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How to Prove PTSD to VA

June 16, 2019
How to Prove PTSD to VA

Post-traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur in people who have experienced or witnessed a distressing, shocking, or otherwise traumatic event.  Unfortunately, many veterans experience PTSD stemming from their military service.  The symptoms of PTSD can often be very debilitating and have a negative impact on an individual’s daily life.  When assigning a disability rating for PTSD, VA will consider the frequency, duration, and severity of your symptoms along with the resulting level of social and occupational impairment.  In other words, your disability rating reflects how you are affected both in your personal life and your work life.  Generally, the more severe your symptoms are, the higher your rating will be.

To determine your disability rating for PTSD, VA uses the General Rating Formula for Mental Disorders under 38 CFR § 4.130.  This rating scale ranges from 0 percent to 100 percent with in-between ratings of 10, 30, 50, and 70 percent.  However, before you receive a disability rating, you must establish service connection for PTSD.  This process can often be very challenging for veterans.

Establishing Direct Service Connection for PTSD

To prove PTSD to VA and establish direct service connection, veterans must satisfy the following elements:

A Current Diagnosis of PTSD

It is important to note that veterans will not be eligible to receive VA disability benefits if they are not currently diagnosed with PTSD.  For service connection purposes, VA requires a formal diagnosis from a qualified healthcare professional, whether it be a therapist, psychiatrist, or general practitioner, made using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).

In-service Stressor

The traumatic event or incident that caused the veteran’s PTSD is known as a “stressor.”  Generally speaking, the occurrence of the stressor should be consistent with the circumstances of the veteran’s service.  In some cases, veterans will have to provide VA with evidence to corroborate the reported stressor.  Corroborating evidence involves evidence from a source other than the veteran, supporting the fact that the claimed in-service stressor occurred.  Such evidence can include buddy statements, military records, newspaper articles, police reports, and more.  However, there are also circumstances in which veterans do not have to provide stressor corroboration:

Combat Exposure

If a veteran’s stressor is related to combat, VA has specific regulations for how it adjudicates the veteran’s PTSD claim.  Specifically, if the veteran’s stressor stems from their time in combat, VA should presume that their PTSD is a result of their combat service and award service connection.

Fear of Hostile Military or Terrorist Activity

In this case, a lay statement may be helpful to outline the circumstances surrounding the veteran’s fear of hostile military or terrorist activity.  Again, the veteran’s report should be consistent with the circumstances, places, and type of service.  For these types of stressors, veterans will usually need a qualified healthcare professional to determine that their diagnosed PTSD is the result of the fear of hostile military or terrorist activity; however, no other stressor corroboration is needed.

Prisoner of War

A prisoner of war is somebody who was forcibly detained in the line of duty by an enemy government or hostile force.  For prisoners of war with PTSD, a lay statement alone is sufficient to prove their in-service stressor to VA.  From there, service connection should be presumed.

Military Sexual Trauma (MST)

Military sexual trauma (MST) involves an incident in service in which a servicemember is physically assaulted, or is a victim of battery of a sexual nature, or experiences sexual harassment.  MST can serve as a stressor event in PTSD cases.  However, there is a lower threshold for corroboration as VA recognizes that MST frequently goes unreported in the military.  Evidence can take different forms than evidence typically used in cases with other stressors and includes the following:

  • Pregnancy tests
  • Instances of pregnancy
  • Sexually transmitted disease tests or diagnoses
  • Rape crisis center reports
  • Mental health treatment

Veterans can also use evidence of a change in behavior in service to corroborate MST stressors:

  • Evidence of poor performance
  • Bad conduct notices
  • Requests for transfer

Medical Nexus

The last step in proving PTSD to VA involves establishing a medical nexus (i.e. link) between your PTSD and the in-service stressor.  Importantly, a medical nexus is not required in cases where PTSD is presumed to be connected to your service as described above.  However, when a medical nexus is necessary, it must demonstrate that your PTSD is at least as likely as not related to your in-service stressor.  VA will likely obtain a medical opinion regarding this nexus, but it is important to note that you are able to seek an outside opinion from a psychological expert as well.

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