How the VA Rates Narcolepsy

Excessive daytime sleepiness, falling asleep at the drop of a hat, and waking up frequently throughout the night are tell-tale signs of the sleep disorder narcolepsy. An estimated 135,000-200,000 people in the U.S. have narcolepsy, including many veterans.  

If you suspect your narcolepsy is related to your military service, you might qualify for a narcolepsy VA rating.  This article describes what narcolepsy is, how to service connect your disability, and the VA rating for narcolepsy.

What is narcolepsy?

Narcolepsy is a chronic sleep disorder characterized by the loss of control over when you fall asleep and excessive sleepiness during the day, making it a challenge to live a normal life. People with narcolepsy fight the urge to sleep or try to stay active, but still fall asleep, usually for a short period of time.

Other symptoms of narcolepsy include:

• Excessive daytime drowsiness
• Difficulty keeping awake
• Frequent night wakings
• Hallucinations
• Not being able to move when you are awake (Sleep paralysis)
• Cataplexy – loss of muscle control or unexpected muscle weakness

Narcolepsy can be a dangerous sleep disorder that negatively affects your family life, work, and overall quality of life. 

Types of narcolepsy

There are two types of narcolepsy depending on whether or not you have cataplexy. 

• People with narcolepsy type 1 have cataplexy, a sudden loss of muscle tone that mirrors the way the body keeps you from moving during sleep and acting out your dreams. It can be triggered by strong emotions like surprise or fear, though cataplexy is most often caused by positive behaviors like laughing. Cataplexy can be mild, only affecting your face and neck, or severe. Severe cataplexy can cause you to suddenly collapse to the ground. 
• People with narcolepsy type 2, the most common form of the disorder, do not experience cataplexy.

Causes of narcolepsy

Most cases of narcolepsy are diagnosed in a person’s 20s, 30s, or 40s. However, symptoms can begin in the teen years. Although the exact cause of narcolepsy isn’t known, medical professionals believe it’s often caused by a lack of hypocretin in the brain, which regulates wakefulness.

Possible triggers of narcolepsy include:

• Changes in hormone levels 
• Severe physiological stress
• Swine flu 
• Flu vaccine (Pandemrix)
• Genetics
• Sudden changes in patterns of sleep 

Secondary narcolepsy could also develop after:

• Multiple sclerosis (MS)
• A head injury or traumatic brain injury (TBI)
• Encephalitis
• A brain tumor

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Narcolepsy in veterans

Narcolepsy is considered a relatively rare disorder, and little research has been done on narcolepsy among veterans. However, we do know sleep disorders are common in veterans and can develop from stressful military work situations, irregular work hours being required to stay awake and alert for long periods of time in combat situations, and a general disturbance of their body’s natural sleep cycle.

The combined effects of narcolepsy can dramatically affect a veteran’s ability to work and live a normal life. Because of this, regardless of when you were diagnosed with narcolepsy, if the condition can be service-connected, you are owed VA disability compensation. If your claim for VA benefits for narcolepsy is granted, you could receive more than $3,831.30 per month. 

VA disability lawyer Zack Evans explained, “Narcolepsy onset usually occurs between 10 and 30 years old. Think about the significance of that. Usually, that’s the age in which someone is serving in the military. So it’s not uncommon that when we do see a narcolepsy case, the onset occurs while they’re serving in the United States Armed Forces.”

Narcolepsy VA rating

If you’re a veteran dealing with narcolepsy that’s related to your military service, you deserve disability compensation. The VA rates narcolepsy using the General Rating Formula for Major and Minor Epileptic Seizures. The narcolepsy VA rating you’re assigned depends on the severity and frequency of your symptoms.

Below is a chart describing the rating criteria for narcolepsy: 

General Rating Formula for Major and Minor Epileptic Seizures	VA Rating	Monthly payment (vet only)
Averaging at least 1 major seizure per month over the last year	100%	$3,831.30
Averaging at least 1 major seizure in 3 months over the last year; or more than 10 minor seizures weekly	80%	$2,044.89
Averaging at least 1 major seizure in 4 months over the last year; or 9–10 minor seizures per week	60%	$1,395.93
At least 1 major seizure in the last 6 months or 2 in the last year; or averaging at least 5 to 8 minor seizures weekly	40%	$774.16
At least 1 major seizure in the last 2 years; or at least 2 minor seizures in the last 6 months	20%	$346.95
A confirmed diagnosis of epilepsy with a history of seizures	10%	$175.51

As you look over the chart, also keep these notes in mind:

• The VA characterizes a major episode by the generalized tonic-clonic convulsion with unconsciousness. (The term “tonic” is the loss of consciousness, and the term “clonic” refers to convulsions, or muscles contracting involuntarily). 
• Minor episodes are considered brief interruptions in consciousness or conscious control. During these minor episodes, the veteran may stare, blink rhythmically, nod their head, or make jerking movements. They may also have trouble staying standing. 
• If continuous medication is necessary for the control of episodes, the minimum rating you should receive is 10%. If a veteran has both major and minor episodes, the VA rates the predominating type. There is no distinction between major episodes that occur during daytime and nighttime. 

Service connecting narcolepsy 

When you file a claim for a VA rating for narcolepsy, a VA adjudicator will be looking for proof that your condition is connected to your military service. You’ll also probably have to go through a sleep study to measure the quality of your sleep.

To prove there’s a service connection between your narcolepsy and your time in service, you must show proof of:

• a current narcolepsy diagnosis from a medical professional
• an event, injury, or illness that you experienced during your time in the service 
• a medical link between your narcolepsy diagnosis and the event, injury, or illness  

“We’re looking for disciplinary violations,” explained VA-accredited attorney Zack Evans. “Were you falling asleep in the mess hall? Were you late to Reveille? Did you fall asleep on watch? These disciplinary records from command can be a good signpost that we found something related to a sleep disorder. And if it’s uncontrolled sleep onset, and you were later diagnosed with narcolepsy after you left service, that’s good evidence of onset.”

A veteran could also prove a secondary connection if an additional condition such as stroke,  diabetes, or hypertension was caused or worsened by their service-connected narcolepsy.

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TDIU for narcolepsy

Veterans with narcolepsy may experience performance issues at work that could lead to increased safety risks. Poor quality of sleep at night sometimes leads to increased tardiness, and a lack of attention throughout the workday. Suddenly falling asleep at work could cause serious physical harm to yourself and others.  

VA disability lawyer Zack Evans said, “Narcolepsy is a somewhat rare disorder, but you are not alone. Vets can win service connection for this. And if that happens, from my perspective, that’s in the ball game of TDIU because you’re nearly unable to work in any capacity. It doesn’t matter whether it’s a factory and you fall asleep on the factory production line, which for obvious reasons is a danger, or if you’re in an office setting and you cannot stay awake at a keyboard at a computer.”

For veterans who are unable to maintain “substantially gainful employment” due to a service-connected disability, total disability based on individual unemployability (TDIU) benefits may be available.  TDIU pays veterans the same monthly compensation as a 100% rating does, even if your disability rating is less than 100%. 

Veterans will typically be eligible for TDIU if they have:

• At least one service-connected disability rated at 60% or more disabling OR
• Two or more service-connected disabilities with at least one rated at 40% or more disabling and a combined rating of 70% or more

How Woods and Woods can help

Woods and Woods has been fighting for people with injuries and disabilities since 1985. Our team of accredited VA disability lawyers, case managers, legal analysts, and intake specialists knows the ins and outs of the VA so you don’t have to do all the hard work. Call us today for your free and confidential case evaluation. 

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