Understanding Sleep Apnea and Social Security Disability

Sleep apnea is a condition where your breathing stops and starts repeatedly while you sleep. The most common type of sleep apnea is obstructive sleep apnea (OSA), which occurs when the muscles in the throat relax and block the airway. Central sleep apnea and complex sleep apnea syndrome are less common types.

While sleep apnea can be a serious condition that severely affects your health, Social Security Disability benefits are typically granted only if your condition significantly impairs your ability to work and meet the SSA’s disability criteria.

Sleep Apnea and SSA’s Listing of Impairments

The SSA maintains a Listing of Impairments that outlines conditions and the medical evidence required to qualify for benefits. Sleep apnea is not explicitly listed in the Listing of Impairments, but that doesn’t mean you can’t qualify for benefits.

To qualify, your sleep apnea must be severe enough to meet the SSA’s disability requirements. The SSA considers sleep apnea under respiratory disorders if it results in severe limitations or complications. Here's how it is evaluated:

• Impairment Severity: The SSA looks at the severity of your condition and how it limits your ability to perform daily activities. If your sleep apnea causes chronic respiratory failure or significantly affects your ability to breathe normally, it may qualify under the SSA’s respiratory disorder guidelines.
• Documented Symptoms: You’ll need medical evidence showing that your sleep apnea results in symptoms such as severe daytime fatigue, difficulty staying awake, and inability to perform basic work tasks.

Proving Your Disability Claim for Sleep Apnea

When applying for disability benefits for sleep apnea, the SSA requires strong medical evidence to prove that your condition prevents you from working. Here’s what you’ll need to do:

• Medical Diagnosis: You must have a formal diagnosis from a healthcare provider, usually confirmed by a sleep study (polysomnography) that shows evidence of frequent apneas (breathing cessations) or hypopneas (partial blockages).
• Document Your Limitations: The SSA will want evidence that your condition is significantly impairing your ability to perform work-related tasks. This could include:
• Chronic fatigue and the inability to stay awake during the day.
• Difficulty focusing or concentrating due to poor sleep quality.
• Symptoms of heart or lung complications if your sleep apnea has caused secondary issues, such as high blood pressure, heart disease, or respiratory failure.
• Treatment Records: You should provide documentation of your treatment for sleep apnea, including:
• Continuous Positive Airway Pressure (CPAP) or BiPAP therapy use.
• Ongoing medical treatments and medications.
• Improvement or lack of improvement with treatment.

What to Do If Your Claim is Denied

It’s common for Social Security Disability claims to be denied, even if you meet the SSA’s medical criteria. If your claim for sleep apnea benefits is denied, you have the right to appeal the decision. The appeals process includes:

• Requesting Reconsideration: The SSA will review your case again to ensure all necessary documentation was considered.
• Requesting a Hearing: If reconsideration is denied, you can request a hearing before an Administrative Law Judge (ALJ). This is where you can present more detailed evidence, including testimony from your doctor about how sleep apnea limits your ability to work.