Info for Veterans About VA Ratings for Insomnia and How Your Insomnia VA Rating is Calculated

Insomnia or difficulty sleeping is a condition that many veterans suffer from. If you or a loved one is suffering from insomnia as a result of an injury, illness, or event during qualifying active service, you could qualify for VA disability benefits. The evidence that you provide with your application and additional forms will determine your insomnia VA rating, and in turn the benefits that you are provided. Your benefits generally include coverage for any related medical or mental health services, and if your disability is rated at 10 percent or greater, tax-free monthly compensation payments. 

Collecting the VA disability benefits you are entitled to is not automatic, and without the kind of evidence the VA expects, your claim could be delayed or denied. To ensure that you fill out the application properly and provide the evidence the VA needs to see to make the most of your benefits, connect with one of the VA disability lawyers from our VA disability benefits law firm. 

What is Insomnia? 

The National Institute of Health defines insomnia as trouble falling asleep, staying asleep, or receiving quality sleep. Insomnia happens even when the impacted person has time and a proper environment to sleep well. While insomnia is generally a non-serious condition, it can impact your ability to engage in daily activities and can result in you feeling sleepy during the day. This, in turn, often affects cognitive function and job performance.  We have seen veterans be unable to maintain gainful occupation due to the inability to focus and concentrate as a result of insomnia.

Insomnia can be a result of stress or changes in your schedule or environment and is considered short-term if it lasts for a few days or weeks. Chronic or long-term insomnia happens 3 or more nights weekly, happens for more than 3 months, and is not fully explained by a different health issue. 

Diagnosing insomnia requires that you seek out the opinion of a healthcare provider. They may request that you monitor your sleep habits, engage in cognitive behavioral therapy for insomnia, or take medications to manage your insomnia. 

The Symptoms of Insomnia

Insomnia can result in serious consequences that impact your ability to engage in social and occupational interactions. When you are unable to engage in social situations normally, or if you cannot work due to a lack of concentration or other symptoms of insomnia, you are entitled to VA disability benefits. 

Symptoms of short-term insomnia include: 

• Impacted memory and concentration 

Chronic insomnia can result in an increased risk of:

• Coronary heart disease 
• Diabetes
• High blood pressure
• Cancer 

The fact that chronic insomnia can lead to serious health problems underlines the fact that insomnia can be a disabling condition and one that the VA recognizes as such. Conditions that magnify the severity of other conditions or lead to others are primary, and insomnia in this way is recognized as a secondary condition that can in turn result in serious other conditions. 

Can You Get a VA Rating for Insomnia? 

In order to be eligible to receive an insomnia VA rating, it is essential that you meet the following 3 criteria:

1. A medical diagnosis of a current condition of insomnia, either acute/short-term or chronic/long-term, in a medical record and generally accompanied by the results of a sleep study that verify your insomnia
2. You must demonstrate that your insomnia was caused by your active duty, or made worse as a result of your active service, meaning there is an in-service event and a nexus between your current condition and service
3. Persistent and ongoing symptoms of insomnia that impact your ability to engage in your social life and work

Veterans suffering from insomnia are able to reach out to their local VA healthcare facility for an assessment. The VA takes mental health issues seriously and will help you receive an assessment. You are also able to pursue your own independent health assessment, which our network of mental health professionals can provide in support of your VA disability appeal. 

A Sleep Study is Essential to Collect VA Disability Benefits for Insomnia 

While for many disabilities all that is necessary is a medical opinion that links your current condition to your active service, for insomnia you may also be required to submit the results of a sleep study that proves your insomnia. Applying for VA disability benefits based on your insomnia requires a sleep study to verify that you do in fact suffer from insomnia. 

A sleep study, also called polysomnography, is a test that is used to measure how well you sleep, and the way in which your body responds to sleep problems. They are a valuable tool for doctors to diagnose sleep disorders, and involve the monitoring of your brain waves, heart rate, and blood oxygen levels over the course of a full night’s sleep. Sleep studies are also useful for the diagnosis of other sleep-related issues such as sleep apnea, narcolepsy, or restless leg syndrome. 

What is the Average VA Rating for Insomnia? 

While there is no diagnostic code (DC) under the VA ratings schedule that specifically designates insomnia, however, it is noted as occurring alongside other conditions. In fact, a study published by the VA found that some 90-100% of Vietnam-era veterans with PTSD suffer from insomnia. Sleep problems, including chronic insomnia and nightmares, are some of the most frequently reported symptoms of veterans with PTSD. 

As noted by the VA, insomnia is a disability that is rated in an analogous way to mental health disorders. In this way, insomnia is rated in a manner similar to the Schedule for Ratings for Mental Disorders, with disability ratings ranging from 0 percent to 100 percent. Your measurements are supported by VA assessments, and also the private medical assessments we’ll help you schedule with our network of mental health and medical experts. 

The following symptoms are generally assigned to mental health disabilities which your insomnia will be rated in a similar way to: 

• 0 percent – while the veteran may have a current diagnosis of insomnia, the symptoms do not seriously impact their life or ability to work. It is important to note that at 0 percent and 10 percent disability, a veteran may qualify for healthcare benefits, but not for tax-free payments. 
• 10 percent – at this level, the condition happens more often, but is manageable and does not significantly impact work or social life, and may be managed with occasional medication. 
• 30 percent – at 30 percent, insomnia would begin to impact the veteran’s ability to enjoy life and to work, but generally can be managed or controlled with medication. It is at this level that tax-free monthly VA disability payments become available to the veteran. 
• 50 percent – the symptoms at this level begin to seriously impact the capacity of the veteran to live everyday life and work, and medication may not be sufficient to control or manage the symptoms.
• 70 percent – at this rating the veteran has major deficiencies in most areas of living daily life or working due to the severity of related symptoms and may require assistance. 
• 100 percent – this rating is for total disability, and for mental health problems that insomnia is analogous to this rating means the veteran is totally disabled by the condition, unable to work or have social interactions, and may be a danger to self or others. This rating for mental health also means that medications are incapable of managing or controlling the condition. 

The VA rating that is assigned to your insomnia will depend upon what condition it is linked to. Mental health issues as rated by the VA require evidence from mental health professionals to verify your current condition that serves as the foundation for your insomnia, whether PTSD, pain, or other issues. The majority of insomnia cases that we have are associated with mental health disorders and are typically rated under VA’s General Rating Formula for Mental Disorders.

Is Insomnia Caused By Pain a VA Disability? 

To receive a VA rating for insomnia, you’ll generally take advantage of 3 pathways:

1. A direct service connection for insomnia proven through C&P examinations – you are able to get a Compensation and Pensions Examination from the VA to determine whether your VA disability claim is supported by a medical review. When the report issued by the C&P exam provides sufficient evidence of your disability and connection to service, your claim may be approved. Independent medical exams can also be submitted in support of your claim
2. Service connection for insomnia by aggravation – you are able to file a VA disability claim when your insomnia is aggravated by another service-connected condition, like pain, or if it was pre-existing before you joined the military, and was made worse by your active service. 
3. A secondary service connection for insomnia – this is the most common way that veterans are able to receive VA disability coverage for their insomnia, which happens when the veteran can demonstrate that the insomnia was triggered by a primary service-connected condition that has already been proven to be service-connected. 

When you attach insomnia as a secondary condition to a primary claim, such as tinnitus or chronic pain, the rating received for insomnia can be added to your primary condition and could result in VA TDIU compensation for individual unemployability. This compensates a veteran at the 100 percent disability rate when they meet certain conditions, including  conditions that together total 70 percent or greater disability. It is necessary that one condition has a minimum rating of 40 percent and you are unable to maintain gainful employment.

What is the VA Rating for Insomnia Secondary to Tinnitus? 

A disability is a primary condition when it is directly caused by an event, injury, or illness during active duty. Tinnitus is the perception of a sound that does not have an external source, meaning others cannot hear it. It is often described as a ringing sound by those who suffer from the condition. When the condition lasts for three or more months, it is considered to be chronic. 

Tinnitus is rarely associated with serious medical issues, and while it generally does not interfere with daily life, it can when it impacts your ability to sleep or concentrate. In limited circumstances, tinnitus can also result in anxiety or depression. There is presently no cure for tinnitus, however, treatment methods can include sound therapy devices, medications, and behavioral therapies. 

Insomnia can sometimes be a secondary condition to tinnitus, and you are able to file a secondary claim to get more VA disability benefits for a new disability that is linked to a service-connected disability that you already have. Examples provided by the VA include a service-connected knee injury that leads to arthritis, or heart disease that develops due to high blood pressure that is service-connected. 

The Department of Veterans Affairs Regional Office  determined that insomnia can be a secondary condition to service-connected tinnitus. If your insomnia is a qualifying secondary condition to your service-connected tinnitus, the VA rating will be determined based on the severity of your symptoms and the evidence provided. While insomnia is generally attached to another condition, that does not mean that the VA does not take it seriously. 

Connect with an VA Disability Lawyer for Help with Your Insomnia VA Rating 

If you or a loved one who has served active duty in the U.S. Armed Forces is experiencing insomnia due to a service-connected disability, you could be entitled to VA disability benefits. Our VA disability lawyer team can help if you have had your initial claim denied and need to appeal. 

To learn how our experienced VA benefits lawyers can help, give us a call at 888-878-9350, or visit our site to schedule a free case evaluation. Your initial consultation is free, and as we’ll discuss, we only get paid if we generate a positive decision in your case. Our VA disability lawyer team has decades of combined experience helping veterans like you collect the benefits they deserve, and we are standing by to get started with your concerns.