The criteria turn on what the condition requires
Under §4.97, DC 6847:
| Level | Criterion |
|---|---|
| 100% | Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or requires tracheostomy |
| 50% | Requires use of breathing assistance device such as a continuous airway pressure (CPAP) machine |
| 30% | Persistent day-time hypersomnolence |
| 0% | Asymptomatic, with documented sleep disorder breathing |
Read the 50% criterion closely. It asks whether the condition requires a breathing assistance device — not whether one was issued, and not which device. Do not assume every treatment is interchangeable with CPAP for this purpose, and do not assume a device in a cupboard establishes the requirement. Clinician documentation of the need is what the criterion is asking about.
Two separate questions
A sleep study and clinical assessment can establish the diagnosis. The Sleep Apnea DBQ documents it; the general respiratory form says in its own title that it is for conditions other than sleep apnea. Check which one an exam was requested on.
A claim that apnea was caused or aggravated by another service-connected condition needs evidence addressing that relationship. Two diagnoses in the same record establish nothing on their own. §3.310 treats causation and aggravation separately, and an opinion answering only the first leaves the second open — see medical opinions. Two court decisions limit how VA may handle the aggravation half, and both of them help: the worsening need not be permanent (Ward), and worsening because a service-connected condition made treatment impossible is compensable (Spicer).
On weight as an intermediate step. A common theory runs service-connected condition → weight gain → apnea. VA had treated obesity as categorically incapable of being service connected at all; Adams v. Collins (2025) held that bar impermissible for secondary claims, while leaving the bar on direct service connection in place. It is not a sleep apnea decision — that issue was not before the court — and it grants nothing. What it does is leave the chain open to be proved, link by link, which still takes a medical opinion that addresses each one.
Nighttime breathlessness is a symptom with several possible causes. Record when it occurs and how it was evaluated, rather than assuming it is apnea or anything else.
Rules and forms change, and exceptions apply. Follow the instructions on your own decision letter and the linked governing sources. This site does not track your deadlines or file anything for you.
Reviewed October 6, 2026