7 Most Common Disabilities Among Women Veterans
U.S. Women Veterans Statistics
Women comprise approximately 14.5 percent of the active duty military force and almost 18 percent of National Guard and Reserves. As the number of women in the military increases, so does the number of women veterans. Specifically, women make up the fastest growing population of veterans in the United States, totaling approximately 2 million (i.e., 10 percent of the veteran population) as of 2017. According to a 2015 study, it was anticipated that the number of women veterans would increase by about 18,000 over the next ten years. This would raise the percentage of women veterans from 10 to 16.3 percent of all living veterans.
It is also interesting to note that the population of women veterans is very young. About 80 percent of the women veteran population is between the ages of 25 and 64. We are also seeing that more than half of them served during the Gulf War Era.
Women Veterans and Disability Statistics
As of 2018, there were approximately half a million disabled women veterans in the United States. That comprises about 23 percent of all veterans with a service-connected condition(s). That number increased about 30,000 in 2018 alone. Furthermore, 54 percent of those women have a service-connected condition(s) that is rated 50 percent or above. Interestingly, 3 percent more women veterans have a service-connected condition as compared to male veterans.
The top seven conditions affecting women veterans that are described below account for 33 percent of all service-connected conditions in women veterans.
Most Common VA Disabilities for Women Veterans
1. Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder is a mental health condition that develops in some people who have experienced a shocking, scary, or dangerous event. While it is natural to experience a range of reactions after a traumatic incident, most people recover from initial symptoms over time. Those who continue to experience problems may be diagnosed with PTSD. Symptoms of PTSD usually begin within three months of the traumatic incident, but sometimes they begin years afterwards. Specific diagnostic criteria for PTSD are divided into different types of symptoms, including the following: (1) re-experiencing symptoms; (2) avoidance symptoms; (3) arousal and reactivity symptoms; and (4) cognition and mood symptoms.
PTSD accounts for 12 percent of all service-connected conditions among women veterans, totaling about 48,000 women. Women veterans may experience some sort of stressor in service that can be due to combat or some other stressful experience.
Military Sexual Trauma (MST) and PTSD
Unfortunately, many women veterans develop PTSD as the result of military sexual trauma (MST). It becomes challenging for women veterans to prove claims for PTSD because VA requires credible supporting evidence of the in-service stressor. Some stressors are documented in veterans’ service and treatment records. However, it is unlikely that MST-related stressors would be documented as not many women report the incidents.
VA will require something other than women veterans’ own statements to show that they experienced MST during service. In order to prove your stressor in that case, you will likely need lay statements from friends, family, or other veterans you served with. Additionally, you can look for behavioral markers in your service records – that is, certain events or incidents showing that there was some sort of behavioral change during service. Perhaps prior to the reported MST, your performance was very good and you did not have many problems. However, after the stressor, you can see in your personal records that your performance started to decline. These behavioral markers can be very helpful in claims for PTSD related to MST.
VA’s History of Adjudicating Claims for PTSD Due to MST
Historically, claims based on MST have been disproportionately denied. In November 2013, the American Civil Liberties Union (ACLU) and the Service Women’s Action Network (SWAN) published a study that showed that VA was granting PTSD based on MST at significantly lower rates every year from 2008 to 2012. Furthermore, there were 10 percentage points between the denial rates of PTSD claims for men and for women, which is a staggering difference. Shortly after that study was published, VA did make some internal changes to their training and claims processing procedures. For some time, it appeared as though MST claims were going to be handled better. However, in 2018, VA’s own Office of Inspector General (OIG) found that there were still many problems with the processing of PTSD claims based on MST.
Specifically, the OIG found that half of MST claims were improperly processed. Adjudicators’ lack of specialized training on MST claims was one of the main reasons for this problem, despite the fact that such training was part of VA’s initiative following the ACLU and SWAN report. VA was marking veterans’ claims as contradictory without doing any type of clarification or follow up. Hopefully, such issues will be resolved soon.
2. Musculoskeletal Conditions of the Back
Musculoskeletal conditions of the back are some of the most common disabilities among women veterans. In 2015, about 58 percent of women were treated for musculoskeletal conditions of the back whereas only about 47 percent of men were being treated for these conditions. There are three different back conditions that are most often seen in women.
Cervical or Lumbosacral Strain
Generally speaking, cervical or lumbosacral strains are microscopic tears of the muscles in the tendons, typically caused by overuse. VA will rate this condition based on range of motion testing by looking at how much you can bend forwards, backwards, or side to side.
Intervertebral Disc Syndrome
Intervertebral disc syndrome occurs when the discs between the vertebrae start to break down. It is usually made worse when there is prolonged sitting and standing, and bending down. This condition is rated a little differently than the cervical or lumbosacral strain. Specifically, this condition is rated based on incapacitating episodes (i.e., periods of time that require bedrest). However, if range of motion testing would result in a higher rating, VA will rate the condition based on range of motion.
Degenerative Arthritis of the Spine
The third most common back condition that affects women veterans is degenerative arthritis of the spine, which involves the breakdown of the cartilage between the joints and the discs in the neck and back. Again, this is caused by overuse, repetitive stress on the back, and it is another very common cause of pain.
VA C&P Exams for Back Conditions
As mentioned above, VA does largely rate back conditions based on range of motion testing, which will be performed at a Compensation & Pension (C&P) exam. The examiner will be asking you to complete a series of physical tests, including bending forwards, backwards, and side to side. Importantly, examiners should also be looking at things like how severe your condition is during flare-ups, or with repetitive use over time. They should be asking you questions about how it affects your daily life and how severe it is on a day to day basis. It is important to be honest about your symptoms. Veterans should not over-exaggerate symptoms or diminish what they are experiencing. It is critical for the examiner to have a good understanding of your disability as VA does rely on the examiner’s findings when making decisions on claims for benefits.
3. Major Depressive Disorder (Depression)
Major depressive disorder is actually the second most common service-connected condition among female veterans. Women veterans are 1.7 times more likely to experience major depression as compared to their male counterparts. Right now, there are 26,500 cases of depression among women veterans. It is understandable that depression is associated with military service because a lot of times, people are separated from their families for long periods of time, undergo multiple deployments, and feel isolated from their support systems. Women experience these problems, but women also face issues with harassment from their peers and superiors at disproportionate rates.
Importantly, claims for depression are different from claims for PTSD insofar as you do not need a stressor. Nonetheless, it is helpful for women veterans to look for documentation in their service treatment records that may show their depression began during service. For example, if a veteran sought treatment or disclosed to a doctor in service that she was experiencing feelings of depression, it can be used as evidence. Many times, people do not seek treatment until many years after service. In those cases, you can submit lay statements from yourself or anybody else who has personal knowledge of the onset and progression of your symptoms.
4. Migraine Headaches
Migraine headaches can be very severe and often come with many residual issues. When someone experiences a migraine, they usually also experience photosensitivity (i.e., sensitivity to light), noise sensitivity, nausea, vomiting, lightheadedness, etc. Currently, about 24,000 women veterans are receiving VA disability benefits for migraines. Some of the most common reasons that migraines are related to service involve other primary conditions. Namely, migraines are often secondary to other service-connected conditions. For example, veterans with neck conditions sometimes develop issues with headaches as well.
How VA Rates Migraines
When VA is rating migraine headaches, it is looking at how prostrating the attacks are. Here, prostrating is essentially referring to how debilitating it is. Again, lay statements are going to be one of the most important pieces of evidence in migraine claims. In these statements, veterans can describe how severe their symptoms are and talk about the things they are not able to do when they have migraines. VA considers whether the migraines affect veterans to the point where they cannot complete their normal activities of daily living, such as cooking, cleaning, or working. As such, talking about how severe the migraines are, how they prevent you from doing those day to day things, and how frequently they occur may be beneficial.
5. Gynecological Conditions
The VA Schedule for Rating Disabilities (VASRD) recognizes a variety of gynecological conditions including endometriosis, polycystic ovarian syndrome, female sexual arousal disorder, and more. Importantly, gynecological conditions do not have to be related to a specific in-service event or injury to receive service connection. Instead, as long as the gynecological condition first began in service, then that is enough to establish service connection. Most of these conditions cannot be rated higher than 30 percent. This could be due to the fact that VA has not had a ton of experience related to these types of issues, since women have not been in the VA benefits system for very long. Hopefully, this area will continue to grow and develop in order to become more representative of the wide-ranging severity of these types of conditions.
How Gynecological Conditions Can Result from Military Service
It is possible that a veteran experienced a traumatic injury that results in damage to the ovaries or uterus. However, as indicated above, gynecological conditions do not have to be related to a specific in-service event or injury. Another thing to keep in mind is that Gulf War veterans who experience unexplained gynecological issues (i.e., symptoms cannot be attributed to a known diagnosis), are entitled to service connection on a presumptive basis. Essentially, the law will presume that since the condition cannot be explained, it has something to do with possible exposures in the Persian Gulf. Ultimately, if the gynecological condition began during service, service connection may be warranted.
In Vitro Fertilization (IVF) Benefits for Women Veterans with Service-Connected Gynecological Conditions
Recently, VA has approved paying for in vitro fertilization (IVF) for veterans who suffer from fertility issues as a result of a service-connected gynecological condition. This is a major breakthrough as many women veterans suffer from fertility issues due to their service-connected gynecological conditions and previously could not find any help from VA in starting a family.
6. Bronchial Asthma
Another common condition among women veterans is bronchial asthma. It is currently estimated that over 10,000 women veterans are diagnosed with bronchial asthma and actually receive VA disability benefits. The high rate of bronchial asthma may also be due to women veterans’ service in the Gulf War as they are exposed to environmental toxins causing respiratory symptoms. Again, if their bronchial asthmas has unexplained etiology or pathophysiology, service connection should be presumed. The rates of bronchial asthma among women veterans may also be due to post-9/11 service in the South West Asia theatre of operations. Here, many veterans were exposed to burn pits and inhaled various toxins, carcinogens, smoke, and particulate matter, which can cause many other respiratory issues as well.
How to Prove Burn Pit Exposure
Service records can be really helpful in proving exposure to burn pits. If you have service records that place you in a location where burn pits operated, you can make an argument for service connection based on exposure. Additionally, lay evidence can be really important in these cases. Specifically, if you were exposed to burn pits, having lay evidence discussing how you were exposed to those burn pits, how frequently you were exposed, and how close you were to them, can be really beneficial.
Tinnitus is a hearing condition marked by near-constant ringing in your ears. Many veterans file claims for tinnitus in conjunction with claims for hearing loss. If service connection for hearing loss has been granted, tinnitus is usually granted as well. However, tinnitus is most commonly rated at 10 percent because that is the highest schedular rating for the condition. There are exceptions to that in really extraordinary circumstances; however, it is really difficult to prove and unlikely to succeed in most cases.
It is common for VA to deny service connection for tinnitus by stating that the veteran did not start experiencing it until many years after service. However, this reasoning on its own is not enough to deny service connection. There is a lot of emerging research saying it is possible that the type of noise exposure that veterans receive in service can affect the nerves inside the ear in such a way that it does not actually register until many years later.
Secondary Conditions Due to Tinnitus
It is important to note that sometimes the veteran’s tinnitus is so extraordinary that it leads to depression or anxiety. In these cases, it is possible to get secondary service connection for the mental health condition. Veterans must provide evidence showing that their mental health condition is caused or aggravated by their tinnitus.
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