VA Questioning “Recent Surge” in Sleep Apnea Compensation

Prior to 1996, the Veterans Administration (VA) did not compensate for sleep apnea treatment. Last year, the VA shelled out an estimated $1.7 billion in sleep apnea related reimbursement for equipment such as CPAP.

According to Shreveport Times columnist Tom Philpott, the relatively new amounts have not gone unnoticed by the VA Advisory Committee on Disability Compensation. In fact, the committee privately recommended to Allison A. Hickey, under secretary for Benefits, that the Department of Veterans Affairs (DVA) consider four steps to address a “recent surge” in VA compensation awards for sleep apnea.

The VA briefer that accompanied the recommendation noted that 13% of all veterans with service after 9/11, and who draw VA disability pay, are being compensated for sleep apnea.

According to Philpott, the committee recommended that the VA:

• have compensation exams for sleep apnea given exclusively by VA doctors to ensure required sleep tests are properly conducted;

• have the Institute of Medicine conduct a detailed study on degree of actual disability associated with sleep apnea, particularly for veterans who are prescribed a CPAP machine, which under VA regulations results in an automatic rating of 50%;

• conduct a review of criteria and methodology for establishing service connection to sleep apnea; and

• review criteria for establishing average earning loss for veterans diagnosed with sleep apnea.

Michael Webster, a family law attorney in Shalimar, Fla, and former naval aviator, reportedly complained to the House Veterans Affairs Committee last year of widespread abuse in sleep apnea claims. He called the boom in payments a scam perpetuated mostly by retirees coached toward an easy 50% rating.

According to Philpott, a staff member for the House Veterans Affairs Committee investigated Webster’s charges and concluded “there does not appear to be widespread abuse of compensation related to this disorder.”

“His report is silent on the larger issues raised by VA advisors—whether obstructive sleep apnea is disabling when a CPAP is prescribed and provides relief, and whether CPAP usage should trigger a 50% rating,” writes Philpott. “A soldier who loses two dominant fingers, such as a thumb and index finger, also earns a disability rating of 50%.”

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