Can I get 100% VA Disability for Sleep Apnea?

Can I get 100% VA Disability for Sleep Apnea?

Can I get 100% VA Disability for Sleep Apnea?

Sleep is required to function. Sleep Apnea is a condition where someone briefly and repeatedly stops and starts breathing. This can severely disrupt someone’s sleeping patterns affecting their mental, emotional, and physical health.

Service Connection

For the VA to assign a 100% rating for Sleep Apnea, the VA must first determine that the condition is related to service.

  1. Proof of a current diagnosis,
  2. Proof of an in-service event, disease, or injury, and
  3. Proof of a medical nexus between the first 2 elements.

VA Schedule of Rating

After the VA grants service connection, it must determine the correct rating.  To do so, VA consults the Schedule of Ratings.  The ratings should reflect how much that specific disability impairs your ability to work. 

Requirements Specific to Sleep Apnea

The Schedule of Ratings breaks down disabilities into different categories. Each category contains groups of medical problems.  For example, Sleep Apnea is found in the Respiratory System category.  Each group contains a list of disabilities, each with its own diagnostic code.  In turn, each diagnostic code specifies the symptoms required for various ratings.  For example, the 6847 code applies to Sleep Apnea.  See 38 C.F.R. § 4.97

  1. Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or
  2. The condition requires a tracheostomy.

Chronic Respiratory Failure

Chronic respiratory failure usually happens when the airways that carry air to your lungs become narrow and damaged.  In other words, less oxygen gets in and less carbon dioxide goes out.  A tracheostomy is a surgically made hole in the front of your neck where a breathing tube is connected to your windpipe to help you breathe.  Naturally, a veteran with these extreme symptoms deserves a 100% VA rating for Sleep Apnea.

Medical Evidence

Only medical evidence can satisfy these requirements.  It is not enough for the veteran to say “I cannot work because of my sleep apnea.”  Fortunately, the VA provides rating tools such as Disability Benefits Questionnaires (“DBQs”) on their website.  Specifically, VA provides a Sleep Apnea DBQ that focuses on the symptoms described in the Schedule.  Veterans seeking a higher rating for sleep apnea should have their doctors complete the DBQ. The VA will likely grant the rating if the DBQ includes the criteria for a 100% rating for Sleep Apnea.

Disability Benefits Questionnaire

Watch out for Pyramiding

When seeking a 100% rating for Sleep Apnea, one must consider every rule and exception related to VA ratings.  Under the VA rating system, a veteran should be compensated for each service-connected disability.  However, there is one big exception.  VA cannot pay a veteran more than once for the same disability or same manifestation.  For example, Asthma and Sleep Apnea have nearly identical manifestations.  They both involve airway impairment, share symptoms such as daytime fatigue and are under the same category in the Schedule of Ratings.  A veteran who is service connected for both will only receive a rating for one of them.  In that circumstance, the VA must assign the higher of the 2 possible ratings.

How We Can Help

Many variables come into play when trying to get 100% VA disability for Sleep Apnea. The first step is to not give up. Our team of experts are here to support you the entire way through. Whether you are struggling to secure your VA disability or need help with your denied SSD claims, we’re only a phone call away. To learn more about how our team can help you call us today at (800) 800-3332 or contact us here now for a FREE consultation.

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Helpful Resources

If Someone Getting SSD Dies, Can I Get Their Benefits?

If Someone Getting SSD Dies, Can I Get Their Benefits?

If Someone Getting SSD Dies, Can I Get Their Benefits?

Not exactly. Social Security disability benefits (SSD) are for the disabled worker, and those benefits terminate when the recipient passes away. But that doesn’t necessarily mean dependents are on their own. Here are some benefits that may be available to surviving family members when an SSD recipient passes away. 

Social Security Death Benefit

The Social Security Administration (SSA) pays a one-time, lump-sum death benefit when a recipient of either SSD or Social Security retirement benefits passes away. This is a small payment. In 2023, it’s $255. This benefit is payable to the surviving spouse if there is one. If not, the benefit may be paid to a child of the deceased.

Survivor’s Benefits

Some dependents of a deceased SSD recipient can receive survivor’s benefits.

These family members may qualify for benefits on the deceased’s work record: 

  • A surviving spouse aged 60 or older
  • A surviving spouse of any age who is caring for a child of the deceased who is under the age of 16
  • A surviving spouse of any age who is caring for a child of the deceased who is disabled
  • A surviving spouse aged 50 or older who became disabled during the SSD recipient’s life or within seven years of their death. 
  • An unmarried child of the deceased who is under the age of 18, or up to age 19 and two months if they are a full-time student in elementary or secondary school
  • An adult child with a disability that began before age 22

In some circumstances, others may be able to receive survivor’s benefits.

These include: 

  • A former spouse who was married to the SSD recipient for at least 10 years and who has not remarried or who remarried after age 60
  • A former spouse who is caring for a child of the deceased who is under the age of 16 or disabled and is receiving child’s benefits, regardless of the length of the marriage
  • Parents of the deceased who are at least 62 years of age, if they received at least half of their support from the deceased SSD recipient
  • Grandchildren or stepchildren, under certain circumstances

The amount of survivor’s benefits that a family member receives will depend on both the deceased’s work record and the number of family members receiving benefits. 

An Experienced Disability Benefits Attorney Can Help

Applying for Social Security survivor benefits can be complicated. If you’ve been denied survivor benefits, don’t believe you are receiving the right amount, or just aren’t sure how to find out whether you qualify, we’re here to help. Call us today at (800) 800-3332 or fill out our contact us here now for a FREE consultation.

How Long Do I Have to Work to Qualify for SSD?

How Long Do I Have to Work to Qualify for SSD?

How Long Do I Have to Work to Qualify for SSD?

When most people think of qualifying for Social Security Disability (SSD), they think about proving that their medical condition is severe enough that they are unable to earn a living. That is a necessary part of the process. But, there are technical criteria that must be met before the Social Security Administration (SSA) even looks at your medical condition.

To qualify for SSD, a disabled worker must have sufficient work credits. For disability benefits, these credits are measured in two ways. The applicant must have a certain number of total work credits and a certain number of recent work credits. The number of each type of credit required varies depending on the applicant’s age.

What are Work Credits?

When you work and pay into Social Security, you collect work credits. The maximum number of credits you can earn in a year is four, regardless of how much money you make during that year. The amount of earnings it takes to constitute a credit changes over time. In 2023, you must earn $1,640 to earn one credit. 

Earning credits for the year tops out at $6,560/year, so most people who work full-time–or even steady part-time jobs–will accrue four credits in a year. If you earn less, you’ll get fewer credits.

How Many Work Credits Are Required for SSD? 

For most disabled workers, the minimum number of total work credits accrued to qualify for SSD benefits is 40. That’s the equivalent of 10 years of work. It’s also the same number of work credits required for Social Security retirement benefits. However, disability qualification has another element. Unless you are legally blind, you must also have a certain number of recent work credits. For most applicants, that number is 20 (the equivalent of five years of work) within the 10 years prior to applying.

Credit Requirements are Lower for Younger Workers

A worker who becomes disabled Earlier in adulthood hasn’t had as much time to receive work credits. So the number of work credits required is adjusted based on the applicant’s age. For instance, if the disabled worker is under the age of 24, they need just six work credits (1.5 years) of work in the prior three years. 

If your social security record indicates that you do not have enough work credits, review the record carefully. If there are jobs missing from your record or incorrect time periods, you can correct your record. 

Talk to an Experienced SSD Benefits Advocate

The rather complicated formula for work credits above is just one element of qualifying for Social Security disability benefits. Proving that your condition meets or equals a condition listed in the Blue Book, or that you are unable to work, can be much more complicated. Most Social Security disability initial applications are denied. To give yourselves the best chance of approval, work with a qualified disability benefits advocate who knows what the SSA is looking for. 

To learn more about how we can help, call (800) 800-2009 right now or contact us here.

Can I get A 100% VA Rating for PTSD due to Military Sexual Trauma?

Can I get A 100% VA Rating for PTSD due to Military Sexual Trauma?

Can I get A 100% VA Rating for PTSD due to Military Sexual Trauma?

Post Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental disability triggered by a traumatic event.  When the average person thinks of a traumatic military event, they often think of combat.  However, some military threats come from within our own ranks.  Military Sexual Trauma, or MST, refers to experiences of sexual assault or sexual harassment during military service.  According to national data provided by the VA, 1 in 3 women and 1 in 50 men say that they experienced military sexual trauma (MST) when screened by their VA provider.

Military Sexual Trauma (MST)

Military Sexual Trauma includes any sexual activity where a service member is involved against his or her will.  He or she may have been pressured into sexual activities (for example, with threats of negative consequences for refusing to be sexually cooperative or with implied better treatment in exchange for sex), or may have been physically forced into sexual activities.

Other MST experiences include unwanted sexual touching or grabbing; threatening, offensive remarks about a person’s body or sexual activities; and threatening and unwelcome sexual advances.  

PTSD is the most common mental health diagnosis related to MST.  You may be eligible for VA 100% if your PTSD is due to MST.

Service Connection PTSD due to MST

Before VA will assign a 100% rating for PTSD due to MST, they must first determine whether it is related to service.  In other words, VA must first grant service connection before it will assign a rating.

There are 4 requirements to prove service-connection PTSD due to MST

  1. Current diagnosis,
  2. In-service event, disease or injury,
  3. Medical nexus between the first 2 elements, and
  4. Credible supporting evidence that the claimed in-service stressor occurred.

The challenge of Proving Military Sexual Trauma (MST)

Most victims are not eager to report MST to their superiors.  This is especially true if a superior has committed the MST, the VA is well aware of this.  Absent an official law enforcement record, how does one prove PTSD due to MST?

The VA looks for credible supporting evidence.

Credible supporting evidence of MST can include:

  • In-service pregnancy tests or tests for sexually transmitted diseases,
  • Statements from clergy, family members, roommates, or
  • Evidence of behavior changes following the claimed assault.

Rating PTSD due to MST

After the VA grants service connection for PTSD due to MST, it must determine the correct rating.  To do so, the VA consults the Schedule of Ratings.

The Schedule of Ratings breaks down disabilities into different categories.  Each category contains groups of medical problems.  For example, PTSD due to MST is found in the General Rating Formula for Mental Disorders.  Depending on the symptoms, a veteran may receive either 0%, 10%, 30%, 50%, 70%, or 100%.

100% Rating: Total occupational and social impairment from PTSD due to MST

  • Gross impairment in thought processes or communication
  • Persistent delusions or hallucinations; grossly inappropriate behavior
  • The persistent danger of hurting self or others
  • Intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene)
  • Disorientation to time or place
  • Memory loss for names of close relatives, own occupation, or own name

70% Rating: Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood

  • Suicidal ideation
  • Obsessional rituals which interfere with routine activities
  • Speech intermittently illogical, obscure, or irrelevant
  • Near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively
  • Impaired impulse control (such as unprovoked irritability with periods of violence)
  • Spatial disorientation
  • Neglect of personal appearance and hygiene
  • Difficulty in adapting to stressful circumstances (including work or a work-like setting
  • Inability to establish and maintain effective relationships

50% Rating: Occupational and social impairment with reduced reliability and productivity

  • Flattened affect
  • Circumstantial, circumlocutory, or stereotyped speech
  • Panic attacks more than once a week
  • Difficulty in understanding complex commands
  • Impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks)
  • Impaired judgment
  • Impaired abstract thinking
  • Disturbances of motivation and mood
  • Difficulty in establishing and maintaining effective work and social relationships

30% Rating: Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal)

  • Depressed mood
  • Anxiety
  • Suspiciousness
  • Panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, and recent events)

10% = Occupational and social impairment due to mild or transient symptoms

  • Decrease work efficiency and ability to perform occupational tasks only during periods of significant stress
  • Symptoms controlled by continuous medication

0% Rating: A mental condition has been formally diagnosed

  • Symptoms are not severe enough either to interfere with occupational and social functioning
  • Require continuous medication

You May Be Entitled to VA 100% PTSD due to MST

The type, severity, and duration of a veteran’s symptoms will vary based on a number of factors.  For example, race, religion, and sexual orientation can affect the impact of MST.  Whether the MST happened once or was repeated over time may affect how long the symptoms last. 

If your PTSD due to MST has caused any of the symptoms in the 100% range, then you may be entitled to VA 100%.

Call Disability Help Group for a FREE Case Review! If you have more questions about getting a 100% rating for PTSD due to MST, please fill out our information form here or call us at (800) 800-3332.  We offer a 100% guaranteed free case review.  We will be happy to answer your questions.

Resource for PTSD due to MST

How to File a Social Security Disability Application

How to File a Social Security Disability Application

How to File a Social Security Disability Application

You have multiple options for filing an SSDI application. The Social Security Administration (SSA) recommends filing online and treats the online application as the default method. Here are a few reasons you may want to use the online application process: 

  • You can apply any time it’s convenient for you, rather than having to wait for an appointment and then apply during business hours
  • The SSA says that online applications are typically processed more quickly than other application types
  • You can stop and start the online application, meaning that the process won’t be derailed if you’re missing some information

With the average wait time for an initial determination crossing the 7-month mark in February of 2023, it makes sense to take the most efficient route possible. However, if you can’t apply online or just don’t want to, you have other options. 

Alternative Ways to Apply for Social Security Disability Benefits

Apply at Your Local Social Security Office

You can apply for disability benefits in person. One advantage to this approach is that you’ll have an SSA staff member available to answer questions or provide other assistance. You can find your local office through the SSA’s field office locator tool. 

If you choose to apply in person, be sure to call ahead for an appointment. And, make sure you have all of the required information gathered. 

Apply by Phone

Applying by phone is similar to applying at your local office. You’ll have an SSA representative to assist you, and they’ll ask you questions to collect the information you would fill in when completing the application. The SSA offers a starter kit to help you prepare to complete your application and interview, whether you apply online, by phone, or in person. 

Need Help with Your SSDI Application? 

Most Social Security disability benefits applications are initially denied. You can improve your chances of being among those applications approved in the first round by ensuring that your application is completed properly and that you have provided adequate supporting documentation to fully establish your claim. Working with an experienced disability benefits advocate can help ensure that you put together the best application possible. 
To learn more about how Disability Help Group can help, call (800) 800-3332 right now, or fill out the contact form on this site.

What Does “Appeal Under Review” Mean for SSDI?

What Does “Appeal Under Review” Mean for SSDI?

What Does “Appeal Under Review” Mean for SSDI?

The Social Security Administration’s “appeal under review” update in the Social Security disability (SSDI) appeals process can be perplexing. The notification advises you that a decision has been made. You read all of the information you can find carefully, and it contains no clues about what that decision may be. 

You’re not missing anything. You won’t be advised of the decision until the review is complete. Many SSDI applicants think “under review” sounds negative, or just worry about why they’re seeing this update and what they should do. Here’s what you need to know if you receive an “appeal under review” letter or see that status. 

What Does “Appeal Under Review” Tell You?

The short answer is that seeing “appeal under review” doesn’t tell you anything especially useful about your case. It means that a medical decision has been made, but that decision could be positive or negative. It tells you that the SSA has assigned someone to review certain elements of your claim. But, that’s not necessarily a problem for you. It’s just a step in some SSDI appeals.

In other words, you don’t know anything more about the outcome of your case than you did before the status update, except that the process is nearing an end. For better or worse, there’s generally nothing to do but wait. If and when your claim is approved, you’ll be clearly notified. If your claim is denied, you’ll be notified and have an opportunity to take the next step in the process. 

What if the Appeal is Denied? 

The appeals process is a multi-step one, so if you receive a denial after the review is complete, you still have options.  The hearing before the administrative law judge (ALJ) is one of the last steps in the process, but it’s not the end of the road.  The next step is to request a review by the Appeals Council. Unlike the other steps in the process, there’s no right to this review–the Appeals Council decides whether or not to take up the case. 

If they pass or rule against you, the final step is the federal district court. That is a much more complex process that is best attempted with the help of an experienced disability lawyer. 

How a Social Security Disability Advocate Can Help

Most SSDI claims are initially denied, and it can take months or years to work your way through the appeals process and secure benefits. That means it’s especially important to construct a strong application with thorough documentation and to keep the process moving forward if you have to appeal. 

At Disability Help Group, we can assist at any stage of the process, from initial application through the Appeals Council review. To learn more about how we can help, contact us here or call (800) 800-3332. Generally, the earlier in the process you get help, the better.