VA offers service-connected compensation for multiple sleep disturbances including sleep apnea, insomnia, and narcolepsy. Importantly, service connection for sleep disorders can be awarded on a direct, secondary, or presumptive basis.
Sleep apnea is a common sleep disturbance in which a person’s breathing is repeatedly interrupted, or ceases, during the course of a night’s sleep. Sleep apnea is rated by VA under 38 CFR § 4.97, Diagnostic Code 6847 as Sleep Apnea Syndromes. Within this diagnostic code, VA recognizes three types of sleep apnea: obstructive, central, and mixed. Veterans are assigned 0, 30, 50, and 100 percent ratings for sleep apnea, depending on the severity of their condition. A non-compensable 0 percent rating indicates asymptomatic sleep apnea while a 100 percent rating indicates chronic respiratory failure with carbon dioxide retention. Most commonly, veterans receive either a 30 percent rating due to persistent day-time hypersomnolence, or a 50 percent rating consistent with the use of a CPAP machine.
Direct service connection for sleep apnea may be granted for veterans who can show that their sleep apnea began in service using service medical records, or by providing a nexus opinion from a qualified medical professional that links sleep apnea to events or exposures in service. Additionally, veterans of the Persian Gulf War may be awarded presumptive service connection for their sleep apnea under 38 CFR § 3.317
Insomnia is a chronic sleep disorder that involves an inability to fall asleep and/or difficulty staying asleep throughout the night. This condition can have a negative impact on social and occupational functioning. While it is possible that a veteran’s insomnia began in service, it is common for it to develop later on as a result of another disability. If the causal condition is already service-connected, then service connection for insomnia may be granted on a secondary basis. For example, insomnia is associated with psychiatric disorders such as depression, anxiety, and PTSD. Additionally, insomnia can be caused by chronic pain from other disabilities. VA tends to rate insomnia as a component of the underlying disability. For example, if a veteran is service-connected for PTSD and suffers from insomnia as a result of the PTSD, it is possible VA will consider insomnia in its overall evaluation of the veteran’s PTSD disability rating. Another example could be if a veteran is service-connected for an orthopedic condition that causes chronic pain and insomnia, VA might assign a separate disability rating for insomnia based on the schedule of ratings for mental disorders.
Diagnosing Sleep Disturbances
When seeking service-connected compensation for sleep disturbances, it is important to note that you must have a current diagnosis of the condition you are claiming. If you do not have a diagnosis on file, it is likely VA will deny your claim for service connection outright, or at the very least schedule a Compensation & Pension examination to determine if you meet the criteria for a diagnosis. If you do not meet the criteria for a diagnosis, service connection will not be awarded.