A 70% PTSD rating and a 50% sleep apnea rating do not add up to 120%. They do not even add up to 100%. Under the VA whole person method they combine to 85% raw, which rounds to a 90% schedular rating.
The Math, Step by Step
The VA always starts with your highest rating and works down. Here PTSD at 70% goes first.
- Start at 100% efficiency.
- Apply 70% PTSD. That consumes 70 points and leaves 30% efficiency remaining.
- Apply 50% sleep apnea to the remaining 30%. Fifty percent of 30 is 15.
- Add that 15 to the running total of 70. Raw combined is 85%.
- Round to the nearest 10%. 85 falls in the 85 to 94 band, so the rounded rating is 90%.
What It Pays in 2026
| Scenario | Rating | Veteran alone | With spouse |
|---|---|---|---|
| PTSD only | 70% | $1,808.45 | $1,961.45 |
| PTSD + sleep apnea | 90% | $2,362.30 | $2,559.30 |
That is an increase of $553.85 per month, or $6,646.20 per year, tax free, for a veteran with no dependents.
How Sleep Apnea Gets Service Connected to PTSD
Sleep apnea is rarely granted on a direct basis years after service. The realistic path is secondary service connection under 38 CFR 3.310, where the apnea is caused or aggravated by an already service connected condition.
You generally need three pieces of evidence:
- An established primary rating. PTSD must already be service connected. The rating percentage does not matter for the nexus, only that service connection exists.
- A current diagnosis. An in lab or at home sleep study showing obstructive sleep apnea, with the AHI documented. A CPAP prescription that follows from that study is what supports the 50% tier.
- A medical nexus opinion. A physician statement explaining why the PTSD, the PTSD medications, or the weight gain associated with both caused or aggravated the apnea. The opinion should use the "at least as likely as not" standard.
Why the Aggravation Theory Matters
Many veterans are denied because the examiner says the apnea is caused by weight or anatomy rather than PTSD. Aggravation is a separate, independent basis. If PTSD related insomnia, nightmares, sedating medications, or weight gain made an existing apnea worse, that supports service connection even when PTSD was not the original cause.
The 50% Tier Requires a Prescribed Device
Under diagnostic code 6847, sleep apnea is rated 50% when it requires the use of a breathing assistance device such as a CPAP machine. The word that decides claims is requires. A machine you bought yourself, or one issued without a documented prescription, will not reliably support 50%. Sleep apnea with persistent daytime hypersomnolence but no prescribed device is rated 30%, which combines with 70% PTSD to 79% raw and rounds to 80%, worth $2,102.15 per month.
Where This Sits Against 100%
At 90% you are at 85 raw. Reaching a 100% schedular rating requires 95 raw, which means adding enough new disability to cover another 10 raw points from a base where only 15% efficiency remains. That would take a new rating of roughly 67% or higher, which does not exist as a single tier for most conditions. In practice veterans at this level reach 100% either by stacking several more conditions or by qualifying for TDIU.
Check whether you meet the TDIU schedular threshold →