Insomnia is one of the most common and most misunderstood health problems affecting U.S. veterans. Difficulty falling asleep, staying asleep, or waking up exhausted can quietly erode every part of daily life, from job performance and relationships to physical safety and mental health.
Yet many veterans are surprised to learn that the VA usually does not rate insomnia as a standalone disability. Instead, under current VA policy, insomnia is most often treated as a symptom of another service-connected condition, such as PTSD, depression, chronic pain, traumatic brain injury (TBI), or sleep apnea.
As VA disability attorney and educator Brian Reese explains,
“The VA doesn’t deny insomnia because it isn’t serious. It does so because insomnia almost always points to a deeper, underlying service-connected condition.”
Understanding how the VA evaluates insomnia and how to file your claim the right way can significantly improve your chances of receiving accurate, long-term compensation.
What Is Insomnia and Why Veterans Are Especially Affected?
Insomnia is defined as chronic difficulty initiating sleep, maintaining sleep, or achieving restorative sleep, despite adequate opportunity to rest. For VA purposes, insomnia must be persistent, typically lasting at least three months and occurring multiple nights per week.
Veterans experience insomnia at much higher rates than the general population due to:
- Combat stress and hypervigilance
- Shift work, night operations, and irregular sleep cycles
- Chronic musculoskeletal pain
- Traumatic brain injuries
- Mental health conditions such as PTSD, anxiety, and depression
Sleep deprivation does more than cause fatigue. It worsens pain sensitivity, impairs concentration, increases irritability, and raises the risk of accidents factors that are critical in VA disability evaluations.
A VA mental health clinician noted in training guidance,
“Chronic sleep impairment often drives the severity of a veteran’s overall disability picture, even when it isn’t the primary diagnosis.”
Overview: How the VA Treats Insomnia Claims
| Key Question | VA Policy Answer |
|---|---|
| Is insomnia a standalone VA disability? | Usually no |
| How is insomnia evaluated? | As a symptom of another condition |
| Common underlying conditions | PTSD, depression, anxiety, chronic pain, TBI, sleep apnea |
| Governing regulations | 38 CFR §§ 4.130, 4.14 |
| Rare exception | Primary insomnia with no other cause |
Why the VA Generally Will NOT Rate Insomnia Separately?
The VA’s Schedule for Rating Disabilities no longer includes insomnia as its own diagnostic code. Under 38 CFR § 4.130, “chronic sleep impairment” is listed as a symptom within the General Rating Formula for Mental Disorders.
The VA’s reasoning is based on both medical consensus and legal doctrine:
- Insomnia is usually caused by another diagnosable condition
- Separate ratings would result in duplicate compensation
- VA regulations prohibit “pyramiding” under 38 CFR § 4.14
As one former VA rater explained,
“If the VA rated insomnia separately every time it appeared, nearly every mental health claim would be double-paid for the same symptoms.”
Conditions Where Insomnia Is Typically Considered a Symptom
- Mental health disorders (PTSD, major depressive disorder, anxiety)
- Chronic pain conditions (back injuries, migraines, fibromyalgia)
- Neurological disorders (TBI, post-concussive syndrome)
- Sleep-related breathing disorders (sleep apnea)
How the VA Rates Insomnia as a Symptom?
When insomnia is linked to another condition, the VA evaluates it under the diagnostic code for that primary disability.
Common Rating Pathways
- Mental health–related insomnia → Rated under 38 CFR § 4.130
- Pain-related insomnia → Often supports a secondary mental health rating
- Sleep apnea–related insomnia → Rated under 38 CFR § 4.97, DC 6847
A VA examiner handbook notes,
“Chronic sleep impairment is a core symptom that often supports higher evaluations when it causes occupational and social impairment.”
When Can Insomnia Be Service-Connected on Its Own?
Although rare, the VA can grant direct service connection for insomnia as a primary disability but only when strict criteria are met.
To qualify, a veteran must show:
- An in-service diagnosis or documented onset
- A current DSM-5 diagnosis of “insomnia disorder”
- A medical nexus linking insomnia to service
- No underlying physical or mental health cause
Because the VA actively looks for another explanation, the burden of proof is high.
A VA-accredited physician summarized it this way:
“Standalone insomnia claims succeed only when every other medical explanation has been ruled out and that’s uncommon.”
VA Mental Health Ratings That Include Insomnia
Most insomnia claims are ultimately compensated through mental health ratings, where chronic sleep impairment is explicitly listed as a ratable symptom.
General Rating Formula for Mental Disorders (Includes Insomnia)
| VA Rating | Level of Impairment | Examples of Symptoms |
|---|---|---|
| 100% | Total occupational & social impairment | Severe cognitive impairment, persistent danger |
| 70% | Deficiencies in most areas | Suicidal ideation, near-continuous depression |
| 50% | Reduced reliability | Panic attacks, impaired judgment |
| 30% | Occasional work impairment | Chronic sleep impairment, anxiety |
| 10% | Mild symptoms | Sleep controlled by medication |
| 0% | Diagnosed, no impairment | No functional limitation |
Insomnia frequently plays a decisive role in pushing ratings from 30% to 50% or higher.
How to File a VA Disability Claim for Insomnia (Best Strategy)?
Veterans should rarely file a claim labeled only “insomnia.” Instead, claims should be filed based on the most likely underlying cause.
Step 1: Gather Medical Evidence
- Formal diagnosis
- Treatment notes documenting sleep impairment
- Nexus Letter if filing secondarily
Step 2: File Under the Correct Condition
- PTSD, anxiety, depression → File a mental health claim
- Chronic pain → File insomnia as secondary
- Rare primary insomnia → File direct service connection
Step 3: Prepare for the C&P Exam
- Describe frequency, severity, and duration
- Explain daytime effects (fatigue, irritability, safety issues)
- Be consistent and detailed
As one VA examiner noted,
“The veterans who clearly explain how lack of sleep affects work and relationships tend to receive more accurate evaluations.”
Can Anxiety and Insomnia Be Rated Separately?
In most cases, no.
The VA prohibits pyramiding under 38 CFR § 4.14, meaning overlapping symptoms cannot be rated twice. If insomnia is caused by anxiety, PTSD, or depression, it is factored into one combined mental health rating.
A separate insomnia rating is only possible when insomnia has no identifiable underlying cause, which is uncommon.
Final Thought
Insomnia is real, disabling, and life-altering for many veterans but under VA rules, it is usually compensated as part of a broader service-connected condition. Veterans who understand this framework are far more likely to receive the rating they deserve.
As Brian Reese often reminds veterans,
“The goal isn’t to fight the VA’s structure it’s to use it correctly so your insomnia is fully recognized and compensated.”
FAQs
Can I get VA disability for insomnia?
Yes, but insomnia is usually rated as a symptom of another service-connected condition, not on its own.
Why doesn’t the VA rate insomnia separately?
The VA considers insomnia a symptom of another mental or physical condition to avoid duplicate ratings under 38 CFR § 4.14.
When can insomnia be rated by itself?
Only in rare cases when a DSM-5 insomnia disorder is diagnosed and no other cause exists.
What VA rating does insomnia fall under?
Insomnia is typically rated under mental health criteria in 38 CFR § 4.130, ranging from 0% to 100%.
Can I be rated for both anxiety and insomnia?
No. If insomnia is caused by anxiety or PTSD, it is included in one mental health rating.
Does insomnia affect security clearance?
No. A VA rating for insomnia or mental health conditions does not impact a security clearance.
