In the U.S. military population, PTSD and insomnia often co-occur, and insomnia is the most commonly reported symptom of PTSD. Veterans disabled by post-traumatic stress disorder are likely to also struggle with insomnia disorder.
If this is your experience, it’s essential to understand how an insomnia diagnosis can potentially increase your PTSD rating.
Returning veterans may shrug off degraded sleep as part and parcel of the challenges of post-traumatic stress disorder. We have worked with many veterans claiming disability for PTSD who were also stricken with chronic insomnia − yet they were unaware that sleep disorders like insomnia can entitle them to additional disability benefits.
In most cases, the VA will appoint a disability rating for insomnia secondary to related service-connected conditions such as PTSD. If your insomnia was undiagnosed and unclaimed when your initial PTSD claim was rated and awarded benefits, this is often an excellent opportunity to increase your present VA rating.
In other cases, the VA may find insomnia to be a condition that started in service and can be directly service-connected and rated separately.
By associating your PTSD and insomnia, or insomnia secondary to your PTSD, you can give the VA a more complete picture of how severely your PTSD is impacting your life. This article explains how you can merit a higher VA disability rating by reinforcing your PTSD claim with an insomnia diagnosis.
Even if you’ve not been diagnosed with this sleep disorder but show symptoms of insomnia, it’s worth giving us a call to discuss the options you may have.
What Is Insomnia?
Acute insomnia lasts for short periods and then goes away. However, for many veterans, insomnia is a long-term (chronic) sleep disorder.
Chronic insomnia can make it extremely difficult to function normally. It can cause the veteran problems at work, trouble focusing, provoke behavioral issues, disrupt relationships, and interfere with daily life generally.
The VA defines insomnia according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5), which lists three main symptoms:
- Difficulty falling asleep
- Inability to maintain sleep
- Early morning wakefulness – you’re awake at least 30 minutes before you should wake up and before sleep reaches 6.5 hours.
Further insomnia disorder criteria necessary for insomnia diagnosis include:
- sleep difficulty is present at least three nights per week and lasts for at least three months
- you’re unable to sleep even with ample opportunity
- no other sleep-wake disorder, substance, or coexisting mental health condition explains the insomnia experience
Further symptoms of insomnia include:
- Sleep Anxiety
- Extreme fatigue and weariness (sleep time is tiring, not restorative)
- Behavior and mood problems, such as depression, irritability, impulsiveness, or aggression
- Impaired cognitive function, such as trouble focusing, concentrating, and remembering
According to the VA,sleep disorders—especially chronic insomnia and nightmares—are among the most distressing traits of PTSD. While sleep disorders are often symptoms of PTSD, studies show they can eventually become independent problems that require specialized sleep disorder evaluation and treatment.
Insomnia is reported to occur in 90-100% of Vietnam-era veterans with PTSD. Insomnia was also the most commonly reported PTSD symptom in a survey of veterans from Afghanistan and Iraq.
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The VA Rates PTSD and Insomnia in the Same Manner
The VA rating schedule does not have a diagnostic code for insomnia alone. Like PTSD, the VA will generally rate insomnia disability similar to a mental health disorder.
The VA rating schedule is found in 38 CFR § 4.130 – Schedule of Ratings for Mental Disorders and is based upon DSM–5. Disability percentages for all mental disorders are 0, 10, 30, 50, 70, and 100 percent, the very same ratings allowed for PTSD.
Recognizing the likely causes of your insomnia can be crucial to your VA disability claim. While every veteran’s case is unique, and the underlying cause or causes may not be apparent, some of the most common reasons for insomnia among veterans include:
- Psychological or physical injuries, such as posttraumatic stress disorder (PTSD) or traumatic brain injury (TBI), which can be directly service-connected.
- Ongoing pain or illness
- High levels of stress
- Erratic sleep schedule
- Extreme or inhospitable living conditions
How can I qualify for VA disability benefits for Insomnia Secondary to PTSD?
Secondary service claims require the same evidence that primary service claims require. You need to:
- Have a current insomnia diagnosis from an approved VA-approved doctor, and
- Show that your PTSD and insomnia are directly related. If you can, this will allow you to claim insomnia as secondary to your direct service-connected PTSD. The VA would rate each condition and bundle both under your current PTSD disability.
Example: You are diagnosed with PTSD during military service, and sometime later, you develop insomnia due to your PTSD. You can claim insomnia as a condition secondary to posttraumatic stress disorder. With your secondary insomnia assessment, your VA rating could add up to be higher than your PTSD rating alone.
When assessing your PTSD disability, the VA claims examiner will review the comprehensive impact on your social and occupational functioning. The severity of symptoms, such as the frequency and intensity of insomnia, will be carefully assessed.
The VA disability rater looks at how all of your symptoms affect your ability to perform substantially gainful employment, maintain relationships, and handle everyday tasks and activities.
Eventually, you may develop further disabilities related to insomnia, such as reduced immune system function, diabetes, high blood pressure, heart attack, heart failure, or stroke. Such associated physical impairments could also qualify for service connection if they result inoccupational and social impairment, thus adding to your total VA disability rating.
Example: Your service-connected PTSD was initially rated at 30%, and you have since developed insomnia because of your PTSD. Your VA rating may now be increased to, say, 50%, depending on the severity of symptoms caused by your insomnia. Eventually, you have a heart attack due to your chronic insomnia. Your insomnia links your service-connected PTSD and heart attack for an additional VA rating.
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How to Get TDIU Disability Rating for PTSD and Insomnia
This benefit is officially labeled Total Disability Based on Individual Unemployability (TDIU), often shortened to Individual Unemployability (IU).
When your VA scheduler rating is less than 100%, but you can demonstrate that your service-connected impairments obstruct you from getting or maintaining gainful employment, you may be entitled to TDIU compensation at the 100% rate.
The following requirements are for the scheduler award of TDIU:
- If you have one service-connected disease or injury, it must be rated at 60 percent or more.
- If you have a combination of service-connected disabilities, at least one condition is rated at 40 percent or more, and there is enough additional disability to bring the combined rating to 70 percent or more.
PTSD alone rated at 70% could feasibly qualify you for TDIU. However, if your 50% PTSD rating also caused you to develop insomnia as a secondary condition, these combined disorders may entitle you to TDIU.
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How Our Veterans Attorneys Can Help
If your service-connected PTSD has caused your insomnia, allow our accredited veteran’s attorneysreview your case at no cost. Veterans struggling with PTSD and insomnia merit the maximum rating from the VA, and we would be honored to represent you.
When paired with PTSD, insomnia can be an effective argument for a higher VA rating. You will be in a better position to win the maximum disability compensation and healthcare benefits you deserve.
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