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Does a Sleep Apnea Nexus Letter Help Your Claim?


By Telemedica


Nexus Letter

Table of Contents

  1. What is a Sleep Apnea Nexus Letter?
  2. How To Get A Nexus Letter For Sleep Apnea
  3. Do I Need a Sleep Apnea Nexus Letter?
  4. Nexus Letters for Sleep Apnea
  5. VA Rating for Sleep Apnea VA Disability
  6. Sleep Apnea DBQ
  7. Did You Know?
  8. Conclusion

In this post, we outline what you need to know about a Sleep Apnea Nexus Letter. We also explain why sleep apnea nexus letters can be helpful and how veterans can get a nexus letter for sleep apnea.

If you’re a veteran, getting treatment for service-connected sleep apnea starts by getting a VA rating for sleep apnea. One way to bolster your chances of winning your claim is with a high-quality sleep apnea nexus letter.

Get a Nexus Letter

What is a Sleep Apnea Nexus Letter?

A sleep apnea nexus letter is a written statement from a qualified medical professional stating that, in their professional opinion, your sleep apnea is caused by an in-service event, injury, or illness.

For the VA to validate your claim, they need to determine if your condition was caused or made worse by your military service. This is known as “service connection.”

Proof of service connection is required for all VA claims and can be established by medical opinion or medical evidence. Nexus letters serve as a medical opinion.

A nexus letter can provide a statement connecting any disability to your military service, not just sleep apnea.

How To Get A Nexus Letter For Sleep Apnea

The VA only accepts nexus letters written by licensed providers.

It’s your responsibility to find a physician and request a nexus letter. The VA doesn’t identify qualified physicians or set up appointments specifically for nexus letters on your behalf like they do for C&P exams.

The VA accepts nexus letters from both VA or VA-contracted physicians and private physicians as long as they are qualified to evaluate your condition. 

But the question still remains, “How do I find a doctor who writes nexus letters?”

The best way is through a service with a network of providers qualified to write a nexus letter for your specific disability. Telemedica is one such service that is qualified and able to assist.

Telemedica is a telehealth platform with a network of independent providers who can write you a nexus letter based on your medical records. We also offer virtual mental health exams, telemedicine evaluations, rebuttal letters, and recurring therapy.

Check out our FAQ sheet for answers to some of your nexus letter questions.

Do I Need a Sleep Apnea Nexus Letter?

The VA does not require you to get a nexus letter. Service connection can be established in other ways, such as with the medical evidence in your files.

However, having a statement from a medical professional saying that your condition was caused or aggravated by your military service can really bolster your claim. The VA values the opinions of medical professionals, especially if they’re specialists in the field related to your condition.

Here’s a simple litmus test to help determine if you should pursue a nexus letter:

  • Was your disability diagnosed while in service and is it in your military medical records? If it is, you likely don’t need a nexus letter.
  • If your disability was not diagnosed while in service or if it is not in your military medical records, then a nexus letter could benefit your VA claim.
  • Are you re-filing for a previously denied claim or filing for a secondary condition? Nexus letters can strengthen these types of claims.

Nexus Letters for Sleep Apnea

What your nexus letter for sleep apnea looks like will vary depending on the source. However, all good nexus letters have these four things:

  1. Supporting Evidence: Your provider should mention the medical and/or personnel records they’ve reviewed that are related to your claim.
  2. Evidence-based Rationale: Your provider should explain how your in-service event, injury, or disease caused your disability. They can refer to medical studies, case laws, or research journals to help show that their opinion is evidence-based.
  3. A Nexus Opinion: Your provider should provide a medical opinion as to how likely it is that your disability was caused or made worse by an in-service event, injury, or disease. The strength of their opinion will depend on the evidence. Make sure they use language like:
  • “Is due to” = 100% certain
  • “More likely than not” = greater than 50% certain
  • “At least as likely as not” = equal to 50% certain
  • “Not likely due to” = less than 50% certain
  • “Is not due to” = 0% chance

Doctor’s Credentials: Make sure your provider signs and dates the letter and lists their title, specialty, and any other credential that proves they’re an expert.

VA Rating for Sleep Apnea VA Disability

Sleep apnea is rated by the VA at 0%, 30%, 50%, or 100%.

VA sleep apnea rating chart.

Figure 2. VA Sleep Apnea Rating Chart

These rating percentages come from the Veteran Affairs Schedule for Rating Disabilities (VASRD).

The VASRD is a list of diagnostic codes for every condition the VA rates. Listed with the codes are the symptoms of each condition and their respective rating percentage.

The percentage the VA awards a disability depends on how negatively the symptoms affect your life. The more debilitating your symptoms, the higher your rating.

Sleep Apnea DBQ

DBQ stands for Disability Benefits Questionnaire. DBQs are VA forms that guide VA medical providers through a C&P Exam.

VA DBQ forms cover a wide range of disabilities. All in all, there are 71 different DBQ forms available to the public ranging from musculoskeletal conditions to dermatological conditions.

The VA recently made all of its DBQ forms available to the public again. At one point, they were only available to doctors. The DBQ form for sleep apnea can be found on the VA’s website.

Did You Know?

  • A Sleep Apnea Nexus Letter is a statement from a medical professional that can help a veteran establish service connection.
  • The VA doesn’t require nexus letters, but they can help your claim.
  • The VA rates sleep apnea at 0%, 30%, 50%, or 100%.

The American Medical Association (AMA) estimates that about 30 million people in the United States suffer from sleep apnea.

Even more interesting is that the AMA also reports that only 6 million people in the United States are actually diagnosed with sleep apnea. That means millions of people are suffering from a very treatable condition, and might not even know it. 


Our mission at Telemedica is to provide innovative, quality care to the veteran community. Our standard of care applies to everything we do, including nexus letters. If you need a nexus letter for sleep apnea, don’t hesitate to reach out.

Book your free 20-minute Consultation Call now and a qualified provider will review your medical records and provide a comprehensive chart review summarizing your medical records and documents that may support your claim.