Sleep Apnea and Asthma rated together? Please anyone advise...

NAVYMA1

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Hey all, in addition to my probable appeal coming for my referred conditions, I also have another possible issue. The VA rated my apnea at 50%. And asthma at 30%. Those numbers are accurate based off the criteria needed. The problem is, instead of two separate numbers used for the combined ratings... They put the two conditions together, eating them at just 50%. I have not heard of them doing this for anyone else. If they separate them, my combined ratings will go up from 80% to 90%. Suggestions/advice/similar stories??
 

gsfowler

Super Moderator
Staff Member
PEB Forum Veteran
The conditions can be combined, if the manifestations are duplicative and overlapping. This is often not the case however.

Here is the verbiage from a successful appeal.

The RO found that 38 C.F.R. § 4.96 bars the assignment of a
separate rating for the asthma condition apart from the sleep
apnea condition. However, that provision states that ratings
under Diagnostic Codes 6600 through 6817 will not be combined
with each other. That provision also states that ratings
under Diagnostic Codes 6822 through 6847 will not be combined
with each other. The two specified ranges of diagnostic
codes are stated in the disjunctive and thus, the provision
does not automatically prohibit the assignment of a rating
under Diagnostic Codes 6600 through 6604 in addition to the
assignment of a rating under Diagnostic Codes 6822 through
6847.

Furthermore, under 38 C.F.R. § 4.96, a separate rating can be
assigned for asthma even when the veteran is receiving
compensation for sleep apnea. While these respiratory
conditions each impair his ability to breathe, each condition
has distinct and separate symptomatology. The sleep apnea is
caused by obstructive factors and results in disruption of
breathing during sleep; the condition is alleviated by the
use of CPAP. The asthma is caused by exposure to allergens
and irritant particles and results in recurrent attacks of
spasmodic contraction of the bronchi; the condition is
alleviated by the use of bronchodilators. Because the
symptomatology does not overlap, a separate rating should be
assigned for the asthma. See Esteban v. Brown, 6 Vet. App.
259, 261-62 (1994).
 

NAVYMA1

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Appreciate the info, I will look a little deeper into that case. My priority now is going to be focused on my appeal of referred conditions but I definitely want to deal with this as well.
 

gsfowler

Super Moderator
Staff Member
PEB Forum Veteran
You should do a formal appeal to get the asthma as unfitting and have the OSA separated at the same time. You can argue that the OSA is a smoke screen clouding the unfitting condition of asthma.
 

PEB boot

New Member
Registered Member
I believe if rated separate it will not be 80% it will be 65% ...va math is sleep apnea is 50% leaving 50% to work with ...asthma was rated at 30% like you said ....in va land that means 30% of the remaining 50% equaling 15% then combined with the sleep apnea would be 65% Vice 80% which would make sense but that's the jacked up way the govt saves money
 

trini123

PEB Forum Regular Member
Registered Member
Gsfowler,
I'm currently going through a PEB for Venous thromboembolism and im taking anticoagulants. I also have sleep apnea and im worried that they would claim them as pyramiding and rate them together. Do you have any examples of the VA rating 6817 and 6847 separately and what's your taughts on my situation?
 
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