At a sleep apnea C&P (Compensation and Pension) exam, a clinician reviews your sleep study and asks how the condition affects you and how it is treated. At Rank and Pay, we publish free guides on Department of Veterans Affairs (VA) disability ratings, including [how VA rates sleep apnea](/va-disability/sleep-apnea/).
The clinician records the findings on a disability benefits questionnaire (DBQ), and VA uses that form to rate the claim. VA wants a sleep-study-confirmed diagnosis, and for a higher rating it looks for evidence of treatment, including whether you were prescribed a breathing device. Prepare by gathering your sleep study, treatment records, and device prescription, then describe your symptoms accurately.
Steps at a Sleep Apnea C&P Exam
A sleep apnea C&P exam combines a review of your records with an interview and, where needed, a physical check. It ends with a questionnaire the clinician completes for VA. The exam can happen with a VA clinician or with a provider VA contracts with.
- VA, or a VA-contracted provider, schedules the exam to gather the medical information VA needs to decide your claim. VA explains the process on its [claim exam page](https://www.va.gov/disability/va-claim-exam/), and our [Optum Serve guide](/explainers/optum-serve-cp-exam/) covers one contract exam vendor.
- The clinician reviews your records, starting with your sleep study results and the diagnosis they support.
- The clinician asks whether you were prescribed a breathing device, such as a continuous positive airway pressure (CPAP) machine, and whether you use it.
- You answer questions about daytime sleepiness, your other symptoms, and the treatment you have had so far.
- Where needed, the clinician does a physical check.
- If you claim another condition caused your sleep apnea, the examiner reviews the medical opinion that links the two conditions.
- The clinician records everything on the Sleep Apnea DBQ, and VA uses that questionnaire to rate the condition.
VA uses the DBQ to rate the condition.
Sleep Study Requirement for a VA Diagnosis
VA generally requires a sleep study, also called polysomnography, to confirm a sleep apnea diagnosis. A diagnosis without a sleep study is a common reason a sleep apnea claim stalls.
The C&P exam for sleep apnea does not replace the sleep study. If your file has no sleep study, the exam cannot supply the confirmed diagnosis VA looks for.
Find your sleep study report first, with its date and the facility that ran it.
Examiner Questions and the Sleep Apnea DBQ
The Sleep Apnea DBQ is the disability benefits questionnaire for this condition, and VA uses it to collect the medical facts it needs for a rating. The examiner's questions generally cover five topics, and you can prepare an answer for each one before the appointment.
- Sleep study and diagnosis. Know the date of your study, the facility that performed it, and the diagnosis it produced.
- Breathing device. Be ready to say whether a device was prescribed and whether you use it.
- Daytime sleepiness and other symptoms. Think through how sleepiness shows up on a normal day and on a bad one.
- Treatment history. List the treatments you have had and when you started each one.
- Medical opinion for a secondary claim. If you say another condition caused your sleep apnea, the examiner looks at the opinion that links them. Our guides on [sleep apnea secondary to post-traumatic stress disorder (PTSD)](/va-disability/sleep-apnea-secondary-to-ptsd/) and the [nexus letter template for sleep apnea](/va-claims/nexus-letter-for-sleep-apnea-template/) cover that link in detail.
VA Rating Criteria Under Diagnostic Code 6847
VA rates sleep apnea under Diagnostic Code 6847 in the VA Schedule for Rating Disabilities, found at Title 38 of the Code of Federal Regulations (CFR), section 4.97.
Proposed Changes to Sleep Apnea Ratings
VA has proposed changes to how it rates respiratory conditions, and sleep apnea is one of the conditions affected. Any percentage you read, here or elsewhere, may not match the rule in force when VA decides your claim. Before you rely on one, check the current rule on va.gov, and see our [sleep apnea rating guide](/va-disability/sleep-apnea/) for more on the rating side.
Records to Bring to a C&P Exam for Sleep Apnea
Bring the records the examiner is likely to ask about, and keep a copy of every record you hand over.
- Your sleep study report, or at least the study date and the facility that performed it
- The prescription for your CPAP machine or other breathing device
- Information about the device you use
- Your treatment records
- For a secondary claim, the medical opinion linking sleep apnea to the other condition
- A written list of the questions you want to ask
Our [C&P exam records guide](/explainers/cp-exam-foia-records-guide/) explains how to request a copy of what the examiner wrote.
Exam-Day Checklist for a Sleep Apnea C&P Exam
Run through these steps the day before and the morning of the appointment.
- Write down the appointment date, time, and address, and reschedule in advance if you cannot attend.
- Pack your sleep study report, device prescription, and treatment records.
- Make copies of anything you plan to hand over, and keep the copies.
- Bring your written list of questions.
- Plan to describe a typical day and a bad day with sleep apnea.
- Answer every question accurately and never exaggerate.
Tips for Describing Your Symptoms
Say what happens, how often you notice it, and what you do about it. Keep every answer accurate and never exaggerate.
Write your questions down before the appointment so you remember them in the exam room. For advice that applies to any condition, see our [C&P exam tips](/va-claims/c-and-p-exam-tips/), and our [
buddy statement guide](/va-claims/buddy-statement-guide/) covers written statements from people who know you.
Consequences of Missing the Exam
Missing a scheduled C&P exam without good cause can lead VA to deny a claim or reduce a benefit under 38 CFR 3.655. The result depends on the type of claim.
| Type of claim | Possible result of missing the exam without good cause |
|---|
| Original claim | The claim can be denied |
| Reopened claim | The benefit can be reduced or stopped |
| Claim for an increase | The benefit can be reduced or stopped |
If you cannot make the appointment, contact VA or the exam scheduler right away to reschedule. VA's [claim exam page](https://www.va.gov/disability/va-claim-exam/) describes how C&P exams work.
Sleep Apnea VA Reexamination Rules
VA may schedule a sleep apnea reexamination when it needs to find out whether the condition has improved or worsened, under 38 CFR 3.327. Reexams are generally not scheduled for ratings that are stable or permanent.
Ratings that have been in place a long time carry added protections under 38 CFR 3.344. Whether those protections apply to your rating is a question for VA or an accredited Veterans Service Officer (VSO), who helps veterans for free.
If VA does schedule a reexam, prepare the same way you would for the first exam. Bring your current device prescription and your latest treatment records.
Review Options After a Decision
If you disagree with VA's decision on your sleep apnea claim, VA describes three review options: a
supplemental claim, a
higher-level review, and a
Board appeal. VA lays out each one on its [decision reviews page](https://www.va.gov/decision-reviews/). Our [Form 20-0995 page](/va-forms/20-0995/) covers the supplemental claim.
Who This Page Is Not For
- If you have never had a sleep study, a claim generally lacks the confirmed diagnosis VA looks for, and the exam does not supply it. A VSO can help you plan the claim at no cost.
- If you want a detailed breakdown of rating percentages, our [sleep apnea rating guide](/va-disability/sleep-apnea/) goes deeper than this exam-focused page.
- If VA has already decided your claim and you disagree, go straight to the review options on VA's [decision reviews page](https://www.va.gov/decision-reviews/).
What Would Change This Answer
- If VA finalizes its proposed changes to respiratory ratings, the criteria VA applies to sleep apnea may differ from what older guides describe.
- If your claim says another condition caused your sleep apnea, the medical opinion linking the two becomes part of what the examiner reviews.
- If your rating has been in place a long time, 38 CFR 3.344 adds the protections described in the reexamination section above.
Start today by finding your sleep study report and device prescription, and put both in one folder for your sleep apnea C&P exam.
This page is general information and is not medical or legal advice, and Rank and Pay is not affiliated with the VA. For questions about your own claim, use VA's [claim exam page](https://www.va.gov/disability/va-claim-exam/) or ask an accredited Veterans Service Officer, who helps for free.