The process of seeking a VA rating for sleep apnea secondary to tinnitus can be challenging and frustrating for Veterans because the Department of Veterans Affairs (VA) disability rating system for sleep apnea and tinnitus is complex and difficult to navigate, causing delays and confusion.
In this article, we’ll share success stories from veterans who have successfully endured the process and received their deserved ratings. These veterans have shared their strategies for success, which can serve as a guide for other veterans seeking to do the same.
What is Tinnitus?
As described in an Oxford Academic study, tinnitus is commonly known as persistent ringing in the ears that affects 10-15% of adults, with one in five experiencing it to a bothersome extent. It affects the quality of life and leads to comorbidities such as anxiety, sleep disorders, and early-onset dementia. For veterans, it is the most prevalent service-connected disability awarded by the VA.
Sleep disturbance, anxiety, and depression are common comorbidities with tinnitus, affecting productivity, memory recall, and job performance. The study offers a unique opportunity to investigate the impact of tinnitus on service members.
Background on VA Rating for Sleep Apnea Secondary to Tinnitus
After military service, a veteran’s sleep apnea is likely caused or aggravated by service-connected tinnitus, according to a medical expert’s opinion. “Tinnitus and sleep are closely related, with up to 71% of patients with tinnitus reporting sleep problems”.
The study found that sleep-disordered breathing (SDB) is much more common and severe in men with tinnitus. SDB includes obstructive sleep apnea syndrome (OSA), which can be caused by tinnitus or aggravate it.
Another study found that approximately 60% of patients with tinnitus experience disturbances of the typical sleep pattern, and ten patients out of 26 with tinnitus and sleep disturbances were diagnosed with OSA. Sleep disturbance is a common complaint reported by tinnitus sufferers, and it’s highly correlated with depressive symptomatology. The combination of the Veteran’s sleep apnea secondary to PTSD, migraines, and tinnitus is likely to cause OSA.
Hope is not lost! When asking yourself, “Can I claim sleep apnea secondary to tinnitus?” the answer is a resounding “Yes!” if you press your claim as the following veteran success stories did.
Success Story #1: John Doe
John was a veteran diagnosed with tinnitus, a ringing in his ears, which he had received as a result of active service. He claimed that his tinnitus was causing him to develop a sleep disorder and that he woke up three to four times a night due to the noise produced by his tinnitus. John had sought treatment for obstructive sleep apnea. He had been diagnosed with in August 2001, and had been using a continuous airway pressure (CPAP) machine for it. He also reported suffering from sleep latency due to his tinnitus, and an assessment of insomnia was provided.
An April 2011 VA respiratory examination report reflected a diagnosis of obstructive sleep apnea and noted that the Veteran’s sleep disorder was due to a general medical condition (tinnitus). Although John had not set forth a theory of direct service connection, he asserted that he had developed a sleep disorder due to his service-connected tinnitus. A June 2012 private note from Dr. White indicated that John’s tinnitus impacted his sleep and that the association between tinnitus and sleep disturbance was irrefutable.
In August 2011, a VA examiner opined that John’s claimed condition was less likely as not approximately due to or the result of the Veterans service-connected condition. However, the VA examiner’s opinion seemed focused primarily on the physical disability. In contrast, the private views distinguished between John’s service connected sleep apnea and insomnia and reflected a causational link between John’s tinnitus and that specific sleeping problem.
After resolving reasonable doubt in John’s favor, the Board found that John had a sleep disorder – best characterized as insomnia – related to his service-connected tinnitus. The Board concluded that service connection was warranted for insomnia, and John was granted the appropriate compensation for his condition.
John had been suffering from tinnitus and sleep apnea for several years. He knew he needed the correct sleep apnea VA rating to receive the benefits he deserved. His success was due to his persistence, advocacy, and thorough documentation.
Success Story #2: Mike Jones
The Veteran had been struggling with tinnitus, a constant humming noise in his left ear, since at least 2000. In May of that year, a private physician noted that the Veteran had adapted to the hearing loss caused by the tinnitus and no longer had trouble sleeping. In August, a service connection was granted, and the Veteran was given a 10% rating for tinnitus.
However, by November of that year, the Veteran sought treatment from the VA for sleep disturbance related to tinnitus. A clinician noted that his insomnia might be related to tinnitus and prescribed nortriptyline. Over the next few years, the Veteran saw various medical professionals and underwent treatments, including Trazodone, Celexa, and a noise generator.
The tinnitus worsened, affecting the Veteran’s ability to concentrate and function properly, and he reported feeling exhausted throughout the day. He had to give up his business as an airplane mechanic due to his inability to concentrate and double-check his work. He also had to relinquish his pilot’s license because of his tinnitus, insomnia, and medication.
In May 2005, a VA psychiatric examination and general medical examination were conducted, resulting in a sleep disorder diagnosis due to tinnitus, insomnia, and depressive disorder. The Veteran reported difficulty falling asleep, awakening unrefreshed, and feeling chronically sleep deprived.
Despite this, the Director of Compensation and Pension Services denied service connection for the Veteran’s insomnia in December 2005, stating that “VA treatment records showed episodes of treatment for problems sleeping which the veteran attributed to tinnitus; however, clinical findings also showed complaints of job stress, life stresses, and depression.”
The Veteran continued to seek medical attention for his tinnitus-related sleep disorder and was seen by a private physician in August 2006. The doctor diagnosed tinnitus and depression but did not mention sleep disturbance. However, in October of that year, the same physician submitted a supplement to his previous letter, stating that the Veteran’s tinnitus had become so loud that it interfered with his ability to sleep, causing anxiety and depression.
The Board ultimately found that the Veteran’s tinnitus caused a sleep disorder, despite initial opinions that the relationship between the two was too speculative. The Board determined that the evidence was in relative equipoise and, by the benefit of the doubt rule, granted secondary service connection for the Veteran’s sleep disorder due to his persistent tinnitus.
Common Themes and Strategies
There are several common themes and strategies among the success stories of these veterans. One of the most important is persistence. Both veterans followed up on their C&P exam for sleep apnea secondary to tinnitus and paperwork and kept going until they received the benefits they deserved.
Also, both veterans got statements from their doctors and sleep studies to support their claims. They also sought medical opinions from multiple doctors, which helped strengthen their cases.
Understanding the VA disability rating system is also crucial. Veterans should research the requirements for a higher rating and make sure to meet them. Seeking help from a VA accredited law group like VetsForever or a Veterans Service Officer (VSO) or expert can also help navigate the VA system and get the proper documentation.
Summary
Navigating the VA disability rating system for sleep apnea with tinnitus can be daunting for veterans. However, the success stories of John Doe and Mike Jones show that you can receive the rating you deserve. The key is persistence, advocacy, gathering the necessary medical evidence and documentation, and understanding the VA disability rating system can also be beneficial. Veterans should never give up until they receive the rating they deserve.
FAQs
Is there a nexus between tinnitus and sleep apnea?
While the exact cause and link are not entirely understood, evidence suggests a significant association between chronic tinnitus and sleep disturbances such as sleep apnea. For instance, a study has shown a strong connection between the two conditions, potentially allowing you the opportunity to write a strong personal statement in support of claim receive a Nexus letter for sleep apnea secondary to tinnitus.
What are secondary conditions related to tinnitus?
Veterans frequently claim tinnitus as a disability, which can potentially result in the development of secondary conditions such as sleep disorders, anxiety, and migraines.
What is the VA disability rating for secondary sleep apnea?
The VA rating for sleep apnea secondary to tinnitus is as follows:
- If you have no symptoms, the rating is 0%, but it can still be recorded with the VA for potential future changes.
- If you experience persistent daytime or chronic sleepiness during the day due to your sleep apnea, the rating is 30%.
- If you require a breathing assistance device such as a CPAP machine to achieve and maintain sleep, the rating is 50%.
- If you suffer from chronic respiratory failure, which includes carbon dioxide retention and may necessitate tracheostomy surgery, the rating is 100%.
- Sleep apnea can be claimed as secondary to tinnitus if it can be shown that it has caused or worsened sleep apnea. However, this will require medical evidence to support the claim.
Can sleep apnea be claimed as secondary to tinnitus?
The VA provides different disability ratings for ailments such as tinnitus and sleep apnea, but some can be considered secondary. A good example is when a veteran’s sleep apnea can be evaluated as a secondary condition to their tinnitus.