SLEEP DISTURBANCE

GAYLE STROMMEN · 2026 · Case ID: A26028998

DENIED

Summary

The Veteran, who served in the U.S. Navy from June 1989 to November 1993, appeals the denial of an increased disability rating for insomnia. The Agency of Original Jurisdiction (AOJ) had previously granted service connection for insomnia with a 10 percent rating effective October 28, 2020. The Veteran sought a higher rating for the period from October 28, 2020, to June 20, 2024. The Board of Veterans' Appeals reviewed the evidence of record prior to the AOJ's April 2021 rating decision and any evidence submitted within 90 days of the Veteran's hearing withdrawal. The Veteran did not submit additional evidence pertaining to insomnia symptoms after 2021. A VA examination in March 2021 diagnosed insomnia with chronic sleep impairment, concluding it caused mild or transient symptoms affecting work efficiency only during significant stress or when symptoms were controlled by medication. The Veteran reported positive social interactions and engagement in hobbies like camping and boating, though he noted occasional irritability due to fatigue. He also reported a history of multiple jobs and owning his own business. The Board found the VA examiner's assessment highly probative, noting the absence of symptoms meeting higher rating criteria. The Veteran's reported social functioning, employment history, and recreational activities did not demonstrate more than mild or transient symptoms. Therefore, the Board denied an increased rating beyond 10 percent for the period under review, finding the evidence did not support a higher evaluation.

Rationale

No treatment records during appeal period.; VA examiner diagnosed insomnia with chronic sleep impairment.; Examiner concluded mild/transient symptoms affecting work efficiency only during significant stress or when controlled by medication.; Veteran reported positive social functioning and employment history.; Veteran reported occasional irritability due to fatigue but did not identify limitations meeting higher rating criteria.; Board found VA examiner's assessment highly probative.; Evidence did not show symptoms equating to higher rating criteria.

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210723-174412

Full Decision Text

Citation Nr: A26028998
Decision Date: 03/31/26 Archive Date: 03/31/26

DOCKET NO. 210723-174412
DATE: March 31, 2026

ORDER

Entitlement to a disability rating in excess of 10 percent for insomnia from October 28, 2020 to June 20, 2024, is denied.

FINDING OF FACT

For the period from October 28, 2020 to June 20, 2024, the Veteran's insomnia more nearly approximated the criteria for a 10 percent rating with occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.

CONCLUSION OF LAW

The criteria for entitlement to a disability rating in excess of 10 percent for insomnia for the period from October 28, 2020 to June 20, 2024 have not been met. ?38?U.S.C. §§?1155, 5107;?38?C.F.R. §§?4.1-4.7, 4.125, 4.126, 4.130, Diagnostic Code 9440.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service in the U.S. Navy from June 1989 to November 1993.

The Appeals Modernization Act (AMA) creates a new framework for Veterans dissatisfied with Department of Veterans Affairs' (VA) decision on their claim to seek review.? The AMA applies to all?initial?decisions issued after February 19, 2019.??

This appeal comes to the Board of Veterans' Appeals (Board) from an April 2021 rating decision issued by the Agency of Original Jurisdiction (AOJ).? The Veteran timely appealed this rating decision to the Board in a February 2021 VA Form 10182 Notice of Disagreement and chose the hearing option.? However, the Veteran withdrew his request for a hearing on November 12, 2024. Accordingly, the Board may consider the evidence of record at the time of the April 2021 rating decision and any evidence submitted by the Veteran or his representative within 90 days following his hearing withdrawal request. 38?C.F.R. §?20.302(b).

Evidence was added to the claims file after the evidentiary window closed. As the Board is deciding the Veteran's increased rating claim, it may not consider this evidence in its decision. 38 C.F.R. § 20.300. The Veteran may file a Supplemental Claim and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Increased Rating

Disability ratings are determined by evaluating the extent to which a Veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing the symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). 38?U.S.C. §?1155; 38?C.F.R. §§?4.1, 4.2, 4.10.

In evaluating a disability, the Board considers the current examination reports in light of the whole recorded history to ensure that the current rating accurately reflects the severity of the condition. The Board has a duty to acknowledge and consider all regulations that are potentially applicable. Schafrath v. Derwinski, 1?Vet. App.?589 (1991). The medical, as well as industrial history is to be considered, and a full description of the effects of the disability upon ordinary activity is also required. 38?C.F.R. §§?4.1, 4.2, 4.10.

Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. See 38?C.F.R. §?4.7. Reasonable doubt regarding the degree of disability will be resolved in the Veteran's favor. 38?C.F.R. §?4.3. Separate ratings can be assigned for separate periods of time based on facts found, a practice known as "staged" ratings. Hart v. Mansfield, 21?Vet. App.?505.

Pyramiding, which is the evaluation of the same disability or the same manifestation of a disability
is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. See 38?C.F.R. §?4.7. Reasonable doubt regarding the degree of disability will be resolved in the Veteran's favor. 38?C.F.R. §?4.3. Separate ratings can be assigned for separate periods of time based on facts found, a practice known as "staged" ratings. Hart v. Mansfield, 21?Vet. App.?505.

Pyramiding, which is the evaluation of the same disability or the same manifestation of a disability under different diagnostic codes, is to be avoided when evaluating a Veteran's service-connected disability. 38 C.F.R. § 4.14.

When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a Veteran prevailing in either event, or the evidence is persuasively against a claim, in which case, the claim is denied. 38?U.S.C. §?5107 (b); 38?C.F.R. §?3.102.

1. Entitlement to an increased rating for insomnia

In April 2021, the AOJ granted service connection for the Veteran's insomnia and awarded a 10 percent rating effective October 28, 2020, the date the Veteran's intent to file form was received. Accordingly, the appeal period begins on October 28, 2020. 38 C.F.R. § 3.400(o).

During the course of his appeal, the Veteran filed additional increased rating claims for insomnia. The AOJ awarded a rating of 30 percent from June 20, 2024, and a rating of 70 percent from February 23, 2026. The Board will not address higher ratings for these periods, as the Board's review is limited to evidence on record prior to the rating decision on appeal and any evidence submitted by the Veteran within 90 days of the hearing withdrawal request. Here, the Veteran did not submit any evidence pertaining to symptoms or limitations from insomnia after 2021.

Under the General Rating Formula for Rating Mental Disorders, a 10 percent rating is assigned when a Veteran's psychiatric disability causes occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.

A 30 percent rating is assigned when a veteran's psychiatric disability causes occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).

A 50 percent rating is assigned when a veteran's psychiatric disability causes occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short-term and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; or difficulty in establishing and maintaining effective work and social relationships.?38?C.F.R. §?4.130.??

A 70 percent evaluation is warranted when there is occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse?control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting?to stressful circumstances (including work or a work-like setting); and inability to establish and maintain effective relationships.?38?C.F.R. §?4.130.??

The maximum schedular rating of 100 percent is warranted when there is total occupational and social impairment due to such symptoms as gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of close relatives, own occupation or own name.?38?C.F.R. §?4.130.??

In addition,
appearance and hygiene; difficulty in adapting?to stressful circumstances (including work or a work-like setting); and inability to establish and maintain effective relationships.?38?C.F.R. §?4.130.??

In addition, when evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the lengths of remissions, and the Veteran's capacity for adjustment during periods of remission.?38?C.F.R. §?4.126 (a).? The rating agency shall assign an evaluation based on all evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability?at the moment?of the examination.?Id.?However, when evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment but shall not assign an evaluation?on the basis of?social impairment.?38?C.F.R. §?4.126 (b).??

Analysis

There is no record of treatment during the appeal period. However, the Veteran was provided with a VA examination to assess his psychiatric disability in March 2021. The VA examiner provided a sole diagnosis of insomnia and identified chronic sleep impairment as the Veteran's only symptom. The examiner further concluded that the Veteran's insomnia causes occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication.

With respect to his social functioning, the Veteran reported that he has friends and gets along with superiors. He indicated that he has been in a relationship with a woman for over three years. He noted that he has one son and two stepsons, and he remains in contact with them. He reported that he likes to camp, boat, and go snowmobiling. Concerning his interactions, he reported that he has a lack of patience and gets snippy with others due to fatigue.

With respect to his occupational functioning, he reported that he has always had more than one job. He indicated that he has a plumber's license, he is in the pipefitter's union, and he has his own inspection business.

On examination, the Veteran was oriented to person, place, and date. He exhibited good grooming, hygiene, and eye contact. His speech appeared normal and his thought processes appeared coherent and logical. He did not endorse delusions, suicidal ideation, or homicidal ideation. His mood appeared agitated and annoyed.

Based on the foregoing, the Board finds that a disability rating in excess of 10 percent is not warranted, as the evidence does not show that the Veteran's insomnia causes more than mild or transient symptoms.

In reaching this conclusion, the Board notes that the VA examiner did not conclude that the Veteran was more limited or identify symptoms in the higher rating criteria. Additionally, the record includes no statements from the Veteran or treatment records documenting additional symptoms. The Board acknowledges the Veteran's reports or irritability due to fatigue. However, he did not identify any limitations in the higher rating criteria caused by this symptom. Thus, the Board finds that the VA examiner assessment is highly probative.

Additionally, the Board finds that the Veteran's symptoms do not equate in severity, frequency, and duration to cause more than mild or transient symptoms during the period on appeal. As noted, the Veteran reported that he has relationships with a variety of people, including superiors, friends, a romantic partner, and his son. He also reported working numerous jobs, including owning his own business. Furthermore, he reported that he engages in activities such as camping, boating, and going snowmobiling. This evidence further demonstrates that the Veteran does not experience more than mild or transient symptoms from insomnia during the period on appeal. Thus, the Board finds that a rating higher than 10 percent is not warranted from October 28, 2020 to June 20, 2024.

Additionally, the Board finds that entitlement to a total disability rating based on individual unemployability (TDIU) has not been raised by the record. The Veteran has not claimed that he is unable to secure or follow substantially gainful employment due to his insomnia. On the contrary, he indicated that he has always had more than one job.

he reported that he engages in activities such as camping, boating, and going snowmobiling. This evidence further demonstrates that the Veteran does not experience more than mild or transient symptoms from insomnia during the period on appeal. Thus, the Board finds that a rating higher than 10 percent is not warranted from October 28, 2020 to June 20, 2024.

GAYLE STROMMEN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Beech, Tara M.

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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