In our day-to-day practice, many veterans have asked if they are eligible to be compensated by the VA for insomnia. As discussed below, the answer to that question depends on the circumstances. But, there are some cases where obtaining additional compensation for veteran insomnia may be a real possibility.
Before I get into the details, I want to first give some background about what insomnia is. According to the National Sleep Foundation, insomnia is a chronic sleep disorder, characterized by complaints of unsatisfactory sleep, despite having ample opportunity to sleep.
There are many different symptoms that go along with insomnia, but, the essence of this condition is difficulty falling asleep and/or difficulty staying asleep.
Common Symptoms of Insomnia include:
- Difficulty going to sleep
- Waking up during the night and having trouble returning to sleep or not being able to go back to sleep at all
- Waking up too early in the morning
- Non-restorative sleep
- Fatigue and/or low energy
- Concentration problems
- Mood and behavioral problems, such as depression, irritability, impulsiveness, and/or aggression
- Cognitive problems
Types of Insomnia include:
- Acute Insomnia– usually lasts for only a short period of time, less than 1 month
- Chronic Insomnia– more complex than acute insomnia, occurs several times per week, and lasts for at least one month or longer.
Causes of Insomnia include:
- Psychiatric illness, such as depression, anxiety, and/or PTSD
- Chronic pain from other disabilities
- Chronic stress
- Life changes
Obtaining Service Connection for Insomnia:
The first thing that veterans should know when seeking service-connection for insomnia, is that there must be an actual diagnosis of insomnia in the first place (a.k.a the current disability requirement). If there is not already an official diagnosis of insomnia, then depending on the evidence, sometimes the VA may order a Compensation and Pension (C&P) examination in order to answer that question. But, it’s usually best if the veteran already has an actual diagnosis on file, before pursuing benefits.
Once there is an official diagnosis on file, the next step in obtaining service-connection, is for the veteran to prove that the insomnia is related to military service. In other words, there must be some sort of connection or “nexus” to link the insomnia diagnosis to the military.
In my experience, most veterans who suffer from insomnia did not have this condition during their military days. Insomnia seems to develop years later, usually in response to some other service-connected disability; for example, chronic pain from a back condition or some other orthopedic condition, or, due to a psychiatric condition, such as post-traumatic stress disorder (PTSD). If a veteran has insomnia that is caused by another service-connected disability, then he or she may be able to obtain service connection for insomnia through the theory of secondary service connection.
VA Disability Ratings for Insomnia (to include the pitfalls):
Unfortunately, there always seems to be some sort of “catch” when dealing with the VA, and as you may have guessed, pursuing service connection for insomnia is no exception. What I mean is, even if a veteran is awarded service connection for insomnia, then that award may or may not make any difference, whatsoever, regarding the veteran’s overall VA disability rating and regarding the veteran’s compensation.
The VA will normally rate insomnia based on the Schedule of Ratings for Mental Disorders. This means that the VA treats insomnia as a mental health disability, and they will rate insomnia accordingly.
So, for example, if a veteran has PTSD and also insomnia, then the VA is likely going to “combine” those conditions, and only issue one disability rating to take into account both the PTSD and insomnia. In other words, the veteran is not going to be able to obtain a rating for both insomnia and then ALSO obtain a separate rating for the PTSD as well.
In cases where the veteran is not already service-connected for a mental health condition, for example, chronic pain cases where the insomnia is caused by chronic pain, then in those cases, if the VA awards service connection for insomnia, the disability rating that is assigned for insomnia would be based on the Schedule of Ratings for Mental Disorders, and the veteran would also be eligible to have a separate rating for the chronic pain condition itself.
Overall, the takeaway is that dealing with the VA can be difficult to navigate, and obtaining service connection is only one part of the battle. The other part, and the hard part, is whether or not the veteran is able to actually obtain compensation for his or her disability.