Philpott’s Forum presents opinions, insights and, on occasion, answers questions from readers of Tom Philpott’s Military Update news column. Below readers react to a recent column on an explosion of VA claim payments for sleep apnea.
I was diagnosed with sleep apnea 15 years ago. I use a CPAP (continuous positive airway pressure) machine, first obtained through TRICARE, more recently from the VA. It works. I do not consider the illness to be a disabling condition when treated. I weigh 129 pounds so being overweight is not my underlying cause, nor do I snore. I do pay higher premiums for my long-term care insurance based on disclosure of this medical condition. Though I am a Priority 3 VA patient (Purple Heart recipient from Vietnam) and grateful that I qualify for care, I would never think of asking VA for a disability rating based on sleep apnea. To receive a rating, one must show the disease, illness or injury is service related. As you state, the underlying reason for most sleep apnea is obstructive. I do not see how that is service related. It would be a travesty if service members are being released from active duty due to being overweight, only to have them come back to receive a 50 percent disability rating for sleep apnea. Untreated, the condition may be disabling. Treated, I feel more rested and alert than before. I agree that once a veteran receives and uses a CPAP, disability compensation should stop. Thanks for another example of waste, fraud and abuse and for bringing it to the attention of those in a position to make changes. JIM W. Colonel, USA-Ret.
I have to sound off. I served in World War II and Korea and went to Vietnam in 1966. In May 1999 I took an Agent Orange physical at the VA Hospital in Shreveport, La., and was diagnosed with lung cancer. The VA advised me to see my health provider. In June 1999 I was operated on and had part of my upper left lobe removed. In June 2002 the cancer returned. I had 42 radiation treatments. I took a disability physical at the VA Hospital and was awarded a 30 percent rating. I personally know of six individuals who draw disability compensation for sleep apnea. Yes, they are overweight and five of them have good-paying jobs. One doesn’t work but his wife has the good paying job. My real gripe is they have Disabled Veteran license plates. Any one of them could walk 10 miles through the woods if they were pursuing ducks, deer or other wildlife game. Yet they are “disabled” and feel they earned a DV license plate? It is an utter disgrace and deplorable that veterans are awarded that much for being too fat. Clearly, it isn’t sleep apnea causing their sleep difficulties. Politicians and VA representatives who sign off on this are just as guilty as persons driving the getaway car. I was operated on for colon cancer in April 2012. I did not go to the VA because they waste all of that money on sleep apnea instead of treatments for cancer and many other life threatening diseases. By the way, not one of the six I mentioned served in a combat zone. WAYNE O. MORRISON Master Sergeant, USAF-Ret.
There has been a spike in the number of sleep apnea cases because soldiers have been sent off to war for the past 12 years, and a record number were exposed to stressors and situations that can wreck one’s ability to sleep. This coupled with everything that happens on a normal day to day basis, is the perfect combination for apnea. Sleep deprivation is key to combat operations. Any successful combat operation is conducted when the enemy is asleep. Whether in a convoy, a raid, an ambush or on patrol, you just don’t get to do the RIM sleep civilians speak of. Soldiers who served when I served didn’t even know what sleep apnea was. We figured if a guy snored, he just snored. Only after studies and research were done did they figure out why a lot of soldiers snored. I think they are way off when they attribute Apnea to weight gain, and the reasoning behind it. I think it is more the conditions in paragraph 1. I know at least 5 retired soldiers, that are not overweight, but getting compensation from the VA. Very simply put, the life of a soldier is very conducive to one developing Sleep Apnea, depending on what their job is. This is just another attempt by the government to weasel-out of their obligation to take care of the folks who fight its wars. Are there abuses? Probably. But if it is such a concern, and they do not want to classify it as debilitating because of service, then give every person coming in the armed forces a sleep study. It is ridiculous they are toying around with this. It’s a sign they will be attacking every ailment ex-soldiers receive compensation for. LARRY C. BOSTICK Master Sergeant, USA-Ret.
In my opinion, the automatic 50 percent rating for sleep apnea is excessive and being abused. I would suggest that the VA make it mandatory for those clinically diagnosed with apnea also be diagnosed for being obese or overweight, and make it mandatory to be re-evaluated semi-annually to decrease the compensation amount to a more manageable 10 percent along with a weight loss program. JEFF GOTTLOB Veterans Service Officer Texas City, Texas
As a retired soldier I am extremely disappointed that Congress and the VA can’t see how the sleep apnea issue is crossing the line of fraud and waste. Your article makes clear that being overweight or obese is the main cause of sleep apnea. Did the military make us obese or overweight? Military service does not cause sleep apnea. There is no activity in service that can. When recruits go through their entry physicals they aren’t tested for this condition. So how can VA determine if this condition was there before service or was caused due to conditions found in the military? If a veteran is diagnosed with sleep apnea and receives a machine to alleviate symptoms, then why should my tax dollars cover disability pay in addition to pick up the lifetime tab for those machines? I mainly blame the VA for identifying this as a disability. They need to look up the term in the dictionary, and not apply it to symptoms correctable by changing bad habits. I work in a military environment. I hear personnel talk about what symptoms give them the most disability pay. Too many of these individuals are just looking for an easy buck from scamming the disability system. There should be no grandfather clause if VA does change the rules for sleep apnea disability pay. They should be given a new prescription from their doctors stating: “Eat healthy, exercise and stop being a burden on the American taxpayers.” FRANK MANNO Staff Sergeant, retired
A sleep apnea test can be manipulated. How? If a person sleeps all day before the test, that person normally will be thrown off their sleep pattern and will throw off the test results. As my doctor told me, yes, I have sleep apnea. But most people have some form of it. I am a veteran too, and I think too many retirees are taking advantage of this to get VA compensation. This should be stopped now. RICKY E. SKOOG Via email
Why would General Scott recommend that only VA doctors apply the sleep Apnea test? Does he think private doctors cannot do their job? I will tell you why: Because VA docs can deny it from the start. RALPH G. Via email
A board-certified pulmonary specialist told me there are two reasons for sleep apnea. One is structure, what you were born with. Small children can have sleep apnea. Two is obesity. As I see it, both of these have nothing to do with military service. There is surgery that can be done for structural sleep apnea, the type I have. But it is controversial. Many times people are worse off. There also is surgery for obesity. There is also a “mouth guard” of sorts one can wear at night. The VA would save money if they did the following: -- Identify the structural apneas and give them the mouth guard to start and -- For the obese apneas put these vets on an aggressive weight loss program. This will save money down the road for all those weight-related medical problems. DIANNE E. SIMMONS Via email
I’m a Desert Storm veteran who was denied compensation for sleep apnea but was prescribed a CPAP. I didn’t know anything about sleep disorders until years after my medical discharge. Even with the CPAP, which I can’t keep on my face for a lot of the time, I tend to stay fatigued. It’s very disabling at times. ANDREW DURHAM Via email
I am the spouse of a retired veteran. I was diagnosed with sleep apnea and was prescribed a CPAP machine. However I lost 50 pounds and, after being on the machine for a year, a sleep study determined that I no longer needed the machine. Maybe veterans should be required to get tested once a year to see if they really still need the machine. I know of two vets who got disability for sleep apnea and do not even use their machines. My machine had a card that tracked my hours of use. So here’s another idea: Require the vet to submit a monthly usage report. YVETTE KITTELL Via email