Sleep Apnea · Secondary Claims
Sleep apnea secondary to allergic rhinitis: the nexus letter that connects them
If your VA claim for sleep apnea was denied — or you didn't get the rating you believe you earned — and you're already service-connected for allergic rhinitis, you may be one document away from changing that. The missing piece is often a nexus letter: the independent medical opinion that connects your sleep apnea to your service-connected rhinitis.
Direct answer
Can you get VA disability for sleep apnea secondary to allergic rhinitis?
Yes. If the VA has already service-connected your allergic rhinitis, obstructive sleep apnea that is caused or aggravated by it can be claimed as a secondary condition under 38 CFR 3.310. You need three things: a current sleep apnea diagnosis (typically a sleep study), the already service-connected rhinitis, and a medical opinion linking the two to the "at least as likely as not" standard. That opinion is the nexus letter.
The financial stakes
What adding a 50% sleep apnea rating can be worth
Obstructive sleep apnea is commonly evaluated at 50% under current VA criteria when a breathing assistance device such as CPAP is required. Because the VA combines ratings rather than adding them, here is what a 50% OSA rating can add on top of an existing rhinitis rating — for a veteran with no dependents, at 2026 rates.
| Your rhinitis rating | Rhinitis alone | Combined with 50% OSA | New monthly | Monthly increase | Per year |
|---|---|---|---|---|---|
| 10% | $180.42 | 60% | $1,435.01 | +$1,254.59 | +$15,055 |
| 30% | $552.47 | 70% | $1,808.44 | +$1,255.97 | +$15,072 |
2026 VA compensation rates (veteran alone, no dependents), effective December 1, 2025. Combined ratings are calculated under 38 CFR 4.25 (the VA combines, it does not add): 50% and 10% combine to 60%; 50% and 30% combine to 70%. Veterans with dependents receive higher amounts at 30% and above. Figures are illustrative of the rate difference between these levels, not a prediction of any individual outcome — the VA assigns all ratings.
The takeaway: for many veterans, a service-connected sleep apnea rating is worth roughly $1,255 more per month — about $15,000 a year, tax-free — and it often turns on one thing: a nexus letter that properly connects it to a condition you're already rated for.
The medical link
How allergic rhinitis contributes to sleep apnea
Allergic rhinitis — triggered by pollen, dust, or pet dander rather than a virus — causes ongoing swelling and congestion in the nose and upper airway. That chronic nasal obstruction increases upper-airway resistance and makes breathing during sleep harder, which can worsen the frequency and severity of obstructive events in a veteran with sleep apnea.
This is why so many veterans carry both conditions, and why the connection is medically supportable — particularly on an aggravation theory, where service-connected rhinitis makes an underlying sleep apnea worse than it would otherwise be. A strong nexus letter addresses both causation and aggravation, because the VA treats them as separate paths to service connection.
What you need
Proving the secondary connection
To establish sleep apnea secondary to allergic rhinitis, the record generally needs three things:
A current sleep apnea diagnosis, usually confirmed by a sleep study
Your already service-connected allergic rhinitis
A medical nexus opinion linking the two — the piece the VA most often finds missing
Without that third piece, valid claims are denied or under-rated every day. The nexus letter is what turns a plausible connection into documented medical evidence.
What makes it strong
What a good nexus letter includes
Not every letter carries weight with the VA. A letter with "high probative value" reviews your records, states a clear medical opinion, explains the science, and addresses both causation and aggravation. This is what Dr. Allen builds into every opinion:
- A full review of your service treatment records, VA records, and sleep study
- The physician's qualifications and why they are competent to give the opinion
- A clear opinion stated to the “at least as likely as not” standard
- The medical science explaining how nasal obstruction worsens obstructive events
- Both theories addressed — causation and aggravation under 38 CFR 3.310
- A direct response to any reasoning the VA used to deny the claim
Why Brightview
Why the physician who writes it matters
A nexus letter is only as strong as the person writing it. Dr. Jessica R. Allen is a licensed psychiatrist and former VA Compensation & Pension examiner. Having conducted C&P exams herself, she knows from the inside how a rater weighs a secondary opinion — and she is familiar with 38 CFR and the M21-1 adjudication manual, so each letter is written in the medico-legal language the VA is trained to weigh. In addition, she is well versed in sleep medicine and is a member of the American Academy of Sleep Medicine (AASM).
She reviews your records and writes every opinion personally — no templates, no ghostwriting. And if the evidence doesn't support the connection, she'll tell you that honestly, before you commit to anything. If your claim was already denied, that opinion can also be written to answer the specific reasoning the VA used.
No pressure
What happens when you book
Free phone call
Tell Dr. Allen's team about your rhinitis rating and your sleep apnea. No cost, no pressure.
An honest review
She looks at whether an independent medical opinion can actually help your case — and says so plainly.
You decide
If it fits, you move forward. If it doesn't, she'll tell you. No obligation, either way.
Worth knowing
A note on the sleep apnea rating criteria
The VA has proposed revisions to how obstructive sleep apnea is evaluated under Diagnostic Code 6847. As of 2026, that proposal is not final, and the current rating criteria — including the 50% level for veterans who require a breathing assistance device — still apply. We mention this not to pressure you, but because it's accurate: the current framework is what governs claims today, and the strongest step is simply to make sure your medical evidence is complete and well-reasoned.
Talk through your sleep apnea claim
A free phone consultation with Dr. Allen's team. She'll tell you honestly whether a nexus letter can help — before you commit to anything.
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Related reading: sleep apnea nexus letters · learn how obstructive sleep apnea can be claimed secondary to sinusitis.
Educational information only. This article is provided for general educational purposes and does not constitute medical advice, legal advice, or a treatment relationship. Reading it does not establish a physician–patient relationship with Dr. Allen or Brightview Psychiatry Solutions PLLC. No outcome in any VA claim is promised or implied; the VA determines service connection and assigns all disability evaluations. Veterans should consult their own treating providers regarding medical care and an accredited representative, agent, or attorney regarding claims. If you are in crisis, the Veterans Crisis Line is available 24/7: dial 988 and press 1, or text 838255.