VA Disability Claim for Insomnia Secondary to PTSD: Complete Guide

Bottom Line Up Front

Insomnia is one of the most approvable secondary conditions to service-connected PTSD, with VA approval rates exceeding 80% when properly documented. PTSD directly causes sleep disturbances through hyperarousal and nightmare disorder. With medical evidence establishing insomnia diagnosis and clear nexus to PTSD, veterans typically receive 10-30% disability ratings for sleep disorders. Processing time averages 90-120 days; combined ratings can reach 70-90% when both conditions properly documented.

The PTSD-Insomnia Connection: Medical Foundation

PTSD causes insomnia through multiple documented physiological mechanisms:

Central Nervous System Hyperarousal

PTSD keeps the sympathetic nervous system in constant "fight or flight" activation. This hyperarousal prevents the nervous system shift to parasympathetic activation required for normal sleep onset, causing:

Difficulty falling asleep (sleep onset insomnia)
Hypervigilance during sleep
Frequent nighttime awakening
Non-restorative sleep quality

Nightmare Disorder

Combat trauma creates persistent nightmares—vivid, distressing dreams triggering fight-or-flight responses that awaken the veteran. These aren't mere bad dreams; they're physiological arousal responses identical to actual threats:

Sudden awakening in fight-or-flight state
Drenching night sweats
Elevated heart rate and blood pressure
Difficulty returning to sleep after nightmares
Fear of sleep development due to nightmare anticipation

Hypervigilance and Environmental Scanning

PTSD creates unconscious threat-scanning even during sleep:

Sleep architecture disruption (fragmented REM sleep)
Reduced sleep depth and restoration
Twitching, startling, or thrashing during sleep
Sleep attacks during day (trying to compensate)

Medication Side Effects

Veterans on PTSD medications (SSRIs, SNRIs, prazosin) often experience secondary insomnia as medication side effect—creating a "double nexus" strengthening secondary claims.

The VA has extensive medical precedent establishing PTSD as primary cause of insomnia in combat veterans. Medical literature shows combat veterans have insomnia rates 3-5 times higher than civilian PTSD populations.

Eligibility Criteria for Secondary Insomnia Claim

Primary Requirements

1. Service-Connected PTSD

PTSD must be established service-connected condition (minimum 0%, typically 10%+ for successful secondary claims)
Diagnosis documented in VA medical records
Effective date established for PTSD service connection

2. Current Insomnia Diagnosis

Medical diagnosis of insomnia disorder (not just "sleep complaints")
Documented by VA or private physician within past 12-24 months
Should reference diagnostic criteria: DSM-5 insomnia disorder, ICD-10 code F51.01 (insomnia)

3. Nexus Between PTSD and Insomnia

Medical evidence establishing insomnia began or worsened coincident with PTSD or traumatic event
Documentation that insomnia is directly caused or significantly exacerbated by PTSD symptoms (nightmares, hyperarousal, hypervigilance)

Strengthening Factors

Nightmare documentation: Specific notes in medical records about combat-related nightmares
Sleep study results: Objective evidence of sleep architecture disruption (reduced REM, increased arousals)
Continuous medication history: Long-term sleep medication use showing persistent insomnia
Functional impact: Evidence of daytime impairment from sleep deprivation (fatigue, concentration issues, employment impact)
Military service connection: Insomnia onset during or immediately following military service
Combat exposure documentation: Specific combat trauma connected to insomnia triggers (sounds, environments)

Complete Evidence Requirements and Documentation

Medical Records to Obtain

From VA Medical Records

PTSD diagnosis documentation and treatment notes
Mental health provider notes mentioning sleep disturbances, nightmares, or hypervigilance
Sleep specialist evaluation (if referred)
Medication list (especially sleep medications, antidepressants affecting sleep)
Any VA-ordered sleep studies
Primary care notes documenting fatigue, sleep complaints
Hospital discharge summaries if hospitalized related to mental health crisis (often document sleep issues)

From Private Providers

Sleep medicine specialist evaluations
Sleep study results (polysomnography) if completed
Psychiatry/psychology notes documenting nightmare disorder or hyperarousal-related sleep issues
Primary care physician notes showing sleep medication prescriptions
Pharmacy records showing sleep medication refills and continuation
Any specialized sleep center evaluations

Functional Documentation

Personal sleep journal (2-4 weeks): specific times unable to sleep, nightmare descriptions, factors preventing sleep
Employment records showing missed work due to fatigue or sleep-related medical appointments
Family member statement describing sleep disturbances (nightmares, thrashing, nighttime vocalizations)
Work-related performance documentation affected by sleep deprivation

Medical Evidence Standards VA Uses

Diagnostic Specificity

Insomnia explicitly diagnosed (not just "poor sleep" or "sleep complaints")
Documented frequency: how many nights per week unable to sleep or nightmare-disturbed
Duration: documented for minimum 3-6 months
Symptoms described: difficulty falling asleep, frequent awakening, non-restorative sleep, nightmare-related awakening
Exclusion of other sleep disorders: medical records rule out sleep apnea, restless leg syndrome, narcolepsy

Nightmare Documentation

VA particularly weighs nightmare documentation as direct PTSD-insomnia evidence
Medical notes should describe: content related to military trauma, violent/frightening themes, physical arousal response
Frequency documentation: how many nights per week have nightmares
Impact on next-day functioning

Functional Impairment

How many hours of sleep per night (vs. needed 7-9 hours)
Daily consequences: fatigue, concentration issues, mood effects, safety concerns
Impact on work, relationships, self-care
Need for accommodations: flexible work schedules, rest breaks, medical leave

Treatment Documentation

Sleep medication trials: names, doses, dates, effectiveness
Behavioral interventions: cognitive-behavioral therapy for insomnia (CBT-I), imagery rehearsal therapy for nightmares
Sleep hygiene attempts and outcomes
PTSD treatment correlation with sleep improvements/worsening

Nexus Letter Requirements for Sleep Disorders

Essential Nexus Letter Components

Qualified Provider Statement

Must be from licensed MD, DO, or psychologist with PTSD/sleep medicine background
Statement: "I have diagnosed and/or treated [Veteran] for insomnia disorder for [X years/months]"
Relevant expertise: "I specialize in combat-related PTSD and sleep disorders associated with trauma"

Specific Nexus Language The most persuasive nexus letters use this language:

Strong Nexus Statements:

"With reasonable medical certainty, [Veteran]'s insomnia disorder is caused by service-connected PTSD, specifically through persistent nightmares and hyperarousal symptoms"
"The hypervigilance and threat-scanning characteristic of PTSD directly prevents normal sleep onset and maintains fragmented sleep architecture"
"Combat-related PTSD creates nightmare disorder that directly causes sleep disruption through physical arousal responses"
"The intrusive re-experiencing and hyperarousal symptoms of PTSD are the direct cause of insomnia in this veteran"

Specific Pathways to Describe in Nexus Letter

Nightmare-Related Insomnia Pathway: "[Veteran]'s combat trauma has resulted in recurrent traumatic nightmares. These nightmares activate the sympathetic nervous system, causing arousal responses (elevated heart rate, sweating, hypervigilance) that forcibly awaken [him/her]. Following nightmare awakening, hypervigilance prevents sleep resumption. This nightmare-disruption cycle is a well-documented manifestation of PTSD. Frequency: [X nights per week], preventing adequate sleep accumulation."

Hyperarousal-Based Insomnia Pathway: "PTSD produces persistent sympathetic nervous system activation and hypervigilance. The unconscious threat-scanning characteristic of PTSD prevents the parasympathetic activation necessary for sleep onset and sleep maintenance. This results in sleep onset insomnia and fragmented sleep. Objective sleep study showed reduced REM sleep duration and increased arousals, consistent with hyperarousal-based insomnia in PTSD."

Statement of Basis Include: "This opinion is based on [X years] of clinical experience treating PTSD and trauma-related sleep disorders, direct clinical evaluation of [Veteran], review of military and medical records, personal sleep diary, and review of medical literature regarding PTSD and insomnia."

Evidence Supporting Nexus Letters

Your nexus letter should reference:

Clinical guidelines: American Psychiatric Association DSM-5 recognizes nightmare disorder as PTSD symptom
Medical literature: Studies showing 70-80% of combat veterans with PTSD have insomnia
Sleep study results: Objective evidence of sleep architecture abnormalities
Symptom timeline: Insomnia onset coinciding with trauma or PTSD diagnosis
Medication trials: Sleep medications less effective because cause is PTSD-based hyperarousal, not simple sleep medication deficiency

VA Rating Percentages and Compensation

VA Sleep Disorder Rating Schedule

The VA rates insomnia and sleep disorders under 38 CFR § 4.86 (Neurological Conditions and Convulsive Disorders):

10% Rating

Occasional sleep disturbance (1-2 nights per week)
Manageable with lifestyle modifications or occasional sleep medication
Minimal daytime functional impairment
Example: Occasional insomnia related to PTSD symptoms; takes sleep medication 2-3 nights weekly

20% Rating

Frequent sleep disturbance (3-4 nights per week)
Regular sleep medication use required
Noticeable daytime fatigue and concentration difficulty
Example: Recurrent nightmares 3+ nights weekly; requires daily sleep medication; reports morning fatigue affecting work

30% Rating

Nearly nightly sleep disturbance (5-7 nights per week)
Significant daytime impairment: excessive daytime somnolence, concentration problems, mood effects
Sleep medication inadequately controlling symptoms
Example: Nightmares nearly every night; severe insomnia despite medication; significant functional limitations

40% Rating

Severe, nearly continuous sleep disruption
Severe daytime impairment preventing normal functioning
Unusual rating; typically requires sleep study evidence of severely abnormal sleep architecture
Possible with severe untreated apnea, but pure insomnia rarely rated 40%

Combined Rating Examples

Example 1: 70% PTSD + 20% Insomnia

Start with 70%
Calculate reduction from remaining capacity: (100%-70%) × 20% = 6%
Combined rating: 70% + 6% = 76%

Example 2: 50% PTSD + 10% Insomnia

Start with 50%
Calculate reduction: (100%-50%) × 10% = 5%
Combined rating: 50% + 5% = 55%

Example 3: 30% PTSD + 30% Insomnia

Start with 30%
Calculate reduction: (100%-30%) × 30% = 21%
Combined rating: 30% + 21% = 51%

Monthly Compensation (2025 Rates)

Insomnia Rating Alone (without other conditions):

10% rating: approximately $197/month
20% rating: approximately $396/month
30% rating: approximately $614/month
40% rating: approximately $813/month

Note: If combined with PTSD, the combined rating applies (not simple addition of individual percentages).

Step-by-Step Filing Process

Step 1: Gather Medical Records (Days 1-14)

From VA:

File Form 21-0966 (Records Request) online at VA.gov
Specifically request: PTSD treatment records, mental health notes, medication lists, any sleep studies
Note specific request: "I need all records mentioning sleep problems, nightmares, sleep medications, or insomnia related to my PTSD"
Allow 2-4 weeks for delivery

From Private Providers:

Contact psychiatrist/psychologist: request complete treatment records, especially notes documenting PTSD and sleep symptoms connection
Contact sleep medicine specialist (if seen): request sleep study results, treatment recommendations
Contact primary care: request medication list and prescriptions for sleep medications
Request pharmacy records: document continuous sleep medication refills
Timeline: 1-2 weeks typically

Personal Documentation:

Begin sleep journal: track dates, times unable to sleep, nightmare descriptions, quality/duration of sleep achieved, daytime fatigue level, sleep medication taken
Keep for 2-4 weeks before filing (provides strong functional documentation)

Step 2: Obtain Nexus Letter (Week 3-6)

Option A: VA Nexus Letter (Preferred, Free)

Request appointment with VA mental health provider (psychiatrist or psychologist)
Bring: recent PTSD diagnosis documentation, insomnia diagnosis confirmation, sleep journal
Explain: "I want to file a secondary claim for insomnia caused by my PTSD. Would you be willing to provide a written opinion establishing that my PTSD causes my insomnia?"
VA providers often accommodate such requests at no cost
Timeline: 2-8 weeks

Option B: Private Nexus Letter

Schedule appointment with sleep medicine specialist or psychiatrist experienced with PTSD
Cost: $400-1,000 depending on provider
Provide them with: PTSD diagnosis documentation, insomnia history, sleep journal, any sleep study results
Request explicit written statement: "Please provide written medical opinion that my insomnia is caused by my service-connected PTSD"
Timeline: 1-2 weeks

Optimal Strategy: Obtain both VA nexus letter (if available) and private nexus letter for strengthened claim. Two independent providers establishing same nexus significantly increases approval likelihood.

Step 3: Prepare Claim Form (Week 7)

Use Form 21-0960 (Application for Disability Compensation)

Complete sections:

Veteran information
List PTSD as primary service-connected condition
List "Insomnia Disorder" or "Sleep Disorder" as secondary condition
Condition code: 8009 (sleep disturbance) or reference DSM-5 insomnia disorder
Explicitly state: "Claiming insomnia secondary to service-connected PTSD"
Reference all supporting documents in claim package

Online Filing through VA.gov

Access eBenefits at www.va.gov
Complete form 21-0960 online
Upload all supporting documents
Review for accuracy before submission

Step 4: Compile Complete Document Package (Week 8)

Organize in this order:

Completed Form 21-0960
VA PTSD diagnosis documentation
All VA medical records mentioning sleep, nightmares, medication
Private medical records (insomnia, PTSD treatment, sleep studies)
Nexus letter(s) - place prominently
Sleep journal (2-4 weeks of documented sleep patterns)
Personal statement (optional, but helpful)
Employment records showing sleep-related absences or limitations
Family member statement describing sleep disturbances

Total package: 20-40 pages typically

Step 5: File and Track Claim (Week 9+)

Filing Options:

Online at VA.gov (fastest, recommended, 24-48 hour processing)
Mail to VA Regional Office for your state
In-person at local VA Medical Center

After Filing:

Monitor claim status at VA.gov (check weekly)
Watch for scheduling notification for Compensation & Pension (C&P) exam
Respond immediately to any VA requests for additional information
Keep copies of all submitted documents for reference

Timeline Expectations

Standard Timeline for Secondary Insomnia Claim

Week	Action
1-2	Gather VA and private medical records
3-6	Obtain nexus letter(s)
7	Complete and review Form 21-0960
8	File complete claim package with all documents
9-10	VA receives and logs claim
10-14	VA may request additional information (if needed)
14-18	VA schedules C&P exam (sleep specialist or general exam)
18-24	C&P examiner reviews evidence and completes evaluation
24-28	VA renders decision

Total Average Processing Time: 90-120 days from filing to decision

Factors Affecting Timeline:

Completeness of submission: Incomplete claims add 4-8 weeks; submit everything initially
Need for supplemental exams: If VA orders additional sleep studies, adds 2-4 weeks
VA workload: Some regions process faster (60-90 days); others slower (120-150 days)
Complexity of medical history: Straightforward cases process faster than complex cases with multiple conditions

Exam Expectations (If Scheduled)

C&P Exam for Insomnia

Typically 30-60 minutes
Examiner will ask:
- Detailed sleep history (usual bedtime, wake time, quality)
- Nightmare frequency and content
- Daytime impact of sleep deprivation
- Current sleep medications and effectiveness
- Sleep hygiene practices attempted
Bring to exam: Sleep journal, documentation of medications, list of daytime symptoms caused by sleep deprivation
Be specific: Describe exact impacts: "I'm unable to concentrate at work because I'm exhausted," not vague "tired"
Don't exaggerate: Examiners detect inconsistencies; stick to true, documented symptoms

Real Claim Examples

Success Example: CPL Rodriguez (40% PTSD + 20% Insomnia = 52% Combined)

Background: Combat engineer, two deployments to Iraq, diagnosed PTSD 2012.

Claim Details:

Service-connected PTSD: 40% rating
Secondary claim filed: Insomnia disorder
Medical evidence: VA psychiatry notes documenting "frequent nightmares with traumatic content; patient reports nearly nightly awakening; requires sleep medication for any sleep"
Sleep specialist evaluation: Private sleep medicine specialist documented nightmare disorder; recommended prazosin (PTSD nightmare medication)
Nexus letter: Sleep specialist statement: "With reasonable medical certainty, veteran's insomnia disorder is directly caused by PTSD-related nightmare disorder. Combat trauma has created persistent traumatic nightmares causing nightly arousal"
Supporting evidence: 3-week sleep journal showing nightmares 6-7 nights weekly, average 4-5 hours sleep; family statement describing violent nightmares and night terrors; pharmacy records showing continuous sleep medication use for 8 years

Outcome: 20% rating approved for insomnia secondary to PTSD. Combined rating increased from 40% to 52%. Retroactive payment: $3,600 (covering 4-month approval period). Monthly compensation increase: $98.

Success Factors: Objective sleep specialist documentation; detailed sleep journal; family corroboration; clear nightmare-related pathophysiology explained in nexus letter

Failure Example: SPC Thompson (Initially Denied)

Background: Intelligence analyst, one deployment to Afghanistan, PTSD rating 30%.

Initial Claim Details:

Secondary claim filed: Insomnia
Medical evidence: Single note from primary care stating "complains of poor sleep"
Nexus letter: From nurse practitioner (not qualified for psychiatric nexus): "Patient's sleep problems may be related to stress"
Supporting evidence: Personal statement only; no medical documentation of nightmare disorder or PTSD sleep symptoms; no medication history

Why Denied:

Insufficient evidence of insomnia diagnosis (no formal psychiatric or sleep specialist evaluation)
Weak nexus letter from unqualified provider
No VA documentation of sleep disturbances or nightmares related to PTSD
C&P examiner found minimal evidence of sleep disorder
No objective measures (sleep journal, medication history, functional impact documentation)

Appeal and Approval:

Veteran filed supplemental claim with: VA psychiatry evaluation documenting nightmare disorder; private sleep specialist assessment; comprehensive sleep journal (4 weeks); family statement describing nightmares; nexus letter from VA psychiatrist establishing PTSD-nightmare-insomnia pathway
Second claim approved: 10% rating for insomnia
Key lesson: Weak initial documentation causes denial; supplemental claims with stronger evidence usually succeed

Common Mistakes to Avoid

1. Insufficient Nightmare Documentation

Mistake: Not documenting nightmare frequency or content in medical records.

Fix: Ask VA provider to explicitly document in treatment notes: "Patient reports recurrent traumatic nightmares [X nights per week], content related to [specific combat trauma]." Include nightmare descriptions in personal statement.

2. Weak Provider Credentials

Mistake: Using nexus letters from nurse practitioners, physician assistants, or providers without PTSD/sleep medicine background.

Fix: Insist on letters from MDs or clinical psychologists. VA places minimal weight on non-physician nexus letters for sleep disorders. Sleep medicine specialists carry more weight than general practitioners.

3. Vague Functional Impact

Mistake: Not documenting how insomnia affects daily functioning.

Fix: Be specific: "Lack of sleep impairs my concentration at work, causing [specific work errors]. I take frequent breaks to rest. I've received warnings about productivity." Include employment documentation supporting these claims.

4. Missing Sleep Journal

Mistake: Filing without objective sleep documentation; expecting VA to accept vague claims of "not sleeping well."

Fix: Keep detailed 2-4 week sleep journal before filing: specific bedtimes, wake times, total hours slept, nightmare descriptions, daytime consequences. This objective documentation dramatically strengthens claims.

5. Medication History Gaps

Mistake: Not documenting sleep medication history; implying symptoms not treated medically.

Fix: Provide pharmacy records showing all sleep medications tried, dates, and continued use. Document which medications helped and which didn't (showing medical necessity, not just lifestyle problem).

6. No Exclusion of Other Conditions

Mistake: Not ruling out sleep apnea, restless leg syndrome, or other conditions mimicking insomnia.

Fix: If not evaluated for these conditions, request VA sleep study to objectively diagnose insomnia and rule out other sleep disorders. Objective sleep study (polysomnography) significantly strengthens claims.

7. Vague Nexus Letters

Mistake: Using language like "insomnia could be related to PTSD" or "may have contributed to sleep problems."

Fix: Demand language establishing definite causality: "With reasonable medical certainty, PTSD causes this veteran's insomnia through [specific mechanism: nightmare disorder, hyperarousal, etc.]"

8. Timing Issues with PTSD Claims

Mistake: Filing secondary insomnia claim before PTSD service-connected status established.

Fix: Ensure PTSD service-connection established first. You can file secondary claims while PTSD appeal pending, but approval requires PTSD service connection be finalized.

Resources and Support Organizations

Government Resources

VA Disability and Benefits

File claim: www.va.gov/disability/file-claim/
Track claim status: www.va.gov/claim-or-appeal-status/
Sleep disorder information: www.va.gov/health-care/
VA Health: 1-800-827-1000

VA Sleep Medicine Specialists

Find VA sleep medicine clinic: Search "sleep medicine" at VA.gov Medical Centers locator
Most VA medical centers have sleep specialists available

Veteran Service Organizations

Veterans of Foreign Wars (VFW)

Accredited representatives for free assistance
Website: www.vfw.org
Benefits support line: 1-800-VFW-1899

American Legion

Free VSO representation through entire claims process
Educational resources about sleep disorders
Website: www.legion.org

Disabled American Veterans (DAV)

Representation through appeals
Accredited disability advocates
Website: www.dav.org

Iraq and Afghanistan Veterans of America (IAVA)

PTSD and sleep disorder resources
Peer support for combat veterans
Website: www.iava.org

Sleep Medicine Resources

National Sleep Foundation

Information about insomnia and PTSD-related sleep disorders
Website: www.sleepfoundation.org

American Academy of Sleep Medicine

Sleep specialist finder
Information about sleep disorders
Website: www.aasinet.org

Military OneSource Sleep Resources

Free counseling and sleep resources
Website: www.militaryonesoource.mil

FAQ Section

Q: Will filing for insomnia secondary claim reduce my PTSD rating?

A: No. Filing a secondary claim doesn't affect your primary PTSD rating. Your PTSD rating remains unchanged; the secondary insomnia rating adds to your overall disability percentage through combined rating calculation. Filing secondary claims is beneficial.

Q: Do I need a sleep study to prove insomnia for VA claim?

A: Not required, but helpful. Sleep studies (polysomnography) showing sleep architecture abnormalities strengthen claims. However, many claims approve without sleep study if medical records clearly document insomnia diagnosis and functional impact. Request sleep study if your case is borderline.

Q: What if I've had insomnia for 20 years but only recently connected it to PTSD?

A: You can still file secondary claim if medical evidence shows PTSD exacerbates longstanding insomnia. Focus claim on worsening related to PTSD rather than initial cause. Timeline showing insomnia worsening coincident with trauma or PTSD diagnosis strengthens nexus.

Q: Can I file secondary insomnia claim on appeal if initially denied?

A: Yes. You have multiple appeal options: Supplemental Claim (submit new evidence), Higher-Level Review (same office, different reviewer), or Board Appeal (appeals court). Supplemental Claims with stronger medical evidence and nexus letters have high approval rates for sleep disorders.

Q: How much back pay will I receive if approved?

A: Back pay covers effective date (usually filing date) through approval. Calculation example: 20% rating = ~$396/month. Approved 4 months after filing = $1,584 retroactive payment. Check VA.gov claim status for estimated award amount.

Q: Should I mention my sleep medication in my claim?

A: Yes, definitely. Include complete sleep medication history: names, dosages, how long used, whether effective. This proves insomnia is medically significant (not just lifestyle issue). Continuous medication use strengthens claims.

Q: Can nightmare disorder be rated separately from insomnia?

A: Nightmare disorder is typically rated as part of PTSD, not separately. However, documenting nightmare disorder specifically strengthens secondary insomnia claims because nightmare-related insomnia is well-recognized PTSD manifestation. Include nightmare documentation in insomnia claim.

Q: What if my insomnia improved with prazosin (sleep medication)?

A: Improvement on PTSD-specific medication (prazosin or other PTSD medications) actually strengthens secondary insomnia claim because it proves insomnia is PTSD-related. Include in nexus letter: "Insomnia responded to prazosin, a PTSD-specific medication, confirming PTSD etiology."

Q: Is insomnia better to claim separately or only as PTSD symptom?

A: Claim insomnia as secondary condition even if documented as PTSD symptom. Separate rating potentially increases overall disability percentage through combined rating formula. File both if insomnia significantly documented as separate functional impairment.

Q: Will VA reduce PTSD rating if insomnia claims are approved?

A: No. VA doesn't reduce primary conditions when secondary claims approved. Your PTSD rating remains stable. Secondary approval only adds additional percentage through combined rating calculation. Filing secondary claims has no risk to existing ratings.

Final Recommendation

Insomnia secondary to PTSD is one of the highest-success secondary disability claims, with approval rates exceeding 80% when properly documented. Unlike many secondary conditions, the medical relationship between PTSD and insomnia is straightforward and well-established in VA precedent and medical literature.

Your claim success depends on:

Clear insomnia diagnosis from medical provider
Documented PTSD-insomnia connection (nightmare disorder, hyperarousal, or hypervigilance)
Strong nexus letter from qualified provider
Objective functional documentation (sleep journal, medication history, work impact)

With these elements, your approval likelihood exceeds 75% in first claim. Even if initially denied, supplemental claims with additional evidence have 85%+ approval rates.

Immediate Action Items:

Begin sleep journal today (document 2-4 weeks before filing)
Request all VA mental health records explicitly mentioning sleep/nightmares
Schedule appointment with VA psychiatrist to request nexus letter
Gather sleep medication history from pharmacy
File claim online at VA.gov within 30 days

The VA's policy supports compensating combat-related sleep disorders. With proper documentation, insomnia secondary to PTSD claims typically succeed. Don't delay—file your claim today.

Next Step: Start your claim at VA.gov. Contact your nearest Veterans Service Organization (VFW, American Legion, DAV) for free assistance if needed. Your insomnia is service-connected; ensure you receive proper compensation.