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Sleep Apnea and Social Security Disability

While not all individuals with sleep apnea experience significant impairment, if your sleep apnea does prevent you from working, you may qualify for Social Security Disability (SSD) benefits.

Sleep apnea is a respiratory disorder in which you may stop breathing due to malfunction of the respiratory muscles. Episodes last for between 10 and 30 seconds each, but can be quite frequent, with the most severe cases causing breathing to cease as many as 400 times per night. The condition can cause dangerously high levels of carbon dioxide in the blood stream and increased risk of high blood pressure, stroke, heart attacks and heart disease. Of course, sleep disruption also leads to other issues, including headaches, fatigue, and muscle pain and weakness, among others.

Applying for Disability with Sleep Apnea

There are two different forms of sleep apnea: central and obstructive – either of which may qualify you for SSD benefits, provided they result in significant impairment and prevent you from maintaining gainful employment.

Obstructive apnea is caused by disruption of air flow through the trachea. It can result from a number of different physical causes, including problems with the muscles of, or collection of fatty tissue in, the throat, and problems with the tonsils, uvula or tongue.

Central apnea is a more rare form of the condition that is caused by central nervous system issues in which the brain doesn’t send proper signals to the muscles responsible for your breathing. Interruption of signals from the brain to these muscles can also be to blame for central sleep apnea, in some cases. Sleep apnea – in both forms – is evaluated by the Social Security Administration (SSA) under the criteria listed in the “Blue Book” under “Section 3.10: Sleep-related breathing disorders”. However, most claims filed on a basis of sleep apnea must be reviewed under the concept of a “medical vocational allowance”, as they may not meet the listed criteria in the Blue Book, but can still be debilitating enough to result in disability.

The Blue Book is the manual utilized by the SSA in evaluating potentially disabling conditions. A medical vocational allowance essentially means that some applicants, even though they don’t meet the listing criteria of a condition that appears in the Blue Book, are functionally disabled nonetheless and therefore eligible to receive SSD benefits.

Medical evidence is crucial in any disability claim. It is especially important when applying for SSD based on sleep apnea, as most people with the condition don’t suffer severe enough impairment to prevent them from working entirely. The SSA, for this reason, requires extensive documentation of the affects of your condition on your “residual functional capacity”, which is basically how the condition affects you every day, including your ability to perform normal functions in your personal life and on the job.

In the case of sleep apnea SSD applications, there are several components which may increase your odds of being found eligible for benefits, including:

  • Thorough records of all the physical examinations, diagnostic tests, and other evaluations you’ve undergone in an effort to diagnose and deal with your sleep apnea.
  • A detailed statement from your treating physician that documents your condition, the symptoms you have and how your symptoms affect your everyday life, including your ability to get and keep a job.
  • Evidence showing the treatments available for sleep apnea have not been successful in alleviating the symptoms you experience, or at least that the treatments have not been sufficient enough to allow you to be gainfully employed.

Sleep Apnea and Qualifying for a Medical Vocational Allowance

To evaluate your application for a medical vocational allowance through the assessment of your residual function capacity, the SSA will want to know if your sleep apnea causes issues with the following:

  • Difficulty concentrating, focusing or following directions
  • Problems staying awake due to fatigue or lack of sleep
  • Trouble driving, operating equipment, or completing tasks
  • Problems shopping, running errands of doing other everyday activities without the assistance of others
  • Difficulty remembering details or interacting socially

It’s also important that you and your physician work together to ensure your medical records are as close to meeting the listed criteria for sleep apnea as possible. This may mean you need to undergo different tests or procedures in order to satisfy the SSA’s criteria for disability eligibility.

Getting Help with Your Sleep Apnea SSD Application

To build a strong disability claim and collect the necessary documentation for supporting your application can be challenging. You must work in conjunction with your doctor to document your condition and the affects it has on your abilities. You will also want to consider seeking help from a disability advocate or Social Security Disability attorney when completing your application and other forms required by the SSA. Your attorney or advocate can also assist you in compiling supporting documentation, navigating the review and reevaluation processes, and with preparing for and appearing at an appeal hearing, if you’re required to do so in your pursuit of disability benefits.

Free Evaluation of Sleep Apnea Disability Claim