Understanding the VA Rating for Insomnia

A VA disability rating for insomnia is between 0% and 100%, depending on the severity of your symptoms and if you can prove the insomnia is service-connected. You can file a claim based on a direct service connection, a secondary service connection, or if you had insomnia before your active service, which was aggravated by your time in the military.

Insomnia occurs frequently in Veterans and can be attributed to exposure to stressful situations, traumatic events, and an irregular sleep schedule during service.  More than 500,000 Veterans receive VA disability benefits for sleep apnea, while nearly half of Veterans enrolled in VA healthcare are diagnosed with insomnia.

Some benefits you might claim with a disability rating include disability compensation, special monthly compensation (SMC), or claims based on special circumstances.

This is what you need to know if you suffer from a sleep disorder and you believe it is connected to your military service.

Insomnia and its Impact on Veterans

The National Institute of Health (NIH) defines insomnia as a common sleep disorder characterized by trouble falling, staying, or getting quality sleep. It is treated as a disability by the VA when specific diagnostic criteria are met.

Veterans can be affected by short-term (acute) and long-term (chronic) insomnia.  Chronic insomnia is defined as trouble sleeping three or more nights a week for over three months and can’t be explained by or viewed as a symptom of another health problem.

Other common symptoms of insomnia include:

  • Low energy
  • Excessive daytime sleepiness
  • Inability to focus
  • Anxiety
  • Constant worries about sleep
  • Fatigue
  • Depression
  • Irritability
  • Impulsiveness
  • Aggression
  • Cognitive problems
  • Panic attacks

Service members with sleep disorders are at higher risk of developing other serious health problems, including high blood pressure, cancer, heart disease, stroke, and diabetes.

Long-term insomnia significantly interferes with a Veteran’s quality of life and is considered a severe sleep problem. Often, Veterans with severe insomnia cannot perform well at work or are not qualified for employment because of their impairment.

Current VA Disability Ratings for Insomnia

The VA does not have a specific diagnostic code for sleep disorders like insomnia and narcolepsy.  It uses the same rating criteria as it does for mental conditions.

Veterans with service-connected insomnia can be rated at  0%, 10%, 30%, 50%, 70%, or 100%.

The VA rates sleep apnea at 0%, 30%, 50%, and 100%.

The 2023 monthly Veterans disability compensation payment amount is based on your disability rating and details about your dependent family members.  If your spouse receives Aid and Attendance benefits, you will receive an additional amount over and above the Basic monthly rate.  If you have a 10% to 20% disability rating, you won’t receive a higher rate even if you have a dependent spouse, child, or parent.

You can expect to receive the following rates if your disability rating is approved.

Dependent status 10% disability rating (in U.S. $) 30% disability rating (in U.S. $) 50% disability rating (in U.S. $) 70% disability rating (in U.S. $) 100% disability rating (in U.S. $)
Veteran alone (no dependents) 165.92 508.05 1,041.82 1,663.06 3,621.95
With spouse (no parents or children) 165.92

 

568.05 1,141.82 1,804.06 3,823.89
With spouse and 1 parent (no children) 165.92

 

616.05 1,222.82 1,917.06 3,985.96
With spouse and 2 parents (no children) 165.92

 

664.05 1,303.82 2,030.06 4,148.03
With 1 parent (no spouse or children) 165.92

 

556.05 1,122.82 1,776.06 3,784.02
With 2 parents (no spouse or children) 165.92

 

604.05 1,203.82 1,889.06 3,946.09

 

A 100% rating for sleep disorders is difficult to achieve, but if you can provide substantial evidence of complete social and occupational damage, you qualify for Total Disability Individual Unemployability (TIDU) with attendant health benefits.

The VA Disability Criteria for Insomnia

There are several ways to prove to the VA that you have a dysfunctional sleep condition.

Direct Service Connection

To prove a direct service connection, you must present a medical diagnosis of insomnia from a qualified healthcare provider such as those in the Veteran Ratings network.  You must also provide a description explaining its occurrence while in-service, and a medical nexus attesting that your disability resulted from your military service.

Secondary Service Connection

A secondary service connection means you developed insomnia because of a physical or mental disorder. You may have sustained physical injuries or developed PTSD or Gulf War Syndrome while on active duty, which caused insomnia to develop as a secondary condition. Research shows that more than 90% of Veterans with PTSD struggle with insomnia.

To prove a secondary service connection, you must also present a medical diagnosis and a medical statement explaining the connection between your insomnia and the primary health condition.  It is also worth noting that PTSD or Gulf War Syndrome does not need to have developed only while on a military base to be considered an in-service disability.

The same goes for a physical service-connected condition like injuries that hinder good sleeping patterns, such as chronic back pain.

When Veterans file a disability claim with a secondary service connection and attach insomnia as that secondary condition, they may be compensated for both separately.

Service Connection Based on Aggravation

If you had insomnia before joining the service, and an in-service medical disorder aggravated the symptoms, you may be able to use those circumstances to prove sleep dysfunction to the VA.  It’s possible to make the claim that a mild insomnia condition became chronic due to an in-service disorder.

The Importance of a Sleep Study

 

A sleep study, also called a polysomnogram, may be an important step in receiving VA disability benefits for a sleep disorder. Understanding what to expect during a sleep study can help decrease your anxiety about the test.

Although your doctor will sometimes give you equipment and instructions for conducting a sleep study at home, you will most likely spend the night at a sleep lab.

A lab technician will attach several sensors to your head and torso that are used to monitor and measure the following events while you sleep:

  • Brain activity
  • Eye movement
  • Leg movement
  • Changes in muscle tone
  • Heart rate
  • Airflow
  • Oxygen level
  • Breathing efficiency

When you wake in the morning, you’ll go home, and your doctor will contact you shortly to review your results.  You’ll be given a copy of those results, which you can use to support your VA disability claim.

Documentation Needed for VA Disability Claims for Insomnia

The VA requires certain documents to support all claims for disability benefits.  Veteran Ratings has extensive experience in helping Veterans determine exactly what they need to document a claim for insomnia.  Typically, these will include service treatment records, DD214 or other separation documents, medical evidence such as sleep study results from a C&P exam, buddy statements, and other supporting materials.

It’s essential to establish a service connection for your insomnia or establish an aggravated service connection to show how your military service made your insomnia worse.  To establish a connection, you must:

  • Have a current diagnosis of sleep dysfunction.
  • Provide a written statement about the traumatic event (the stressor) that occurred during your military service.
  • Have a written medical opinion from a psychologist or psychiatrist explaining that they believe the stressor was significant enough to cause or aggravate your insomnia.

If you think you meet these conditions, working with Veteran Ratings and our network of consultants and medical professionals to guide you through gathering documentation before you file a claim will give you the best chance for approval at the highest disability percentage possible.

Insomnia C&P Exams

The VA claim exam, called a C&P exam, differs from a regular medical appointment and only occurs if you file a compensation or pension claim for the first time. The VA uses these exams to help determine if your disability is service-connected, the level of your disability, or if your condition should receive an increased rating due to it worsening. You can utilize a third-party medical provider for your exam if you already have a rating.

Exams may last as little as 15 minutes or an hour or longer, depending on the circumstances of your case.  An examiner may ask questions, conduct a limited physical exam or simply review your files with you.

The best way to go through a C&P exam is to be well prepared with complete medical evidence and documentation you submit with your application.  For first-time filers, Veteran Ratings consulting partners will help prepare you on what to expect at your C&P exam.

Tips for Strengthening Your VA Claim for Insomnia

The best evidence for your insomnia disability claim will give you the strongest chance for approval at the highest rating. The more quality documentation you can provide, including medical records, buddy statements, occupational impacts, and how your symptoms have gotten worse are critical as part of the submission process.

Veteran Ratings can pair you up with a Veteran consulting partner that can guide you in what documentation is needed for your insomnia claim.  You may also be guided to one or more medical professionals in our nationwide network of providers who are experienced in developing the documentation you need to strengthen your claim.

What to Do if Your Veteran Disability Claim for Insomnia is Denied

If your claim is denied, you will receive a denial letter from the VA on how they reached their decision. You can use this information to determine what new evidence you should submit with your appeal, which you must do within one year after you get the decision letter.

Due to the complex nature of supplemental claims and appeals, Veteran Ratings and our consulting partners only guide current clients.

How Veteran Ratings Can Help Maximize Your VA Disability Rating for Insomnia

Submitting a VA disability claim can be complicated, and filing an incomplete claim on your own can cause extended delays.  However, when you get assistance from Veteran Ratings, our consultants, and network of medical professionals, we can greatly increase your chances for a first-time approval.

We have a 95% initial submission success rate and have successfully helped more than 20,000 Veterans in their critical quest to obtain important benefits at the highest possible rating.  When you let us guide you, you’ll save time and gain peace of mind knowing you are documenting your best chance for approval.

FAQs About VA Rating for Insomnia

What VA rating do I need to get insomnia treatment covered?

A 0% rating may not be enough to qualify for benefits, but it typically means that the insomnia is not affecting A Veteran’s life severely, if at all.  It’s best to discuss this issue with Veteran Ratings’ network of medical professionals to determine how to best get coverage for your specific level of insomnia.

Can I receive a VA rating for insomnia as a standalone condition?

Yes, although many Veterans also claim insomnia as a secondary condition for things like PTSD or Gulf War Syndrome.

How long does it typically take to receive a VA rating decision for insomnia?

As of June 2023, the VA estimates it takes just over 100 days to receive a decision for disability claims.  However, from our experience guiding other Veterans, you can expect a decision to take much longer in many instances.

What should I do if my insomnia worsens after receiving a VA rating?

Veteran Ratings will walk you through the process if you are seeking an increase, including referring you to our private network of doctors who will provide a medical examination to substantiate your claim further.

Get In Touch

If you are struggling with your VA disability rating or want to learn more about our service, please get in touch with our Veteran Ratings team.

Don’t hesitate! We are happy to answer any of your questions and provide guidance for your unique case.

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