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Veterans Law

VA Disability Benefits for Insomnia

March 25, 2020
woman struggling to sleep due to insomnia black and white

What is Insomnia?

Insomnia is a sleep disorder marked by difficulty falling asleep or staying asleep, even when a person has the chance to do so.  People with the condition can feel dissatisfied with their sleep and experience negative outcomes related to their energy level, mood, health, work performance, and quality of life.  Specific symptoms may include the following:

  • Difficulty falling asleep at night
  • Waking up during the night
  • Waking up too early
  • Not feeling well-rested after a night’s sleep
  • Daytime tiredness or sleepiness
  • Irritability, depression, or anxiety
  • Difficulty paying attention, focusing on tasks or remembering
  • Increased errors or accidents
  • Ongoing worries about sleep

Many people experience short-term, or acute, insomnia, which lasts for days or weeks.  Acute insomnia is typically the result of stress or a traumatic event.  However, some people have long-term, or chronic, insomnia that lasts for a month or longer.  Chronic insomnia can also be the result of stress, a traumatic event, life events, or habits that disrupt sleep.  Additionally, chronic insomnia may be associated with medical conditions or the use of certain medications.

Depending on the circumstances, diagnosing insomnia may involve the following:

  • Physical exam. If the cause of the condition is unknown, a doctor may perform a physic exam to look for signs of medical problems that may be related to insomnia.
  • Sleep habits review. In addition to asking sleep-related questions, your doctor may have you complete a questionnaire to determine your sleep-wake pattern and your level of daytime sleepiness.
  • Sleep study. If the cause of your condition is unknown or unclear, you may need to spend a night at a sleep center where tests are done to monitor and record a variety of body activities while you sleep (e.g., brain waves, breathing, heartbeat, eye movements)

Insomnia may be treated by changing your sleep habits and addressing any issues that may be associated with the condition.  However, in more severe cases, cognitive behavioral therapy, stimulus control therapy, relaxation techniques, sleep restriction, and light therapy may be used as forms of treatment.

Service Connection for Insomnia

While it is possible that a veteran’s condition began in service, it is common for it to develop later on as a result of another disability.  If the primary condition is already service-connected, then service connection may be granted on a secondary basis.  For example, insomnia is associated with psychiatric disorders such as depression, anxiety, and PTSD.  Additionally, the condition can be caused by chronic pain from other disabilities.

It is important to note that if the sleep disorder is the primary condition and later causes additional conditions, secondary service connection may still be warranted.  For example, if a veteran is service-connected for insomnia and then develops depression related to their lack of sleep, they may be eligible for VA disability benefits for depression.

How VA Rates Insomnia

VA will typically rate insomnia according to the Schedule of Ratings for Mental Disorders (38 CFR § 4.130).  However, VA tends to rate the condition as a component of the underlying mental health condition.  For example, if a veteran is service-connected for PTSD and suffers from insomnia as a result, it is likely that VA will consider the sleep condition in its overall evaluation of the veteran’s PTSD.  However, if the veteran’s insomnia is not caused by a mental health condition, but some other condition (e.g., orthopedic condition), then VA will likely assign a separate disability rating for insomnia based on the Schedule of Ratings for Mental Disorders.

TDIU

If a veteran is unable to secure or maintain substantially gainful employment as a result of their sleep disorder, they may be entitled to total disability based on individual unemployability (TDIU).  As mentioned above, insomnia contributes to poor work performance as individuals can become too tired to function effectively during the day.  Importantly, the condition does not need to be the only contributing factor to unemployment.  Rather, if a veteran’s condition and other service-connected conditions combined contribute to their unemployment, TDIU may still be warranted.