosis – A polysomnography test is required to confirm sleep apnea and qualify for disability benefits.
• Document Persistent Symptoms – Provide medical records showing daytime drowsiness, headaches, concentration issues, or other functional impairments.
• Establish a Service Connection – Gather military service records, nexus letters, and lay statements linking sleep apnea to your time in service.
• Get a CPAP Prescription (If Applicable) – Increases the likelihood of qualifying for a 50% rating under the current rules before the 2025 changes.
• Identify Comorbid Conditions – Conditions like PTSD, COPD, cardiovascular disease, GERD, or chronic pain can increase your rating to 50% or 100% if they make CPAP treatment ineffective or cause organ damage.

Legal and Strategic Considerations

What If Your Claim Is in the Appeals Process?

If you filed a claim before the changes and your case is in appeal, you should still be evaluated under the old rating system. However, if your case was previously denied and you reopen it after April 2025, the new criteria will apply.

Could These Changes Be Challenged?

Some veterans’ organizations have raised concerns about the fairness of these changes. While legal challenges are possible, the VA has already conducted a public comment period and moved forward with implementation. For now, veterans should assume the changes will take effect as planned and act accordingly.

VA Sleep Apnea Rating Changes in 2025 – Final Thoughts

The 2025 changes to VA sleep apnea ratings will make it more difficult for veterans to receive a 50% disability rating. The key takeaway noted by Ms. Deming is that filing before April 2025 is the best way to secure a favorable rating. If you believe you have sleep apnea, don’t delay—start gathering medical evidence and file your claim as soon as possible.

For veterans already rated for sleep apnea, the best approach is to avoid requesting an increase unless absolutely necessary, as doing so could put your rating at risk under the new system. If you have questions about your specific situation, consulting with a VA-accredited attorney or claims agent can help you navigate the process and protect your benefits.

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