Can You Get a VA Rating for Insomnia Secondary to PTSD? 

Most veterans with PTSD also experience insomnia that can be connected to their military service. These two conditions are deeply intertwined, with insomnia often presenting as a symptom of PTSD and evaluated as such. But insomnia, which is rated as a mental health condition (with ratings from 0% to 100%) can be used to increase an existing disability rating. Hill & Ponton explains how to get a VA rating for insomnia and PTSD – and higher overall compensation. 

Up to 74% of war veterans with PTSD suffer from insomnia

In a study of U.S. service members returning from deployments, insomnia was the most commonly reported symptom of PTSD and predicted other symptoms of PTSD. In another large study of Iraq and Afghanistan war veterans, 74.0% of the veterans diagnosed with PTSD reported insomnia-related sleep difficulties (trouble falling asleep, waking up repeatedly, trouble staying asleep, non-restorative sleep). 

PTSD is associated with low sleep efficiency (Total sleep time/Time in bed), a longer sleep latency, increased wake after sleep onset, and a shorter total sleep time, largely due to trauma-related nightmares leading to interrupted sleep and fear of falling asleep. Some experts consider sleep disturbances and trauma-related nightmares as a hallmark of PTSD.  

Because insomnia is so often a core symptom of PTSD, the VA usually considers it part of the PTSD rating under Diagnostic Code 9411. It can, however, contribute to a combined mental health rating (for both PTSD and insomnia). 

Does Insomnia Get a Separate Rating as Secondary to PTSD?

Over time, veterans may notice that their sleep problems persist even as other PTSD symptoms (like panic attacks or flashbacks) improve. If insomnia causes additional functional limitations, such as cognitive issues, daytime fatigue, or difficulty maintaining employment, veterans might think about secondary service connection. However, the VA does not assign a separate rating for insomnia and another one for PTSD.  

This means that claims based on secondary service connection are not a winning option for those who suffer from both insomnia and PTSD (or any other mental health condition). Veterans should instead use documented chronic insomnia to claim a higher mental health rating that combines both insomnia and PTSD. 

VA’s Combined Disability Ratings 

When a veteran is diagnosed with PTSD and develops insomnia as a result, they may be eligible for combined VA disability ratings. The combined rating reflects the overall impact these conditions have on the veteran’s ability to function. 

VA ratings for PTSD are based on the veteran’s level of occupational and social impairment and fall under VA’s § 4.130 Schedule of ratings for mental disorders. Insomnia falls under the rating of the underlying mental health condition (in this case, PTSD). This means veterans typically receive one combined rating for both conditions, rather than separate ratings for PTSD and insomnia. 

Insomnia can contribute to higher overall PTSD ratings depending on its severity and how much it affects the veteran’s ability to work and socialize. Veterans experiencing chronic sleep impairment may qualify for a 30% rating under PTSD. If insomnia significantly disrupts daily functioning, it could support a 50% or higher rating as part of the veteran’s PTSD evaluation.  

Example: A veteran rated 50% for PTSD reports worsening insomnia and daily fatigue. Their psychologist notes that the sleep deprivation significantly reduces concentration and reliability at work. Based on that documentation, VA increases their mental health rating to 70%, combining PTSD and insomnia and acknowledging that the insomnia amplifies their functional impairment. 

How to Get VA Disability for Insomnia and PTSD

When a veteran files the disability claim, they must present a current diagnosis of insomnia and medical evidence that links the insomnia to their service-connected PTSD. 

Required Evidence  

Insomnia can contribute to higher overall PTSD ratings depending on its severity and how much it affects the veteran’s ability to work and socialize. For example: 

• A diagnosis of PTSD with documented symptoms of insomnia
• Service treatment records showing the development of insomnia during or after service 
• Medical nexus opinions that link the veteran’s insomnia to their service-connected PTSD
• Lay statements from family, friends, or coworkers that detail how insomnia has impacted the veteran’s life, including sleep behavior, mood changes, daily fatigue, or impaired concentration

Winning a VA Claim 

To successfully get a VA disability rating, veterans with PTSD and insomnia should:

• Work closely with healthcare providers to document both PTSD and insomnia symptoms. 
• Consider filing an appeal if the claim is denied, especially if there is new or additional medical evidence (a VA lawyer can increase the chance of success and there are no upfront costs).
• Use buddy statements from fellow veterans or lay statements from family and friends to show how insomnia affects daily activities.  

A strong claim includes all necessary documentation, such as VA Form 21-526EZ, and medical evaluations from a specialist (a sleep doctor or a psychologist) that link insomnia to PTSD. Medical records should note the severity, duration, and impact of insomnia on daily life.

TDIU: 100% Compensation for PTSD with Insomnia 

Total Disability based on Individual Unemployability is a benefit available to veterans whose service-connected conditions prevent them from working, even if their combined disability rating is less than 100%. It can be an option for veterans with PTSD and insomnia if their combined effects significantly impair occupational functioning. The criteria for TDIU are:

• One service-connected condition rated at 60% or higher, or 
• Two or more service-connected disabilities, with one rated at least 40%, and a combined rating of 70% or higher 

If insomnia and PTSD together result in chronic fatigue, cognitive decline, emotional instability, or an inability to focus, and these limitations make it impossible to secure or follow substantially gainful employment (work that pays above the poverty threshold for an individual), veterans may be entitled to a 100% compensation rate through TDIU. 

My Claim Was Denied, What Can I Do? 

If you’re denied or underrated by the VA, you have several options: 

• Request a Higher-Level Review from a senior VA reviewer
• File a Supplemental Claim with new and relevant evidence
• File an appeal with the Board within one year of the VA decision

It’s important to act within the allowed time frame and provide any missing documentation or evidence to strengthen your appeal. You can reach out to a VA-accredited representative to do the work for you and maximize your benefits.

Content Reviewed by

Attorney Rachel Cheek

Rachel Cheek is an attorney at Hill & Ponton dedicated to helping veterans secure the benefits they deserve. A University of Florida graduate, she combines her passion for social justice with legal expertise to serve those most in need.