OSA Secondary to PTSD

DC 6847Respiratory38 CFR 4.97, DC 6847

Obstructive sleep apnea claimed as caused or worsened by PTSD. Research shows PTSD medications can cause weight gain leading to OSA, and PTSD-related sleep disruption worsens apnea. The VA rates it based on the treatment you need.

How the VA rates this condition

The VA rates this condition based on the type and intensity of treatment you require. Higher ratings correspond to more aggressive treatment regimens, such as daily medication, insulin dependence, or the need for ongoing medical management.

Diagnostic code

DC 6847

Rating range

0% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.97, DC 6847. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have chronic respiratory failure with carbon dioxide retention or cor pulmonale, or you need a tracheostomy for your sleep apnea.

What the VA looks for

Chronic respiratory failure documented
Carbon dioxide retention on blood gas testing
Cor pulmonale diagnosis
Tracheostomy placed for airway management
Arterial blood gas results showing CO2 retention

Common Pitfalls

⚠Not getting a medical nexus letter explaining how PTSD caused or worsened your sleep apnea — the VA needs a doctor to explain the connection, such as weight gain from PTSD medications or sleep fragmentation.
⚠Not documenting weight gain after starting PTSD medications — track your weight before and after starting medications like mirtazapine, quetiapine, or SSRIs.
⚠Not submitting CPAP compliance data — if your CPAP machine tracks usage, download and submit the report showing you use it regularly.
⚠Filing for sleep apnea without first having a service-connected PTSD rating — the secondary claim requires an already-rated primary condition.
⚠Not getting a current sleep study — a sleep study older than a few years may not reflect your current severity.

Related DBQ Forms

DBQ Sleep Apnea Syndromes

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

How the VA rates this condition

Diagnostic code

DC 6847

Rating range

0% – 100%

Rating levels

Rating Levels

You have chronic respiratory failure with carbon dioxide retention or cor pulmonale, or you need a tracheostomy for your sleep apnea.

What the VA looks for

Chronic respiratory failure documented
Carbon dioxide retention on blood gas testing
Cor pulmonale diagnosis
Tracheostomy placed for airway management
Arterial blood gas results showing CO2 retention

Common Pitfalls

⚠Not getting a medical nexus letter explaining how PTSD caused or worsened your sleep apnea — the VA needs a doctor to explain the connection, such as weight gain from PTSD medications or sleep fragmentation.

⚠Not documenting weight gain after starting PTSD medications — track your weight before and after starting medications like mirtazapine, quetiapine, or SSRIs.

⚠Not submitting CPAP compliance data — if your CPAP machine tracks usage, download and submit the report showing you use it regularly.

⚠Filing for sleep apnea without first having a service-connected PTSD rating — the secondary claim requires an already-rated primary condition.

⚠Not getting a current sleep study — a sleep study older than a few years may not reflect your current severity.