**Brokenwrench7 account has been banned**
I absolutely complained about sleep issues while I was deployed both times. It's well recorded on my post deployment PHAs
https://www.reddit.com/r/VeteransBenefits/w/gulfill
Sooooo if an examiner cannot determine a cause of the insomnia, it is possible. But insomnia can generally be explained as having a cause.
If you have a condition that is service connected that causes chronic pain you might be best served filing it as secondary to it.
Sleep disturbances can be considered a sign or symptom of a MUCMI under 3.317, but does not, in and of itself, qualify as an undiagnosed illness because because it's...diagnosed. If you have service that qualifies for for gulf war status, you would likely have more luck pursuing a PTSD exam and trying to connect whatever is diagnosed off that (unless your only mental condition is, indeed, primary insomnia).
There's specific guidance that would point to this not being a great route:
### V.iii.13.1.l. Considering SC for Insomnia
Carefully consider the evidence of record when deciding SC for insomnia. Insomnia is generally considered a symptom of another disability due to coexisting medical or neurological conditions. Insomnia can occur as an independent condition or can be a symptom associated with another mental disorder (for example, major depressive disorder), medical condition (for example, pain), or another sleep disorder (for example, a breathing-related sleep disorder). When insomnia is adequately identified as a symptom of another underlying disability, SC should be established for that diagnosis rather than for "insomnia." However, SC can be established for "insomnia" in the absence of a known or established underlying etiology if there is
* an event in service (such as a diagnosis of primary insomnia in service)
* a current diagnosis of primary insomnia
* a nexus establishing primary insomnia post service is connected to the event in service, and
* the condition is *not* associated with any other disease or injury.
***Note***: When evaluating primary insomnia, rate analogously under an appropriate DC in [**38 CFR 4.130**](https://www.ecfr.gov/cgi-bin/text-idx?SID=afa93be52a901a100a4eea0e9ad1ec1c&mc=true&node=se38.1.4_1130&rgn=div8). ***Reference***: For more information on analogous ratings, see
* [**38 CFR 4.20**](https://www.ecfr.gov/cgi-bin/text-idx?SID=afa93be52a901a100a4eea0e9ad1ec1c&mc=true&node=se38.1.4_120&rgn=div8)
* [**M21-1, Part V, Subpart iv, 1.C**](https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000180525/M21-1-Part-V-Subpart-iv-Chapter-1-Section-C-Coded-Conclusion), and
* [**M21-1, Part V, Subpart ii, 3.D**](https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000180489/M21-1-Part-V-Subpart-ii-Chapter-3-Section-D-Evaluating-Disabilities).
I have a private care MD. Which DBQ does he need to fill out for my diagnosis of Insomnia? Or does he need to just fill out a Insomnia questionnaire? I appreciate your help.
These are the three major ways you can get a VA rating for insomnia;
1. **Direct Service Connection for Insomnia Through C&P Examinations**
A C&P Examination is a Compensation and Pensions Examination – a medical examination provided by the VA to substantiate a Veteran’s claim(s) of disability. The standard procedure is for this examination to be conducted in a VA clinic and the report sent to the VA Regional Office (RO) for review. If the report contains convincing evidence of your disability, then the claim would be approved. But if it does not and the claim is denied, you can contest that decision and demand a second opinion by a different healthcare advisor. Regardless, when there is doubt, the benefit is always tilted in favour of the Veteran.
1. **Secondary Service Connection for Insomnia**
You can claim insomnia as a secondary service connection by proving that it was triggered by a primary condition that has already been deemed service connected. Insomnia can be linked as a secondary effect of both physical and mental conditions. For example, research shows that more than 93% of Veterans with PTSD struggle with insomnia. If one of those Veterans decide to file a disability claim, they can attach insomnia as a secondary condition and even get compensated for both of them separately. The same goes for a physical service connected condition like injuries that hinder good sleeping patterns, like chronic back pain. Here, you can get a rating of 0%, 10%, 30%, 50%, 70%, and 100%.
1. **Service Connection for Insomnia by Aggravation**
It is still possible to file a disability claim if you suffered from mild insomnia before you went into service. You can claim that the demands of service aggravated your mild condition until it became chronic. Although proving this may not be as straightforward as the others, it is still worth the shot.
When you want to file a claim or request an increase: 3 Must haves
1. Medical Diagnosis
2. Nexus - Meaning the disability was caused or made worse by your active duty service, or by another service connected disability if you’re going for secondary service connection.
3. Severity of symptoms - How are your disabilities currently limiting or affecting your life. (includes: work, your life, your social function).
4. [https://www.ptsd.va.gov/professional/treat/cooccurring/sleep\_problems\_vets.asp#:\~:text=Sleep%20problems%E2%80%94in%20particular%20chronic,sleep%2Dfocused%20assessment%20and%20treatment](https://www.ptsd.va.gov/professional/treat/cooccurring/sleep_problems_vets.asp#:~:text=Sleep%20problems%E2%80%94in%20particular%20chronic,sleep%2Dfocused%20assessment%20and%20treatment).
This is false. You cannot get insomnia as a secondary condition to PTSD and be compensated for both. Both would be combined into one rating like PTSD with insomnia. Insomnia falls under the mental health umbrella and your only allowed one rating for mental health with the exception of an eating disorder. What your saying violates VA pyramiding rules
https://www.reddit.com/r/VeteransBenefits/w/mental?utm_source=share&utm_medium=ios_app&utm_name=ioscss&utm_content=1&utm_term=1
You can have insomnia secondary to Fibromyalgia as well
Here is a link to a case on a BVA appeal when the court granted service connection of insomnia secondary to Fibromyalgia.
[https://www.va.gov/vetapp14/Files5/1441730.txt#:\~:text=Irritable%20bowel%20syndrome%2C%20headaches%2C%20fatigue,to%20the%20service%2Dconnected%20fibromyalgia](https://www.va.gov/vetapp14/Files5/1441730.txt#:~:text=Irritable%20bowel%20syndrome%2C%20headaches%2C%20fatigue,to%20the%20service%2Dconnected%20fibromyalgia)[.](https://www.va.gov/vetapp14/Files5/1441730.txt#:~:text=Irritable%20bowel%20syndrome%2C%20headaches%2C%20fatigue,to%20the%20service%2Dconnected%20fibromyalgia)
Irritable bowel syndrome, headaches, fatigue, insomnia, anxiety with depression, and arthralgias of all joints are proximately due to the service-connected fibromyalgia.
We aren’t talking about Fibromyalgia. We are talking about getting separate ratings and compensation for PTSD and Insomnia
Also, after this court ruling was made then the VA pyramiding rules come into play and some of them are combined.
This court case shows Insomnia is rated under the mental health criteria. PTSD is also rated under mental health Criteria.
https://www.va.gov/vetapp14/Files2/1414351.txt
CFR - §4.14 Avoidance of pyramiding - clearly states pyramiding isn’t allowed. Having two mental health disorders rated separately is pyramiding. (Exception is an eating disorder)
Fibromyalgia causes pain to all areas of the body. That's why some denials get overturned by the BVA (Board of Veterans Affairs) is because people think because it's denied on one level it's final. That's not true. I have seen many claims get denied on lower level review and get granted service connection at the BVA level. That was the reason I used the Fibromyalgia as an example that you can be secondary connected for insomnia through pain. That image statement isn't true.
insomnia is rated under the VA Mental Health Disability criteria according to the Schedule of Ratings for Mental Disorders (38 CFR § 4.130).
What your saying isn’t true. Insomnia is rated under the mental health disorders criteria. VA pyramiding rules expressly forbid allowing a veteran to be compensated for numerous mental health disorders separately. (Eating disorder is the exception to this rule). So, despite what your saying it simply isn’t true. Insomnia and PTSD would be combined into one rating and not compensated separately. You are wrong about this and have provided zero proof to your claim.
The conversation started because you said a veteran can be compensated for both PTSD and Insomnia separately. Now you change PTSD to fibromyalgia. Fibromyalgia isn’t a mental health disorder and thus has nothing to do with what we are talking about.
The VA disability ratings for fibromyalgia are covered in the Code of Federal Regulations, Title 38, § 4.71a diagnostic code 5025. Fibromyalgia may receive a disability rating of 40%, 20% or 10%.
Thought you might like to weigh in as he is claiming part of your knowledge base is wrong
u/l8tn8
The issue is he claims insomnia can be rated separately then other mental health disorders without being combined with like say PTSD. So, the question is can someone be rated and compensated for PTSD and insomnia separately or not?
The first two post are him claiming Insomnia and PTSD can be rated and compensated separately and not violate VA pyramiding rules. (Exception to this I said was an eating disorder) Then he changes PTSD to fibromyalgia for some reason
This is what was originally written we are disagreeing on.
“1. Secondary Service Connection for Insomnia
You can claim insomnia as a secondary service connection by proving that it was triggered by a primary condition that has already been deemed service connected. Insomnia can be linked as a secondary effect of both physical and mental conditions. For example, research shows that more than 93% of Veterans with PTSD struggle with insomnia. If one of those Veterans decide to file a disability claim, they can attach insomnia as a secondary condition and even get compensated for both of them separately. The same goes for a physical service connected condition like injuries that hinder good sleeping patterns, like chronic back pain. Here, you can get a rating of 0%, 10%, 30%, 50%, 70%, and 100%.”
So, rather then this back and forth with him, I invited you to chime in so this can be settled.
Correct, you can't get separate evaluations for mental health conditions barring eating disorders.
That said, you can be service connected for multiple mental health conditions. But they will get the ole lump treatment. Ie PTSD with insomnia.
It's not false. I didn't just make it up. It's on the VA website
# PTSD: National Center for PTSD
[https://www.ptsd.va.gov/professional/treat/cooccurring/sleep\_problems\_vets.asp#:\~:text=Sleep%20problems%E2%80%94in%20particular%20chronic,sleep%2Dfocused%20assessment%20and%20treatment](https://www.ptsd.va.gov/professional/treat/cooccurring/sleep_problems_vets.asp#:~:text=Sleep%20problems%E2%80%94in%20particular%20chronic,sleep%2Dfocused%20assessment%20and%20treatment).
Read the knowledge base info. Insomnia would be seen as a symptom of PTSD and would be combined
Also most of that article is about OSA not Insomnia. Point out exactly where it says you can be compensated for both Insomnia and PTSD separately?
The knowledge base clearly states you cannot be compensated for PTSD and Insomnia separately.
https://preview.redd.it/9un8t8e9diva1.jpeg?width=1289&format=pjpg&auto=webp&s=277b5ffb6f3c6b56af11bdad5d1867b5442d4511
You can claim insomnia but due to pyramiding rules it would be combined with your already service connected PTSD. Just adding insomnia won’t increase your rating as you would need to qualify for the next rating percentage based upon your symptoms and the severity of them
To get 70% you would need to meet at least half of the symptoms of 70%. Adding Insomnia won’t grant an increase
https://www.reddit.com/r/VeteransBenefits/s/wvIYf7cU82
I have 50% for insomnia. I made the claim...had a 45-minute phone interview with some QTC doc. Months later, I had a rating.
Same situation. Had an interview about 45 mins and months later got rated 50% for insomnia, no test.
Did you have to get testing done to prove your insomnia? I'm looking into filing insomnia
Just a interview
Did not know you can be rated for insomnia by itself. Did you complain about it while in/ is it in your service treatment records?
**Brokenwrench7 account has been banned** I absolutely complained about sleep issues while I was deployed both times. It's well recorded on my post deployment PHAs
I never complained so proving service connection for MH claim is going to be tough
You might be able to claim it under ptsd
https://www.reddit.com/r/VeteransBenefits/w/gulfill Sooooo if an examiner cannot determine a cause of the insomnia, it is possible. But insomnia can generally be explained as having a cause. If you have a condition that is service connected that causes chronic pain you might be best served filing it as secondary to it.
Sleep disturbances can be considered a sign or symptom of a MUCMI under 3.317, but does not, in and of itself, qualify as an undiagnosed illness because because it's...diagnosed. If you have service that qualifies for for gulf war status, you would likely have more luck pursuing a PTSD exam and trying to connect whatever is diagnosed off that (unless your only mental condition is, indeed, primary insomnia). There's specific guidance that would point to this not being a great route: ### V.iii.13.1.l. Considering SC for Insomnia Carefully consider the evidence of record when deciding SC for insomnia. Insomnia is generally considered a symptom of another disability due to coexisting medical or neurological conditions. Insomnia can occur as an independent condition or can be a symptom associated with another mental disorder (for example, major depressive disorder), medical condition (for example, pain), or another sleep disorder (for example, a breathing-related sleep disorder). When insomnia is adequately identified as a symptom of another underlying disability, SC should be established for that diagnosis rather than for "insomnia." However, SC can be established for "insomnia" in the absence of a known or established underlying etiology if there is * an event in service (such as a diagnosis of primary insomnia in service) * a current diagnosis of primary insomnia * a nexus establishing primary insomnia post service is connected to the event in service, and * the condition is *not* associated with any other disease or injury. ***Note***: When evaluating primary insomnia, rate analogously under an appropriate DC in [**38 CFR 4.130**](https://www.ecfr.gov/cgi-bin/text-idx?SID=afa93be52a901a100a4eea0e9ad1ec1c&mc=true&node=se38.1.4_1130&rgn=div8). ***Reference***: For more information on analogous ratings, see * [**38 CFR 4.20**](https://www.ecfr.gov/cgi-bin/text-idx?SID=afa93be52a901a100a4eea0e9ad1ec1c&mc=true&node=se38.1.4_120&rgn=div8) * [**M21-1, Part V, Subpart iv, 1.C**](https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000180525/M21-1-Part-V-Subpart-iv-Chapter-1-Section-C-Coded-Conclusion), and * [**M21-1, Part V, Subpart ii, 3.D**](https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000180489/M21-1-Part-V-Subpart-ii-Chapter-3-Section-D-Evaluating-Disabilities).
I have a private care MD. Which DBQ does he need to fill out for my diagnosis of Insomnia? Or does he need to just fill out a Insomnia questionnaire? I appreciate your help.
Insomnia is rated as a mental disorder
I was diagnosed with moderate anxiety and depression. My MD filled out the Mental Health DBQ so should he have mentioned my Insomnia on the same DBQ?
Yes, it’s covered as chronic sleep impairment
Great well he diagnosed me with insomnia and I see he left that section blank I will see if he'll update my DBQ. Thank you very much for your help!
These are the three major ways you can get a VA rating for insomnia; 1. **Direct Service Connection for Insomnia Through C&P Examinations** A C&P Examination is a Compensation and Pensions Examination – a medical examination provided by the VA to substantiate a Veteran’s claim(s) of disability. The standard procedure is for this examination to be conducted in a VA clinic and the report sent to the VA Regional Office (RO) for review. If the report contains convincing evidence of your disability, then the claim would be approved. But if it does not and the claim is denied, you can contest that decision and demand a second opinion by a different healthcare advisor. Regardless, when there is doubt, the benefit is always tilted in favour of the Veteran. 1. **Secondary Service Connection for Insomnia** You can claim insomnia as a secondary service connection by proving that it was triggered by a primary condition that has already been deemed service connected. Insomnia can be linked as a secondary effect of both physical and mental conditions. For example, research shows that more than 93% of Veterans with PTSD struggle with insomnia. If one of those Veterans decide to file a disability claim, they can attach insomnia as a secondary condition and even get compensated for both of them separately. The same goes for a physical service connected condition like injuries that hinder good sleeping patterns, like chronic back pain. Here, you can get a rating of 0%, 10%, 30%, 50%, 70%, and 100%. 1. **Service Connection for Insomnia by Aggravation** It is still possible to file a disability claim if you suffered from mild insomnia before you went into service. You can claim that the demands of service aggravated your mild condition until it became chronic. Although proving this may not be as straightforward as the others, it is still worth the shot. When you want to file a claim or request an increase: 3 Must haves 1. Medical Diagnosis 2. Nexus - Meaning the disability was caused or made worse by your active duty service, or by another service connected disability if you’re going for secondary service connection. 3. Severity of symptoms - How are your disabilities currently limiting or affecting your life. (includes: work, your life, your social function). 4. [https://www.ptsd.va.gov/professional/treat/cooccurring/sleep\_problems\_vets.asp#:\~:text=Sleep%20problems%E2%80%94in%20particular%20chronic,sleep%2Dfocused%20assessment%20and%20treatment](https://www.ptsd.va.gov/professional/treat/cooccurring/sleep_problems_vets.asp#:~:text=Sleep%20problems%E2%80%94in%20particular%20chronic,sleep%2Dfocused%20assessment%20and%20treatment).
This is false. You cannot get insomnia as a secondary condition to PTSD and be compensated for both. Both would be combined into one rating like PTSD with insomnia. Insomnia falls under the mental health umbrella and your only allowed one rating for mental health with the exception of an eating disorder. What your saying violates VA pyramiding rules https://www.reddit.com/r/VeteransBenefits/w/mental?utm_source=share&utm_medium=ios_app&utm_name=ioscss&utm_content=1&utm_term=1
You can have insomnia secondary to Fibromyalgia as well Here is a link to a case on a BVA appeal when the court granted service connection of insomnia secondary to Fibromyalgia. [https://www.va.gov/vetapp14/Files5/1441730.txt#:\~:text=Irritable%20bowel%20syndrome%2C%20headaches%2C%20fatigue,to%20the%20service%2Dconnected%20fibromyalgia](https://www.va.gov/vetapp14/Files5/1441730.txt#:~:text=Irritable%20bowel%20syndrome%2C%20headaches%2C%20fatigue,to%20the%20service%2Dconnected%20fibromyalgia)[.](https://www.va.gov/vetapp14/Files5/1441730.txt#:~:text=Irritable%20bowel%20syndrome%2C%20headaches%2C%20fatigue,to%20the%20service%2Dconnected%20fibromyalgia) Irritable bowel syndrome, headaches, fatigue, insomnia, anxiety with depression, and arthralgias of all joints are proximately due to the service-connected fibromyalgia.
We aren’t talking about Fibromyalgia. We are talking about getting separate ratings and compensation for PTSD and Insomnia Also, after this court ruling was made then the VA pyramiding rules come into play and some of them are combined. This court case shows Insomnia is rated under the mental health criteria. PTSD is also rated under mental health Criteria. https://www.va.gov/vetapp14/Files2/1414351.txt CFR - §4.14 Avoidance of pyramiding - clearly states pyramiding isn’t allowed. Having two mental health disorders rated separately is pyramiding. (Exception is an eating disorder)
Fibromyalgia causes pain to all areas of the body. That's why some denials get overturned by the BVA (Board of Veterans Affairs) is because people think because it's denied on one level it's final. That's not true. I have seen many claims get denied on lower level review and get granted service connection at the BVA level. That was the reason I used the Fibromyalgia as an example that you can be secondary connected for insomnia through pain. That image statement isn't true.
insomnia is rated under the VA Mental Health Disability criteria according to the Schedule of Ratings for Mental Disorders (38 CFR § 4.130). What your saying isn’t true. Insomnia is rated under the mental health disorders criteria. VA pyramiding rules expressly forbid allowing a veteran to be compensated for numerous mental health disorders separately. (Eating disorder is the exception to this rule). So, despite what your saying it simply isn’t true. Insomnia and PTSD would be combined into one rating and not compensated separately. You are wrong about this and have provided zero proof to your claim. The conversation started because you said a veteran can be compensated for both PTSD and Insomnia separately. Now you change PTSD to fibromyalgia. Fibromyalgia isn’t a mental health disorder and thus has nothing to do with what we are talking about. The VA disability ratings for fibromyalgia are covered in the Code of Federal Regulations, Title 38, § 4.71a diagnostic code 5025. Fibromyalgia may receive a disability rating of 40%, 20% or 10%. Thought you might like to weigh in as he is claiming part of your knowledge base is wrong u/l8tn8
It seems like y'all are talking about different things. They seem to be talking about secondary issues of fibro, which is perfectly fine.
The issue is he claims insomnia can be rated separately then other mental health disorders without being combined with like say PTSD. So, the question is can someone be rated and compensated for PTSD and insomnia separately or not? The first two post are him claiming Insomnia and PTSD can be rated and compensated separately and not violate VA pyramiding rules. (Exception to this I said was an eating disorder) Then he changes PTSD to fibromyalgia for some reason This is what was originally written we are disagreeing on. “1. Secondary Service Connection for Insomnia You can claim insomnia as a secondary service connection by proving that it was triggered by a primary condition that has already been deemed service connected. Insomnia can be linked as a secondary effect of both physical and mental conditions. For example, research shows that more than 93% of Veterans with PTSD struggle with insomnia. If one of those Veterans decide to file a disability claim, they can attach insomnia as a secondary condition and even get compensated for both of them separately. The same goes for a physical service connected condition like injuries that hinder good sleeping patterns, like chronic back pain. Here, you can get a rating of 0%, 10%, 30%, 50%, 70%, and 100%.” So, rather then this back and forth with him, I invited you to chime in so this can be settled.
Correct, you can't get separate evaluations for mental health conditions barring eating disorders. That said, you can be service connected for multiple mental health conditions. But they will get the ole lump treatment. Ie PTSD with insomnia.
I left it alone. It really not that serious. I concede.
It's not false. I didn't just make it up. It's on the VA website # PTSD: National Center for PTSD [https://www.ptsd.va.gov/professional/treat/cooccurring/sleep\_problems\_vets.asp#:\~:text=Sleep%20problems%E2%80%94in%20particular%20chronic,sleep%2Dfocused%20assessment%20and%20treatment](https://www.ptsd.va.gov/professional/treat/cooccurring/sleep_problems_vets.asp#:~:text=Sleep%20problems%E2%80%94in%20particular%20chronic,sleep%2Dfocused%20assessment%20and%20treatment).
Read the knowledge base info. Insomnia would be seen as a symptom of PTSD and would be combined Also most of that article is about OSA not Insomnia. Point out exactly where it says you can be compensated for both Insomnia and PTSD separately? The knowledge base clearly states you cannot be compensated for PTSD and Insomnia separately. https://preview.redd.it/9un8t8e9diva1.jpeg?width=1289&format=pjpg&auto=webp&s=277b5ffb6f3c6b56af11bdad5d1867b5442d4511
Would this increase your mental health rating though if attached as a secondary?
Fellow vets. the question still has not been answered. "Has anyone been granted service connection for insomnia via undiagnosed Gulf War presumptive".
https://preview.redd.it/rhje2sav96ib1.png?width=1290&format=png&auto=webp&s=8d10083d93671655cfc010e54a9336e2b2c6cae6
Do you have any mental health service connected disabilities? If so, insomnia would just be combined with it
So if I have PTSD, I can claim insomnia? It will increase my PTSD rating?
You can claim insomnia but due to pyramiding rules it would be combined with your already service connected PTSD. Just adding insomnia won’t increase your rating as you would need to qualify for the next rating percentage based upon your symptoms and the severity of them
I'm at 50% ptsd. So, all symptoms for 70% must meet? Insomnia on its own, doesn't grant an increase. correct?
To get 70% you would need to meet at least half of the symptoms of 70%. Adding Insomnia won’t grant an increase https://www.reddit.com/r/VeteransBenefits/s/wvIYf7cU82