Sleep apnea claims require diagnosis, service-connection evidence, and severity evidence that matches the current VA criteria. A direct or secondary theory must be supported by the facts and competent medical evidence.
A secondary service-connection theory may be relevant when medical evidence supports causation or aggravation involving another service-connected condition. Examples can include PTSD, sinusitis or rhinitis, or an obesity intermediate-step theory, but no relationship should be assumed. Review the VA obesity intermediate step evidence checklist and ask a qualified clinician what opinion, if any, the record supports.
If VA has already connected sleep apnea or you are reviewing a low rating, use the VA sleep apnea rating evidence checklist to organize the sleep study, CPAP proof, Sleep Apnea DBQ, daytime hypersomnolence, and DC 6847 severity evidence.
Review the evidence criteria
Organize the diagnosis, sleep study, treatment history, service-connection theory, and current rating criteria. VA alone decides service connection and the percentage.