Nexus Letter for Sleep Apnea & Sleep Disorders

A nexus letter is an essential piece of evidence that will support a positive outcome in your application for sleep apnea VA benefits. When the VA grants you a disability rating for a service-connected disability, even if the percentage is 0% you are entitled to free healthcare provided by the VA. If the VA disability rating you are awarded is at 10% or greater, then you will be eligible not only for VA-provided healthcare, but also tax-free monthly disability payments from the VA.

Without a strong nexus letter to link your current sleep apnea diagnosis to your military service in support of your VA disability claim, the likelihood that your claim will be denied is far greater. When your VA disability claim is denied, you face the prospect of a complex and time-consuming appeal. A VA appeal can take years to process, and during that time you could miss out on thousands in VA disability payments, and also have to pay thousands of dollars out-of-pocket each year for the sleep apnea treatments. 

Despite the fact that your nexus letter for sleep apnea is of central importance to the success of your claim, it is not easy to get one that will accomplish your goals. To be approved, you must meet the requirements to prove your service-connected sleep apnea to the VA, and following is a guide to help you understand the role that nexus letters play in the process.

Proving Your Sleep Apnea Diagnosis is Connected to Your Military Service 

For a veteran to be eligible to collect VA disability benefits for sleep apnea, the veteran must demonstrate one of the following through evidence: 

• The veteran developed sleep apnea during their qualifying active service, or that,
• The sleep apnea developed as a result of an event, injury, or illness that occurred during service, or as a result of something that already has a proven service connection.

Sleep apnea benefits are achieved either through direct connection to your service, or through a secondary service connection. Providing that your sleep apnea is directly connected to your service is generally a straightforward process. Veterans are able to demonstrate that their sleep apnea began during their active military service by providing military medical records, records of performance, and additional evidence that may have been collected or recorded during active service. 

If you are seeking to collect VA disability benefits for sleep apnea as a secondary service connection, the process can be more difficult. To achieve a sleep apnea VA rating as a secondary condition, it is necessary that you provide the written opinion of a medical professional that your sleep apnea is secondary to a VA-connected disability. The written medical opinion compares and contrasts your current status and diagnosis and medical history in conjunction with scientific literature to prove that your sleep apnea was more likely than not caused by your active military service.

Did you develop a sleep disorder during or after military service?

PTSD, anxiety, depression, Parkinson’s disease, weight gain, chronic pain, Gulf War syndrome, toxin exposure, medications, and other service-related events can lead to the development of a wide variety of sleep disorders. Our medical experts provide VA nexus letters to service connect various forms of sleep disorders.

• Sleep apnea
• Circadian rhythm disorders
• Hypersomnia
• Insomnia
• Mefloquine-associated sleep disorders
• Narcolepsy
• Parasomnias
• REM sleep behavior disorder (RBD)

Sleep apnea is one of the most common sleep disorders we see at Elite Medical Review Associates. A strong nexus letter is necessary to win service-connection for sleep apnea in most cases. And getting one can be challenging.

Typically, symptoms of sleep apnea are not documented during service. However, witness statements from bunk mates, relatives, spouses, roommates, partners, and friends can provide strong evidence of sleep apnea. Persons nearby the veteran during sleep may report loud snoring, long gaps of time with no breathing, gasping for air, insomnia, fatigue, problems concentrating, or sudden irritability.

For many veterans, our doctors write nexus letters supporting sleep apnea secondary to service-connected rhinitis, sinusitis, deviated nasal septum, and other secondary links.

The most common cause of sleep apnea in veterans is weight gain. Various service-related orthopedic problems like back pain, knee pain, or joint pain may prevent proper exercise and activity, causing significant weight gain in the years following service.

Our VA nexus letter doctors have succeeded in winning service connection for sleep apnea secondary to an orthopedic disability for numerous veterans.

We have also been successful in cases where the veteran may have experienced in-service weight gain, have been put in the weight control program, or started to exhibit the signs of metabolic syndrome in service that continued to develop years after service, ultimately leading to obesity and resulting sleep apnea.

One of the most common situations our VA nexus letter doctors see at Elite Medical Review Associates is veterans with a 90% combined VA rating who are employed and seeking an additional 50% rating to achieve a combined rating of 100%.

In these cases, if a veteran has multiple service-connected disabilities that can cause sleep apnea or an intermediary condition that can cause sleep apnea—such as obesity, our medical experts can write an opinion to support service connection for sleep apnea in the VA nexus letter context.

How to Get a Service-Connected Nexus Letter for Sleep Apnea

The majority of veterans who are approved for VA disability benefits for sleep apnea obtain them through a secondary service connection, which includes diagnosis for obstructive sleep apnea (OSA), central sleep apnea (CSA), or complex sleep apnea. 

#1: Obtain a Sleep Apnea Diagnosis

Are you experiencing persistent fatigue despite a full night’s sleep? It could be sleep apnea. A definitive diagnosis typically involves a polysomnography study, evaluating nighttime symptoms like irregular breathing and elevated heart rate. This assessment can be conducted in a sleep lab or at home. A nexus letter for sleep apnea becomes pertinent post-diagnosis.

#2 Identify Causation or Aggravation

You then need to determine whether to claim sleep apnea as a primary or secondary condition. If documented signs appeared during service, even without a formal sleep study, primary claim eligibility may apply.

Many veterans opt for secondary connection, commonly linking sleep apnea to pre-existing service-connected conditions like PTSD. Additionally, secondary claims may stem from mental health disorders such as depression or physiological conditions like sinusitis or asthma.

At Elite Medical Review Associates we will assist in reviewing your records to devise the optimal medical strategy before pursuing a sleep apnea nexus letter.

#3 Obtain a Nexus Letter for Sleep Apnea

Once the connection—whether to PTSD or another condition—is established, validating this link with the VA requires a nexus letter. By obtaining such documentation, veterans can solidify their case for service connection regarding sleep apnea.

How can you establish the link between sleep apnea and your PTSD?

The most effective method to establish the link between your sleep apnea and your PTSD (or other mental health conditions such as depression or anxiety) is to procure a comprehensive, individualized sleep apnea nexus letter authored by a doctor. The nexus letter should incorporate references to your medical records and latest medical findings. What sets our practice apart is that our physicians are not only former C&P examiners but also proficient in the requisite legal terminology essential for a successful nexus letter for sleep apnea.

Primary Health Conditions Leading to Sleep Apnea as a Secondary Condition 

The most common way that veterans access sleep apnea compensation benefits is by claiming sleep apnea as a secondary condition. The following are the most common primary conditions that sleep apnea is secondary to: 

• Asthma
• Depression
• Allergic rhinitis 
• Tinnitus
• Post-traumatic stress disorder (PTSD)
• Obesity
• Generalized anxiety disorder
• Adjustment disorder
• Sinusitis 

Whatever the source of your service-connected sleep apnea, a nexus letter will help to enhance your claim, increasing the chances of a favorable outcome with the initial application.  However, if it is denied, then a veterans’ disability benefits lawyer can help you make the most of your appeal or supplemental claim. 

Decades of experience with veterans’ disability claims, our doctors are renowned for their meticulous research, recognition of all relevant scientific links between service events and sleep disorders, and diligent nexus letter preparation.