VA Ratings For Insomnia: Can You Obtain Service Connection?
While it’s common to have trouble falling asleep occasionally, it’s important to note when difficulty sleeping is more than a night of tossing and turning. Some individuals may experience prolonged periods of nighttime restlessness, which can indicate insomnia. Insomnia is a sleep disturbance that can affect daily life.
In our day-to-day practice, many veterans have asked if they are eligible for disability benefits 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.
If you or a family member is living with insomnia, this guide will help you apply for disability compensation through the Department of Veterans Affairs.
What Is Insomnia?
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.
Some of the most 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
There are two main types of insomnia, which 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
Understanding the potential causes of insomnia can be essential to your VA disability claim. While the central cause of insomnia is not always clear, some of the most common causes include:
- Psychiatric illness, such as depression, anxiety, and/or PTSD
- Chronic pain from other disabilities
- Chronic stress
- Life changes
If you experienced any of the above factors during active duty, it may have led to insomnia following military service. However, veterans need to prove service connection to receive disability benefits for this condition.
Obtaining Service Connection for Insomnia
When seeking service-connection for insomnia, veterans should know that there must be an actual diagnosis of insomnia in the first place (as outlined by the current disability requirement).
If you’re interested in filing a VA disability claim, you will need to prove that your condition is connected to your time in military service. To successfully establish this, you’ll need to include the following three elements in your claim:
- A current diagnosis of insomnia from an authorized medical professional
- The description of the in-service occurrence that resulted in the diagnosis
- An official letter (medical nexus) from the diagnosing medical professional that states your disability was caused by the in-service occurrence.
There are a number of events that can lead to insomnia, including the loss of a fellow service member during combat or a sudden attack during a standard convoy mission. Please note that the in-service occurrence or incident does not necessarily need to have taken place while the veteran is officially in active duty. In other words, the VA does not consider whether you were on base or not when rating your disability.
Events that result in insomnia can be difficult to pinpoint, especially because it may take time before the veteran experiences symptoms. A veteran may have discussed their sleep issues with a doctor for an extended period of time before discovering the root cause of the problem.
C&P Examinations For Insomnia
If a veteran does not have an official diagnosis of insomnia, then depending on the existing evidence, the VA may order a Compensation and Pension (C&P) examination. While it’s usually more beneficial to the claim if the veteran already has a diagnosis on file, a C&P exam can gather medical evidence to support a claim or provide a second opinion.
These exams generally take place at a designated VA clinic or hospital. The doctor is not there to treat your condition or provide any type of medication. They will conduct a routine examination, which may include psychological testing. The doctor may ask specific questions to understand more about the connection between your time in the service and your disability. If your insomnia is caused by a physical condition, they may complete a standard physical examination as well.
After your appointment, the doctor will write a report and send it to the VA Regional Office (RO) for further review. If you get an unfavorable exam result in which the doctor disagrees with your assessment, you are allowed to challenge their conclusion either through a private doctor or healthcare advisor. You can also submit your own statement.
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 medical exam determines that 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 secondary service connection.
Secondary Service Connection for Insomnia
A secondary service connection is a byproduct of a different condition that was already determined to be service-connected. These secondary connections can be applied to both mental and physical conditions.
Many veterans will benefit from seeking a VA disability rating for secondary insomnia. For example, if you were officially diagnosed with PTSD while you were in the service, you may have developed insomnia due to the disorder. If you can show that insomnia and PTSD are directly related, then you can claim PTSD as the primary condition and insomnia as the secondary.
Veterans who were physically injured during military service and later developed insomnia can also file for a secondary service connection. For example, if you developed chronic back pain in the service and can no longer sleep through the night as a result, then insomnia would be the secondary condition.
If you choose to file for benefits based on a secondary service connection, you’ll need to gather similar evidence as a standard service connection claim. This can include a diagnosis for the secondary condition and a letter from your healthcare provider explaining the link between the primary condition and the secondary condition.
Service Connection by Aggravation
If you were diagnosed with insomnia prior to military service, you may still be able to file a disability claim. To do so, you will need to show that your time in the service aggravated your symptoms and made the condition worse. The VA defines service connection by aggravation for insomnia as the inability to sleep worsening after enrollment.
However, it’s important to note that this is different than a natural progression of a condition. For example, this can apply if your insomnia was originally caused by the lingering pain from an old knee injury you sustained in high school. During treatment, your doctor indicated that the discomfort would gradually increase over time. In this case, insomnia as a secondary condition would be caused by the residual effects and progression of a prior condition.
TDIU for Insomnia
The VA offers Total Disability based on Individual Unemployability to veterans who are unable to work due to a service-connected disability. To qualify, a veteran must prove that they are unable to find and maintain gainful employment due to their condition. This benefit requires a 100% VA rating.
While it is possible to achieve this rating for insomnia, it’s often unlikely. However, you may be able to use insomnia as a secondary condition in order to reach the requisite rating.
VA Disability Ratings For Other Sleep Disturbances
Keep in mind that insomnia isn’t the only sleep disorder that can qualify you for VA benefits. The VA also offers benefits for sleep disorders like obstructive sleep apnea and hypersomnolence, which can include narcolepsy and insufficient sleep syndrome. These types of sleep disturbances may be secondary to other service-connected conditions like PTSD. As with insomnia, it’s important to obtain a medical diagnosis and sufficient evidence of service connection when building your claim.
Building Your Veterans Disability Claim
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. If you have any concerns about your VA disability claim for insomnia, contact the team at Hill & Ponton. Our veterans’ disability lawyers can assess your claim and help you obtain appropriate compensation.