Social Security Disability Benefits for Sleep Apnea

Sleep apnea is a fairly common condition where a person stops breathing briefly while sleeping. Although a common symptom of sleep apnea is loud snoring with pauses that are followed by a choking sound, not everyone who snores has sleep apnea.

Are There Different Types of Sleep Apnea?

There are two types of sleep apnea. The most common type is obstructive sleep apnea, which occurs when tissue in the back of your throat slackens and causes the airway to be obstructed. Obstructive sleep apnea is often associated with obesity and snoring.

Another, much less common type of sleep apnea is called central sleep apnea. This occurs when the brain (part of your central nervous system) stops sending the correct messages to the muscles that are involved with breathing. Central sleep apnea may be related to heart failure and certain kinds of brain damage.

Can Sleep Apnea Cause Serious Complications?

Although many people are unaware of their sleep apnea, some people have severe cases where they are constantly being awakened by their breathing disruptions and get very little sleep. Even when people with sleep apnea aren't aware of their disrupted sleep, they often are very tired during the day. People with sleep apnea also may feel irritable and depressed and have headaches in the morning.

But sleep apnea can be much more serious than loud snoring and feeling tired. When you stop breathing during an episode of sleep apnea, the oxygen levels in your blood decrease (hypoxemia). This fluctuation in oxygen levels can lead to a condition called pulmonary vascular hypertension (high blood pressure in the veins that carry blood from the lungs to the heart), which can lead to an enlarged heart and heart failure.

Can You Get Disability for Sleep Apnea?

The Social Security Administration (SSA) no longer has a disability listing for sleep apnea, but it does have listings for breathing disorders, heart problems, and mental deficits. If you meet the criteria of one of the listings due to your sleep apnea, you would automatically qualify for disability benefits. Some ways to meet the listings for complications caused by sleep apnea are by having:

• chronic pulmonary hypertension (listing 3.09)
• chronic heart failure/cor pulmonale (right-sided heart failure) (listing 4.02), or
• severe cognitive deficits, mood disturbances, and/or behavioral issues (listing 12.02).

Listing 3.09 states that chronic pulmonary hypertension can qualify automatically for disability benefits if mean pulmonary artery pressure is equal to or greater than 40 mm Hg (as determined by cardiac catheterization while medically stable).

Listing 4.02 has lengthy criteria for when chronic heart failure will qualify for disability.

Listing 12.02, which covers "neurocognitive disorders," discusses the criteria needed to qualify for disability based on cognitive decline that's caused mental issues like intellectual difficulties or memory problems. To qualify for benefits under this listing, you must be able to show that your condition has caused severe, documented problems with memory, paying attention, judgment, planning, using language, or interacting socially.

The majority of people with sleep apnea will not qualify under one of the listings discussed above, but there is another way to qualify for disability.

Can Limitations From Sleep Apnea Qualify for Disability?

If you have a diagnosis of sleep apnea but don't meet one of the listings above, Social Security will look at your "residual functional capacity," or "RFC." Your physical RFC is the most intense work you can do, such as heavy, medium, light, or sedentary work. Social Security uses the RFC assessment to determine what kind of work you're still capable of doing despite the limitations of your medical condition.

The SSA will look at how tired you are in the daytime and how that affects your ability to work. For example, if you suffer from excessive daytime sleepiness (EDS), or hypersomnia, you should not operate a vehicle or other heavy, dangerous machinery. The SSA will also look at how other conditions impact the work you can do. For example, if you have heart problems, you might not be able to lift more than a few pounds.

The SSA will also prepare a mental RFC assessment for applicants who have difficulties with thinking, remembering, concentrating, or getting along with people. For instance, if your fatigue makes it more likely that you'll make mistakes, fail to follow instructions, or miss important issues, the SSA may agree that you can't do any jobs.

If the SSA finds that you're capable of performing the job you used to have, or any other type of job, the SSA can deny your claim. But if the SSA determines that the symptoms associated with your impairment and treatment are so limiting that you can't perform any jobs, you will be awarded benefits under what is called a "medical-vocational allowance."

_{Updated April 22, 2022}