Many veterans experience both insomnia and PTSD (Post-Traumatic Stress Disorder) due to their service. These two conditions are deeply intertwined, with insomnia often presenting as a symptom of PTSD. However, over time, insomnia can evolve into a separate, debilitating condition eligible for VA compensation. Find out below how to get a VA rating for insomnia secondary to 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.
PTSD VA Ratings are based on the veteran’s level of occupational and social impairment and fall under VA’s § 4.130 Schedule of ratings—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.
Over time, insomnia can persist even after other PTSD symptoms improve. In these cases, it may become a separate diagnosis eligible for a secondary service connection under VA disability.
VA Rating Percentages
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:
- 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.
How to Get VA Disability for Insomnia Secondary to PTSD
When a veteran files a disability claim for insomnia secondary to PTSD, they must present:
- A current diagnosis of insomnia.
- Medical evidence that links the insomnia to their service-connected PTSD.
- Proof that insomnia is either caused by or aggravated by PTSD.
Required Evidence:
- 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.
Winning a VA Claim
To successfully get a VA rating, veterans should:
- Work closely with healthcare providers to document both PTSD and insomnia symptoms.
- Consider filing an appeal if an initial claim is denied, especially if there is new or additional medical evidence (a VA lawyer may help and the case evaluation is free of charge).
- Use buddy statements from fellow veterans or lay statements from family and friends to show how insomnia affects daily activities.
Case Example: Getting a Rating for Insomnia Secondary to PTSD
In this case, a veteran who served in the U.S. Army during two periods from July 1965 to August 1966 and November 1969 to December 1972, including service in the Republic of Vietnam, filed a claim for disability benefits due to sleep disturbances, insomnia, and obstructive sleep apnea. The veteran claimed these conditions were secondary to his service-connected posttraumatic stress disorder (PTSD). Initially, the claim was denied by the Regional Office, leading to the veteran’s appeal before the Board of Veterans’ Appeals.
The Board ultimately granted service connection for a sleep disability manifested by sleep disturbance and insomnia as secondary to the veteran’s service-connected PTSD. The Board found that the veteran’s PTSD had aggravated his insomnia and sleep disturbances, supporting the award of disability benefits for these conditions.
How the Claim Was Won:
- Credible Evidence of Aggravation by PTSD: A VA medical opinion provided in March 2016 concluded that while sleep apnea itself was a physiological condition unrelated to PTSD, the veteran’s sleep disturbances and insomnia were likely aggravated by his PTSD. This medical opinion supported the theory of secondary service connection, which became crucial to the Board’s decision.
- Testimony Linking Sleep Issues to PTSD: The veteran testified that his sleep disturbances, including insomnia, were significantly impacted by stress related to his PTSD. This personal testimony, paired with medical records, helped establish a connection between his mental health condition and sleep issues, reinforcing his claim for secondary service connection.
- The Clemons Doctrine: In line with Clemons v. Shinseki, the Board considered all related sleep conditions, not just sleep apnea, when evaluating the veteran’s claim. This broadened the scope of the review to include insomnia and sleep disturbances, increasing the likelihood of the veteran’s claim being granted.
- Absence of Contradictory Medical Evidence: The March 2016 VA medical opinion that supported the veteran’s claim went unchallenged. Since no other evidence in the record contradicted this opinion, the Board had no reason to deny the claim based on conflicting medical information.
By demonstrating that his insomnia and sleep disturbances were aggravated by his service-connected PTSD, the veteran successfully secured service connection for his sleep-related disabilities.
My Claim Was Denied, What Can I Do?
If you’re denied or underrated for insomnia secondary to PTSD, 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 Matthew Hill
Attorney Matthew Hill, licensed in Florida and Washington D.C., a dedicated advocate for disabled veterans with over two decades of experience, reviewed the information in this post.
