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Insomnia - Combined Rating

15 posts in this topic

I left the Army in 1995 with 20% lower back, 10% left knee meniscus, and 20% right knee PCL deficiency following surgery (50% total). Last year, I asked for an increase on my left knee, right knee and requested a secondary service connection for insomnia due to chronic pain.

Today, I received a letter stating that they denied any increase for my knees but did grant service connection for my insomnia (it dates back to 1998) and awarded 10%. However, the letter states the VA does a combined rating and will not increase past my 50%.

So what does the 10% service connection for my insomnia mean? I was hoping to get at least a 12 month back dated check for the 10% but it doesn't sound like I will get anything.

If someone could explain how this service connection for insomnia will help me....please let me know.

Also, the way they worded the decision, it makes it sound like I'm lucky they didn't decide to reduce my 50%. Amazing!

Any insight would be helpful!

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The letter states we do no add the individual percentages of each condition to determine your combined rating. Also under the insomnia decision, because apparently my doctor didn't put in there that insomnia effects my employment, it has some significance. Even though I only work one day a week (Part time job) and just recently began seeing a therapist for depression side effects.

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Also, if my insomnia condition continues to worsen....since it is service connected now....could I get that temporary total disability? Could my VA Sleep Doctor request that?

Sorry to keep adding questions...I'm just a bit frustrated with that letter. It didn't come at a good time! :rolleyes:

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Detonator, ratings are awarded in increments of 10% (10%, 20%, 30%, etc.). They are also combined with your other ratings, not parsed out and rated separately, or retroactively. What the VA appears to be stating is that even though they've added 10% for the insominia rating, when combined with your other ratings and compared to the Combined Ratings Table in 38 CFR Part 4, it wasn't enough to increase your ratings or payments. A higher rating might have done so, but again, everything is combined and measured through that Combined Ratings Table. There's a calculator on the home page of hadit. Plug in your ratings for your separate conditions and see what you get.


You can file a Notice of Disagreement, get the doctor to clarify his staement saying that you can't work, and while you're at it, file for TDIU (unemployability). Again, there's a lot of information mentioned on the home page here that should help direct you.

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I would try and work the insomnia and chronic pain into a depression claim. You can get a greater percentage rating for depression than insomnia alone. Are you seeing a psychiatrist about your chronic pain and insomnia. If you can't work file for TDIU. Just about eveyone who has chronic pain does suffer from some depression.

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Detonator, I received the same answer on 7-14-08. MY initial rating for DMI II was 40% and hypertinsion was defered on the initial rating pending an additional C&P exam. I was awarded 10% sc for the hypertinsion but my combined rating remained at 40% ( Quote from th rater. We do not add the indiviual percentages of each condition to determin your combined rating. We use a combined rating table that considers the effect from the most serious to the least serious conditions) The way I understand the rating calculator 50% plus 10% gives you a total rating of 55%. If it had been 55.5% it would have been rounded up to 60% total rating. In my case 40% plus 10% equals 46% rounded up to 50%. I am with you, I don't understand this and I am still looking for an explanation. I am sure someone on HADIT can handle that.

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