In recent years, both the Veterans Administration (VA) and the Department of Defense (DoD) have emphasized the importance of identifying and treating Post Traumatic Stress Disorder (PTSD) amongst the military population. The DoD now requires mandatory PTSD/mental health screenings for service members returning from overseas deployments and the VA offers free PTSD healthcare for all veterans with honorable service. Thus, it may come as a surprise that while such an emphasis is placed on identifying and treating PTSD, the burden for obtaining VA disability benefits related to PTSD still rests predominantly on the veteran.
The VA considers disabilities related to military service to be “service-connected.” A service-connected disability qualifies the veteran for free VA healthcare and disability benefits. The VA disability system, which is separate and distinct from the VA healthcare system, is very reactive in nature. Even if a veteran receives treatment and care for PTSD at a VA healthcare facility, the VA will not consider or develop the matter of awarding service-connection for PTSD. Instead, the veteran must always take the initial step of completing and submitting a VA disability application. This application may be completed online through the VA’s application system at VA.gov, or via a paper application which is obtainable online or mailed directly to the veteran by calling the VA claims line at 1 (844) 698-2311. While a Veterans Service Organization (VSO) representative, accredited VA agent, or accredited VA attorney may help a veteran complete the application at no cost, VA regulations require that the veteran personally authenticate and sign the application prior to submission.
With a PTSD claim, submission of the application is merely the first step. In nearly all cases, the VA requires the veteran to describe a stressor that occurred while on active duty, and this stressor must then be verified. A stressor is an event or occurrence that serves as the underlying trauma that led to the development of PTSD. This event must be confirmed to have occurred and the veteran must provide details such as the date of the event, unit of assignment, and location where the event occurred to assist the VA in the verification process. The veteran must have personally experienced the stressor event and note that in the application. As an example, a veteran witnessing another service member commit suicide would be a valid stressor for VA purposes, but a service member merely finding out from another individual that the suicide occurred would not be sufficient.
If the veteran deployed to a hostile pay or designated combat area, and the claimed stressor is related to imminent fear of engagement or possible engagement with a hostile military force, then the stressor will be conceded to have occurred and no further verification is required. Similarly, if the veteran was diagnosed with PTSD while on active duty then the stressor will be conceded, and the VA will presume that any later diagnosis of PTSD warrants service connection unless clear unmistakable evidence proves otherwise.
A similar relaxed standard for verification now exists for veterans who claim PTSD related to Military Sexual Trauma (MST), which includes instances such as sexual assault, harassment, or rape. The VA acknowledged that military members who are the victims of MST may be reluctant to report crimes or harassment, and that the military has often poorly investigated instances of sexual misconduct. In cases involving MST, if there is not clear evidence documenting the stressor such as a police report or command investigation, then the veteran may point to “markers” that demonstrate the stressor occurred. Markers are pieces of evidence that tend to show as a whole that the veteran was dealing with trauma as a result of sexual misconduct and may be things such as a sudden decrease in job performance, request for transfer, journal notes or letters, or sudden shifts in personality noted by friends or family. The VA does not have a bright line rule on what may or may not be a marker, so the veteran is encouraged to identify as many possible markers as they can.
Once the veteran has identified at least one valid stressor, and the VA has conceded its occurrence, a Compensation and Pension (C&P) examination will be scheduled with a medical provider. The purpose of the C&P examination is to identify if the veteran’s symptoms meet the diagnostic criteria for PTSD or a related mental disorder. If the veteran does meet the diagnostic criteria, the examiner will then determine if the disorder is related to the claimed stressor and what symptoms are present. The presence of certain symptoms and their impact on the veteran’s occupational and social capabilities is what the VA utilizes to determine what disability rating percentage is assigned. These percentages may range from 0% to 100%.
Once the C&P examination is complete, if the veteran has a diagnosed mental disorder that is related to service the VA will inform the veteran that service-connection for the disability is granted. A disability rating will be assigned for the disability at that time. If the veteran does not have a current diagnosed mental disorder, or it is determined the disorder is not related to military service, then service connection will be denied, and the disability will not be considered disabling for VA purposes. Should a denial of service connection occur, or if the veteran does not feel that the rating assigned properly reflects their level of disability, the veteran may pursue an appeal via: (1) submitting a supplemental claim with new and relevant evidence, (2) requesting that a higher level review of the claim be conducted, or (3) submitting a notice of disagreement to the Board of Veterans Appeals to initiate review from an administrative law judge. Further appeals may also be pursued to the Court of Appeals for Veterans Claims if necessary.
It is important to remember that the VA disability system is confusing and chaotic in nature. Even the most well-prepared claim may experience unexpected problems that require prompt responses and follow ups from the veteran. For any veteran suffering from PTSD, their disability already places them at a disadvantage in this process and it is important that these veterans are encouraged to seek out competent representation to assist them, and that practitioners are willing and able to give back and to assist these veterans who have already given so much.
Paul Jennings is an accredited attorney authorized to appear before the Veterans Affairs Administration, Board of Veterans Appeals, and Court of Appeals for Veterans Claims. He is also a disabled U.S. Army veteran with three combat deployments to Iraq. He is licensed in Washington and Florida.