Obstructive Sleep Apnea (OSA)
Diagnostic Code 6847 • 38 CFR § 4.97
Current rating criteria and evidence considerations
Diagnostic Code
6847
Sleep Apnea Rating Percentages
Chronic respiratory failure with CO2 retention or cor pulmonale
Requires arterial blood gas showing hypercapnia or right heart failure
$3,938.58/mo
Requires use of CPAP machine
Prescribed CPAP or similar device for breathing-related sleep disorder
$1,132.90/mo
Persistent daytime hypersomnolence
Excessive daytime sleepiness despite treatment attempts
$552.47/mo
Asymptomatic but documented diagnosis
Sleep study confirms OSA but no ongoing symptoms or treatment required
$0
50% criteria (breathing assistance device such as CPAP)
Under 38 CFR § 4.97, DC 6847 includes a 50% evaluation when the disability requires use of a breathing assistance device such as a CPAP machine. That criterion applies after service connection is established; a prescription is not an award by itself. Veteran alone, 50% — $1,132.90/month, $13,594.80/year. VA.gov rates effective December 1, 2025.
Complete regulatory criteria, CFR citations, and official rating notes
Why Sleep Apnea Is So Valuable
💰 High Rating Potential
Veteran alone, 50% — $1,132.90/month, $13,594.80/year. VA.gov rates effective December 1, 2025. Future-year totals depend on COLA and are not projected here.
📋 Documentation focus
A sleep study and records showing a prescribed breathing assistance device can support the 50% criterion after service connection. VA decides each claim from the record.
🔗 Common secondary example
Sleep apnea is sometimes claimed secondary to PTSD, depression, or other service-connected conditions. Secondary service connection still requires a current diagnosis and a medical nexus under 38 CFR § 3.310.
📈 Rating Boost
Adding 50% to existing ratings often bumps combined rating significantly. Can push you from 60% to 80% or 70% to 90%.
Evidence Needed for Sleep Apnea Claims
1. Sleep Study (Polysomnography)
Most critical evidence. Sleep study must show:
- • AHI (Apnea-Hypopnea Index) score
- • Number of apnea events per hour
- • Oxygen desaturation levels
- • OSA diagnosis conclusion
Can be VA sleep study or private clinic study
2. CPAP Prescription or Order
Documentation from a physician prescribing CPAP, BiPAP, or a similar breathing assistance device. The 50% criterion is that the disability requires use of such a device; VA weighs the full record, including whether the device is required.
A prescription can support the criterion. It is not a rating by itself.
3. Nexus Letter (If Secondary Claim)
If claiming sleep apnea secondary to PTSD, mental health, or deviated septum, need nexus from sleep specialist or psychiatrist linking:
- • PTSD → sleep apnea (hyperarousal disrupts sleep)
- • Depression → sleep apnea (medication side effects, lifestyle)
- • Deviated septum → sleep apnea (airway obstruction)
4. Spouse/Partner Statement
Lay statement from spouse/partner describing: witnessed apnea events (stopping breathing during sleep), loud snoring, gasping for air, restless sleep, daytime fatigue.
Primary vs. Secondary Sleep Apnea Claims
Primary Claim (Direct Service Connection)
Sleep apnea caused by in-service event or condition:
- • Deviated septum from in-service injury
- • Tracheal damage from intubation
- • Craniofacial injury affecting airway
- • Weight gain from service-connected immobility
Harder to prove - needs clear in-service cause
Secondary Claim
Sleep apnea claimed as caused or aggravated by an already service-connected condition:
- • PTSD (sleep disruption / hyperarousal — nexus still required)
- • Depression/Anxiety (chronic stress — nexus still required)
- • Chronic pain (sleep disruption — nexus still required)
- • Medications causing weight gain (nexus still required)
Examples only. Each secondary claim needs a current diagnosis and a medical nexus under § 3.310.
Note: PTSD to sleep apnea is a commonly discussed secondary theory. Medical literature may support a link in some cases, but VA still requires a nexus opinion tied to the individual record.
Sleep Apnea Compensation Scenarios
Sleep Apnea Only (50%)
If 50% is assigned after service connection
$1,132.90/mo
Veteran alone, 50% — $13,594.80/year. VA.gov rates effective December 1, 2025.
PTSD + Sleep Apnea Secondary
Combined Rating
90%
Monthly Total
$2,362.30/mo
Sleep Apnea with Multiple Secondaries
Combined Rating
80%
Monthly Total
$2,102.15/mo
50% criteria (breathing assistance device such as CPAP)
Get a Sleep Study
In-lab or home sleep test diagnosing OSA
PLUS
Get CPAP Prescribed
Doctor orders CPAP or similar breathing device
MAY SUPPORT
The 50% schedule criterion — not a grant
Veteran alone, 50% is $1,132.90/month if VA assigns that evaluation after service connection. VA.gov rates effective December 1, 2025.
Important Notes:
- • The schedule language is requiring use of a breathing assistance device such as CPAP — not “prescription equals rating.”
- • Service connection must still be established (direct or secondary with a nexus).
- • VA decides the evaluation from the individual record.
Secondary Conditions from Sleep Apnea
Chronic sleep deprivation and oxygen desaturation are sometimes associated with other conditions. Any secondary claim still needs a current diagnosis and a medical nexus:
❤️ Hypertension
EXAMPLEDC 7101 • 10-60% • Sometimes discussed with oxygen desaturation — nexus required
💔 Heart Disease
EXAMPLEDC 7000-7005 • 0-100% • Sometimes discussed with cardiac strain — nexus required
🤕 Migraines
EXAMPLEDC 8100 • 0-50% • Sleep disruption may be relevant — nexus required
🧠 Cognitive Issues
EXAMPLEVarious • Sleep deprivation may affect memory/concentration — nexus required
🚻 Erectile Dysfunction
EXAMPLEDC 7522 • 0-20% • Sometimes discussed with poor sleep — nexus required
🦴 Acid Reflux (GERD)
EXAMPLEDC 7206 • 0-80% • Sometimes discussed with airway pressure — nexus required
Sleep Apnea Claim Timeline
Get Sleep Study
Week 0-4: Schedule in-lab or home sleep test with your doctor or VA
Receive OSA Diagnosis
Week 1-2 after study: Get results showing AHI score and OSA diagnosis
Get CPAP Prescribed
Same day/week: Doctor prescribes CPAP machine
Get Nexus Letter (if secondary)
Week 1-2: If claiming secondary to PTSD/mental health, get nexus opinion
File VA Claim
Submit Form 21-526EZ with sleep study, CPAP prescription, nexus letter
VA decision
Processing times vary. VA reviews the evidence and issues a decision; a 50% evaluation is not promised.
Complete evidence (sleep study, treatment records, and — if secondary — a nexus) helps VA evaluate the claim. Approval is not assured.
Mistakes That Cost Veterans Thousands
Not Getting Sleep Study
Many veterans have OSA but never get tested. Without a sleep study, you can't claim it. If you snore loudly, wake gasping, or feel tired despite sleeping, GET TESTED.
Not Filing as Secondary to PTSD
If you have service-connected PTSD, some veterans discuss sleep apnea as a secondary theory. That path still needs a current diagnosis and a medical nexus; it is not easier as a matter of regulation.
Waiting Years to File
Effective date rules are in 38 CFR § 3.400. Waiting to file can change the date VA uses if a claim is granted. File when the evidence is ready; discuss timing with an accredited representative.
Not Filing Secondary Claims FROM Sleep Apnea
Sleep apnea is sometimes associated with hypertension, heart issues, cognitive problems, or ED. Those are examples only; each secondary still needs a diagnosis and nexus.
Sleep Apnea Claim FAQs
▸ What if I don't use my CPAP regularly?
The 50% criterion is requiring use of a breathing assistance device such as CPAP. How VA weighs prescription versus actual use is decided from the record. Using the device as prescribed is a health decision; it is not a promise of any evaluation.
▸ Can I get sleep apnea service-connected if I gained weight after service?
Possibly, if the weight gain is due to service-connected conditions. For example: immobility from service-connected knee/back injuries, or weight gain from PTSD medications. The nexus letter must link weight gain → service-connected condition → sleep apnea.
▸ What's the difference between OSA and central sleep apnea?
Obstructive Sleep Apnea (OSA) is physical airway blockage. Central sleep apnea is neurological (brain doesn't signal breathing). Both are rated under DC 6847 using the same criteria. Most cases are OSA or mixed.
▸ How severe does my AHI need to be?
DC 6847 does not set a minimum AHI for the 50% tier. The 50% criterion is requiring use of a breathing assistance device such as CPAP, after service connection. Mild OSA with a prescription is not an award by itself.
▸ Can I get 100% for sleep apnea?
Yes, but it's rare. Requires chronic respiratory failure with CO2 retention (hypercapnia) or cor pulmonale (right heart failure). Must be documented with arterial blood gas tests showing elevated CO2 or echocardiogram showing right ventricular dysfunction.
Related Tools & Resources
⚠️ Important Disclaimer
This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.