Insomnia: what evidence wins at the Board

For insomnia appeals, how often the Board granted the issue when the record held each kind of evidence, and how often when it did not. Measured from the decisions themselves; every number carries its fraction.

What this is computed from: evidence types detected in the full text of 1,929,585 public Board of Veterans' Appeals decisions (va.gov/vetapp), joined to the issue-level outcome. The tables use only single-issue decisions with a clean parse in complete crawl years (1992–2025) — 971,127 decisions — so each evidence flag attaches to exactly one decided issue. A split is shown only when both sides have at least 30 decisions. Every count opens its decisions in the Board decision finder, with links to the full text on va.gov. Data build: 2026-10-16.

Service connection for Insomnia (n = 375)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
A medical source gave a positive nexus opinionEvidence in the record65% (20/31)38% (71/188)+27 pts14% (5/36)
Private physician opinion, letter or DBQEvidence in the record55% (17/31)39% (74/188)+15 pts26% (11/43)
Service treatment records document the condition or injuryEvidence in the record50% (30/60)38% (61/159)+12 pts23% (18/78)
Service treatment records silent for the conditionEvidence in the record34% (26/76)45% (65/143)-11 pts8% (7/83)
Continuity of symptoms argued (38 CFR 3.303(b))Theory argued41% (19/46)42% (72/173)-0 pts16% (9/55)
Board hearing held or testimony takenProcedure44% (35/79)40% (56/140)+4 pts31% (37/120)
Medical literature or treatise citedEvidence in the record56% (19/34)39% (72/185)+17 pts35% (18/52)
Presumptive service connection discussedTheory argued32% (22/69)46% (69/150)-14 pts12% (9/78)
Secondary service connection (38 CFR 3.310) in playTheory argued44% (49/111)39% (42/108)+5 pts30% (49/162)
Combat service / 1154(b) in playTheory argued48% (15/31)40% (76/188)+8 pts11% (4/35)
A medical source gave a negative nexus opinionEvidence in the record53% (44/83)35% (47/136)+18 pts33% (41/124)
Board found a VA exam or opinion inadequateHow the Board read the record65% (26/40)36% (65/179)+29 pts56% (51/91)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record97% (33/34)31% (58/185)+66 pts3% (1/35)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record2% (2/88)68% (89/131)-66 pts0% (0/88)

"Granted" = share of issues decided on the merits (granted + denied); remands and dismissals are excluded from that fraction and shown separately. Fractions are the raw counts.

All Insomnia issues, every benefit type (n = 579)

When the record had…Granted, with itGranted, without itDifferenceRemanded, with it
A medical source gave a positive nexus opinionEvidence in the record65% (26/40)38% (115/304)+27 pts11% (5/45)
Private physician opinion, letter or DBQEvidence in the record51% (25/49)39% (116/295)+12 pts18% (11/61)
Service treatment records document the condition or injuryEvidence in the record52% (34/66)38% (107/278)+13 pts22% (19/87)
Service treatment records silent for the conditionEvidence in the record36% (28/78)42% (113/266)-7 pts9% (8/86)
Continuity of symptoms argued (38 CFR 3.303(b))Theory argued40% (19/47)41% (122/297)-1 pts16% (9/56)
Board hearing held or testimony takenProcedure49% (50/103)38% (91/241)+11 pts31% (51/164)
Medical literature or treatise citedEvidence in the record51% (19/37)40% (122/307)+12 pts36% (21/58)
Presumptive service connection discussedTheory argued31% (22/70)43% (119/274)-12 pts11% (9/79)
Secondary service connection (38 CFR 3.310) in playTheory argued43% (61/141)39% (80/203)+4 pts27% (56/205)
Combat service / 1154(b) in playTheory argued43% (18/42)41% (123/302)+2 pts11% (5/47)
A medical source gave a negative nexus opinionEvidence in the record52% (46/89)37% (95/255)+14 pts33% (43/132)
VA examination or VA medical opinion obtainedEvidence in the record39% (120/305)54% (21/39)-15 pts30% (136/446)
Board found a VA exam or opinion inadequateHow the Board read the record56% (28/50)38% (113/294)+18 pts55% (63/115)
Board found the veteran's statements credibleHow the Board read the record53% (16/30)40% (125/314)+14 pts3% (1/31)
Benefit of the doubt resolved in the veteran's favorHow the Board read the record94% (44/47)33% (97/297)+61 pts2% (1/48)
Preponderance of the evidence against / doctrine not applicableHow the Board read the record6% (8/132)63% (133/212)-57 pts0% (0/132)
Board ordered a new exam or addendum opinionProcedure37% (13/35)41% (128/309)-4 pts80% (136/171)
AMA favorable finding acknowledgedProcedure64% (21/33)39% (120/311)+25 pts23% (10/44)

"Granted" = share of issues decided on the merits (granted + denied); remands and dismissals are excluded from that fraction and shown separately. Fractions are the raw counts.

Reading these tables honestly

Association, not cause. A positive nexus opinion appears in the records of granted appeals far more often than in denied ones. That does not mean any letter wins; it means the Board grants when the evidence supports the claim, and a nexus opinion is how that support usually reaches the file.

Appeals are not claims. Every decision here is an appealed denial. Grant rates at the Board say nothing about the share of initial claims VA grants.

Findings are outcomes in disguise. Rows under "how the Board read the record" — credibility, benefit of the doubt, an inadequate exam — describe how the judge decided, not evidence to gather. They are shown because they say which arguments the Board actually reaches for.

Detection is by text pattern. Each evidence type is found by reading the decision for finding-shaped language with negation handling; precision was read on samples before publication and is stated per feature in the method notes below. Expect a few percent of misclassified rows, not zero.

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