Nexus letter
Obstructive sleep apnea
The most common secondary claim we see — most often secondary to PTSD, sinusitis, weight gain, or tinnitus.
$895 for this condition · $149 to start
What this claim turns on
Sleep apnea is the single most frequently claimed secondary condition in VA practice, and also one of the most frequently denied. The reason is usually the same: the veteran has a sleep study proving the diagnosis, and a service-connected primary condition, but nothing in the file explains how one produced the other. That explanation is a medical opinion. Depending on your history, the mechanism might be weight gain driven by a painful musculoskeletal condition and the medications treating it; upper-airway inflammation from chronic rhinitis or sinusitis; or the disrupted sleep architecture and autonomic arousal that accompany PTSD. Our physicians identify which pathway your records actually support, cite the medical literature for it, and say so plainly. A sleep study showing a confirmed diagnosis is required before we can open a case.
Commonly claimed as secondary to
If one of these is already service connected, this condition may be claimable as secondary to it. Your intake asks which pathway applies.
Conditions often secondary to this one
If sleep apnea is already service connected for you, these conditions are frequently claimed as flowing from it. Each needs its own opinion.
Records to have ready
Your physician needs these to form an opinion. Gathering them before you start is the single biggest thing you can do to move your case quickly.
- DD-214 or other separation document
- Service treatment records covering your time in service
- Current VA or private treatment records showing a diagnosis
- Any VA rating decision or denial letter you have received
- Sleep study (polysomnography or home sleep test) confirming the diagnosis
- CPAP prescription and compliance data, if you use one
- Records for the service-connected condition you are claiming it is secondary to
- Weight history, if claiming a weight-related pathway
Missing something? Start anyway and tell us in the intake. Sometimes a gap changes the approach rather than stopping the claim. How to request your records.