“I haven’t slept properly since it happened.”

The two halves

Treatment: yes. Sleep dysfunction arising from an industrial injury is a compensable consequenceCompensable consequence A new problem caused by the original injury or its treatment. Overusing the other side, the joint above or below, a surgical complication., and treatment for it is medical treatment the employer owes. Sleep studies, medication, CBT-I, treatment of the underlying pain that is causing it.

Rating: usually no. The law provides that there shall be no increases in impairment ratings for sleep dysfunction, sexual dysfunction, or psychiatric disorder arising as a compensable consequence of a physical injury, for injuries on or after January 1, 2013.

That is a real loss, and it is worth understanding why it is not the whole story.

The exceptions in (c)(2)

The bar does not apply where the psychiatric injury results from:

• being a victim of a violent act, or direct exposure to a significant violent act; or
• a catastrophic injuryCatastrophic injury Under § 4660.1(c)(2)(B), “including, but not limited to, loss of a limb, paralysis, severe burn, or severe head injury.” Lifts the bar on psychiatric ratings., including but not limited to loss of a limb, paralysis, severe burn, or severe head injury.

These matter more than they look. If your case involves an assault, a violent incident, or a catastrophic injury, the entire analysis changes — and the psychiatric component becomes ratable rather than excluded. What “catastrophic” turns on. · Psychiatric injury.

And for injuries before 2013, § 4660.1 does not apply at all.

Why it still belongs in the record

Even where it adds nothing to the rating, document it.

It supports the pain and function findings that do rate. Sleep disruption is evidence of the severity of the underlying condition, and the Guides care about function.

It supports a treatment claim that has real value over years.

It supports work restrictions, which affect the vocational side of the case and can matter a great deal on a § 4662 or a LeBoeufLeBoeuf The line of authority permitting a 100% finding where a worker cannot compete in the open labor market.-type analysis.

And it is real. Chronic sleep loss affects concentration, mood, pain tolerance, and recovery. A record that omits it describes someone who is not you.

What to actually do

Tell your treating physician specifically — how many hours, how often you wake, what wakes you, how long it has been going on. “I’m not sleeping well” gets recorded as a passing comment. Numbers get recorded as a finding.

Ask whether a sleep study is indicated, particularly where there was a head injury or where breathing is involved.

And if the sleep problem is really an anxiety or trauma problem — which after a serious injury it very often is — that is its own compensable question with its own route. Mental health treatment.