A Guide to Filing an Insomnia Claim with the VA

The process of filing for VA disability benefits can be a daunting task, especially when it comes to a condition like insomnia. Unlike acute injuries or certain medical conditions, it can be difficult to link your sleep issues directly with your military service. The good news is that there are other options available, like pursuing a secondary claim linked to another condition you have. 

Although many people have their initial claim denied, there is a process for appealing these decisions. In fact, you have the right to appeal if you believe your insomnia VA rating is inaccurate. At Gang & Associates, we can answer your questions and guide you through the appellate process.

Meeting the Underlying Criteria for Disability Benefits

Before you submit an application to the VA, it is important for you to establish your eligibility. This comes in three requirements: (1) you are a veteran, (2) you have been diagnosed with insomnia, and (3) your condition is linked to your service.

Prove You are a Veteran

VA benefits are available to a wide range of individuals who have served their country. A veteran is considered someone who served in active duty, active duty for training, or inactive duty for training. If you received an other than honorable, bad conduct, or dishonorable discharge, you may not be eligible for benefits.

Establish Your Disability

In order for you to qualify for disability benefits, you will need a formal diagnosis of insomnia. While this can come following a physical examination, it is generally a good idea to participate in a sleep study. During the study, a medical professional will monitor your sleep in a clinic. These results are more likely to sway the VA that you are living with insomnia and that it should be rated as a disability. Claims that are not supported by a formal diagnosis are usually denied.

Link Your Condition to Your Service

Often, the most complex part of these cases is finding a nexus between your insomnia and your service. This generally involves identifying an event or occurrence during your service that led to your disability. There are often a range of factors that lead to insomnia, from psychiatric disabilities to obesity. It is often easier to prove that another service-related condition is responsible for your sleep disruptions. 

These are known as secondary conditions, and the evidence needed to establish them is different. Since you are making the case that your insomnia was caused by a disability that has already been linked to your service, your claim should focus on the ties between your sleep disruptions and that disability.

You May Need to Complete an Intent to File Form

In some cases, a key step towards getting your insomnia VA rating is to submit an Intent to File form. Providing this form to the VA allows you time to put together any supporting documentation you need without pushing back your effective start date. An earlier effective date is helpful, as you may be eligible for retroactive payments from that point forward. It can also allow your case to move forward quickly without the risk of making an error due to rushing. If you plan on filing your claim online, submitting an Intent to File form is unnecessary. Your effective date is set on the day you begin to fill out the online form, not when you complete it.

Filing Your Claim for an Insomnia VA Rating

To formally begin this process, you will need to submit your application to the VA. This is possible in different ways. Many people choose to file online through the VA website. You can also apply by mail by completing VA Form 21-526EZ and mailing it to the Department of Veterans Affairs PO box address in  Janesville, WI. Additionally, you can appear in person at your local VA office and apply directly. There is also the option to submit your form via fax at 844-531-7818. 

There is no requirement that you submit evidence along with your claim, but doing so is a good idea. This usually comes in the form of a written statement and your medical records. These records could come from the VA or from a private physician. 

In most cases, the VA will ask you to submit to an examination—even when the exam seems unnecessary. To counteract these exams, you are allowed to submit written statements and something known as a VA nexus letter. This letter provides an expert opinion that your insomnia is linked to your service or another service-related condition. 

It is important to note that at this point, you are required to handle your claim on your own. This is because an attorney is barred from filing your claim or handling your case. You will only have the opportunity to turn to an attorney if your initial claim is denied or if you believe the award is unreasonably low. A lawyer is allowed to represent you during any stage of the appeal. 

Unless the VA sends you a letter requesting more information, your next step is to simply wait for a decision to be made. You should also be sure to attend any exams scheduled by the VA along the way.

Seek Help with Your Appeal – Call Gang & Associates Today to Discuss Your Insomnia VA Rating

A lot goes into a successful insomnia claim. Unfortunately, your best efforts might not be enough to get the outcome you deserve. If your claim is denied or your insomnia VA rating seems unreasonably low, now is the time to seek help from an attorney.

Gang & Associates is dedicated to fighting for veterans. We can review your denial letter and handle every aspect of your appeal. Contact us right away to learn more.