Sleep Apnea — VA Disability Rating Criteria (DC 6847)
Diagnostic Code 6847 · 38 CFR §4.97
What Is It?
Sleep apnea is a condition where breathing repeatedly stops and starts during sleep. The most common form among veterans is obstructive sleep apnea (OSA), where the airway becomes physically blocked during sleep. Central sleep apnea, where the brain does not properly signal the breathing muscles, is less common but also ratable. Diagnosis requires a sleep study (polysomnography) that measures the apnea-hypopnea index (AHI). Sleep apnea is one of the fastest-growing VA disability claims and is frequently claimed as secondary to PTSD, weight gain from medications, or other service-connected conditions.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Chronic respiratory failure with carbon dioxide retention, requiring the need for a tracheostomy, or cor pulmonale (right-sided heart failure secondary to the lung condition). |
| 50% | Requires use of a breathing assistance device such as a CPAP (continuous positive airway pressure) machine. This is the most common rating for sleep apnea because the standard treatment for moderate-to-severe OSA is CPAP therapy. If you have been prescribed a CPAP, you meet the criteria for 50%. |
| 30% | Persistent daytime hypersomnolence (excessive daytime sleepiness) that is not adequately managed by other measures. |
| 0% | Asymptomatic but with documented sleep apnea diagnosis from a sleep study. |
Proposed Changes — Not Current Law
As of August 12, 2026, the criteria in the table above are the criteria in force. A bill in the House — H.R. 9237, the Take Care of America's Veterans Act — would replace them with a scale built on how well treatment works: 0 percent when sleep apnea is asymptomatic with or without treatment, 10 percent when treatment yields incomplete relief, 50 percent when treatment is ineffective or a comorbid condition prevents the veteran from using it and there is no end-organ damage, and 100 percent when there is end-organ damage as well. A CPAP prescription would no longer be the 50 percent criterion on its own.
That bill has not passed. It was debated on the House floor on July 16, 2026, a motion to recommit it to committee failed by one vote, and the chair then postponed further proceedings before any vote on passage. There has been no Senate action. Section 108 of the bill states that the revisions would apply to claims filed after the date of enactment and may not serve as the basis for reducing compensation already in effect, and separately 38 U.S.C. § 1155 and 38 CFR § 3.951(a) bar a change to the rating schedule from reducing an existing rating unless the evidence shows the disability actually improved.
Evidence Needed
You will need: (1) a current diagnosis of sleep apnea confirmed by a sleep study showing your AHI score, (2) evidence of a nexus to military service — either direct (symptoms began during service) or secondary (caused or aggravated by a service-connected condition like PTSD, weight gain from medications, or a nasal/sinus condition), and (3) documentation of your prescribed treatment, particularly if you use a CPAP machine. The sleep study results and the CPAP prescription are the two most important pieces of evidence for determining your rating level. If claiming secondary to another condition, a nexus letter from a medical provider explaining the connection is strongly recommended.
C&P Exam Tips
The C&P examiner will review your sleep study results and current treatment. Be prepared to discuss: when your symptoms started, how you were diagnosed, what your current treatment is (CPAP, oral appliance, positional therapy), and how consistently you use it. If you use a CPAP, make sure your medical records reflect an active prescription. The examiner may ask about daytime sleepiness, fatigue, and how the condition affects your daily functioning. If your CPAP has a compliance data card or app, your usage data may be reviewed. Be honest about your compliance — the rating is based on whether you require the device, not on perfect nightly usage.
How to File
File on VA Form 21-526EZ. If claiming as a direct service-connected condition, describe when symptoms began during service and include any service treatment records showing complaints of snoring, daytime fatigue, or observed breathing pauses during sleep. If claiming as secondary to an already service-connected condition (such as PTSD, obesity from medication side effects, or rhinitis), check the "secondary" box and identify the primary condition. Submit your sleep study results and CPAP prescription. A nexus letter explaining the medical connection between your primary condition and sleep apnea significantly strengthens a secondary claim.
Common Mistakes
The most common mistake is not getting a formal sleep study. The VA requires polysomnography or a home sleep test for diagnosis — self-reporting poor sleep is not sufficient. Another mistake is filing a direct service connection claim when a secondary claim would be stronger. Many veterans developed sleep apnea after service, but it was caused or worsened by a service-connected condition; the secondary route is often easier to establish. Veterans also sometimes let their CPAP prescription lapse — if you no longer have an active prescription for a breathing device, you may not meet the 50% criteria at re-evaluation. Keep your prescriptions current and attend your sleep medicine appointments.
Frequently Asked Questions
Do I need a CPAP to get 50% for sleep apnea?
The 50% criteria requires use of a "breathing assistance device" such as a CPAP machine. If you have been prescribed a CPAP (or BiPAP, APAP, or similar device) for your sleep apnea, you meet this criteria. An oral appliance (dental device) may also qualify, though this is sometimes contested — having the CPAP prescription is the clearest path to 50%.
Can I claim sleep apnea secondary to PTSD?
Yes, and this is one of the most common secondary claims filed. Medical research has established links between PTSD and the development or aggravation of sleep apnea. A nexus letter from a medical provider explaining how your PTSD contributes to your sleep apnea is strongly recommended for this claim.
What if I was not diagnosed with sleep apnea during service?
Most veterans are not diagnosed during service. You can still establish service connection through a secondary claim (linking it to another service-connected condition) or through a direct claim if you can show symptoms began during or shortly after service. Buddy statements from spouses or roommates who observed snoring, gasping, or breathing pauses during sleep can support your claim.
Will the VA reduce my sleep apnea rating if I stop using my CPAP?
Potentially. The 50% rating is based on requiring a breathing assistance device. If at a future re-examination the VA determines you no longer require the device, your rating could be reduced. However, ratings that have been in place for 5 or more years receive additional procedural protections before reduction.