VA Disability Rating for PTSD Related to MST

CCK Law: Our Vital Role in Veterans Law

Military sexual trauma (MST) and post-traumatic stress disorder (PTSD) are closely linked among survivors. Veterans who suffer from military sexual trauma in-service may qualify for VA disability benefits.

While VA does not consider MST a diagnosis, a veteran may receive benefits for PTSD caused by military sexual trauma.

This article will explore both post-traumatic stress disorder and military sexual trauma, along with how they affect women veterans.  We will also discuss how a veteran can file a claim for PTSD caused by MST and explain how VA rates these claims.

What Is Post-Traumatic Stress Disorder?

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur in people who have experienced or have witnessed a distressing, shocking, or otherwise, traumatic event. The symptoms of PTSD can often be very debilitating and have a negative impact on an individual’s life.

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Unfortunately, many veterans experience PTSD stemming from their military service. According to VA’s Annual Benefits Report,  PTSD is one of the most common conditions experienced among veterans.

Symptoms of PTSD can include:

• Reexperiencing the trauma through recurrent memories, flashbacks, and nightmares;
• Avoidance of people, places, and activities that are reminders of the trauma;
• Increased arousal, such as difficulty sleeping and concentrating;
• Hypervigilance;
• Irritable or aggressive behavior; and
• Difficulty maintaining relationships with others.

Symptoms usually begin within three months of the traumatic event, but it is also possible for them to be present later in life.

PTSD can also lead to depression and anxiety and may cause a person to alter their daily life routine to avoid painful memories or associations, sometimes referred to as triggers.

What Is Military Sexual Trauma?

Military sexual trauma, or MST, is a term used by the Department of Veterans Affairs (VA) to refer to the experiences of sexual assault or repeated, threatening sexual harassment that a veteran experienced during their military service.

VA’s formal definition of MST, which comes from Federal law (i.e., 38 USC § 1720D), states the following: “psychological trauma, which in the judgment of a VA mental health professional, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the veteran was serving on active duty, active duty for training, or inactive duty training.”

VA further defines sexual harassment as “repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character.”

Military sexual trauma among veterans has steadily risen over the last ten years.  In the DoD Annual Report for FY 2022, the total number of reported sexual assaults was 8,942, which represents a 1 percent increase from 2021.

Nonetheless, examples of MST include the following:

• Being pressured or coerced into sexual activities, such as with threats of negative treatment if you refuse to cooperate or with promises of better treatment in exchange for sex;
• Someone having sexual contact with you without your consent, such as when you were asleep or intoxicated;
• Being physically forced to have sex;
• Being touched in a sexual way that made you uncomfortable;
• Repeated comments about your body or sexual activities; or
• Threatening and unwanted sexual advances.

How Can MST Affect Veterans?

It is important to note that MST is an experience as opposed to an actual diagnosis or mental health condition.  However, veterans may experience mental health conditions, such as PTSD, depression, and/or anxiety, as a result of MST.

The type, severity, and duration of a veteran’s difficulties following MST may vary and depend on factors such as:

• Whether they have a prior history of trauma;
• The types of responses from others that they received at the time of the MST; or
• Whether the MST happened once or was repeated over time.

Research and statistics show that individuals are often very resilient after experiencing a traumatic event.  Many people can manage their trauma response symptoms, if any, on their own or with the help of a mental health professional.  Examples of trauma response symptoms include:

• Depressed mood;
• Intense, sudden emotional responses to external stimuli;
• Feeling angry/irritable most of the time;
• Feeling emotionally numb or having difficulty experiencing emotions, such as love or happiness;
• Trouble sleeping (e.g., falling/staying asleep, nightmares);
• Difficulties with attention, concentration, and memory;
• Maladaptive substance use; and
• Difficulties with interpersonal relationships (e.g., feeling isolated or disconnected from others, trouble with employers or authority figures, difficulty trusting others)

Again, everyone may respond to the experience of MST differently, and the list above is not intended to be exhaustive.

Filing a Claim for VA MST Disability Benefits

VA considers MST to be a traumatic event or experience, not a diagnosis.  Therefore, VA will not compensate a veteran for MST itself; however, VA will grant service connection for conditions resulting from MST.

The most common diagnosis for MST survivors is post-traumatic stress disorder (PTSD).  VA refers to this diagnosis as “PTSD due to MST” in most of its publications and correspondence.  Veterans filing a claim for PTSD due to MST can fill out VA Form 21-0781: Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s).

However, MST-related claims are not limited to PTSD claims.  Though PTSD may be one result of military sexual trauma, MST does not always result in a diagnosis of PTSD.  It can also be associated with depression or anxiety, for example, or even a physical diagnosis.

VA Service Connection for PTSD from MST

In general, service connection for PTSD requires:

• A current diagnosis of PTSD by a medical professional;
• Evidence of an in-service stressor (i.e., the event that caused the PTSD); and
• A nexus, or link, between the current PTSD diagnosis and the in-service stressor.

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In the case of PTSD resulting from MST, the stressor would be the military sexual trauma event.  To verify MST as a PTSD stressor, the veteran can submit certain documentation to VA, such as:

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

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

• Evidence of poor performance;
• Bad conduct notices; or
• Requests for transfer.

Importantly, there is a lower threshold for corroboration for MST as VA recognizes MST frequently goes unreported in the military.

PTSD and Military Sexual Trauma C&P Exams

When a veteran files a claim for PTSD from MST, VA will sometimes order a Compensation and Pension (C&P) exam.

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This exam is conducted to evaluate the veteran’s PTSD and to assess the severity and connection to service, so that VA may issue a rating if service connection is granted.  The exam will either be conducted by a VA medical professional or a third-party medical professional contracted by VA.

When objective documentation does not exist, VA adjudicators are supposed to rely on markers found in the veteran’s service records or post-service records.  The term marker refers to signs, events, or circumstances that indicate, or mark, that the stressor may have occurred.

According to VA’s standard training on MST-related claims, any marker appearing during the approximate timeframe of the MST stressor serves as sufficient evidence to go forward with scheduling a C&P exam. VA identifies two categories of markers: records (other than service records) and behavior changes occurring during service or at a relevant point following service.

What to Expect At a C&P Exam for PTSD Related to MST

For some veterans, attending these exams may feel intimidating, especially because discussing PTSD relating to military sexual trauma can be exceedingly difficult for survivors.  However, the exam is a crucial step on the path to establishing service connection.  Without a C&P exam, a veteran’s case will often be weaker.

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At an exam, a VA medical examiner will review the veteran’s entire file and get additional details about the assault and associated symptoms.  The VA examiner will then write a medical opinion, which is their judgment of whether the MST event is associated with the veteran’s current PTSD symptoms.

The medical opinion an examiner gives can carry a lot of weight for VA raters who will decide whether service connection is granted and what rating will be issued.

VA does recognize that it is unreasonable to expect all MST survivors to have direct documentation, such as service medical records or official reports, of their traumatic event, especially given the difficult of reporting MST.

Because of this, the evidence standard for establishing MST as a stressor for PTSD has been “liberalized,” or made easier.  VA adjudicators do not always follow these more liberal standards, however, so veterans should be aware of them in the case that they want to appeal a negative C&P exam or claim denial.

How Does VA Rate PTSD from MST?

PTSD is rated as a mental health condition under 38 CFR § 4.130.  Ratings range from 0, 10, 30, 50, 70, and 100% based on:

• The level of social and occupational impairment, and
• The frequency, duration, and severity of the symptoms listed in the criteria.

However, the symptoms listed are not exhaustive.  They are meant to serve as a guide for the level of impairment at each rating.

100% VA Rating for PTSD from MST

Total occupational and social impairment, due to such symptoms as:

• Gross impairment in thought processes or communication;
• Persistent delusions or hallucinations;
• Grossly inappropriate behavior;
• Persistent danger of hurting self or others;
• Intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene);
• Disorientation to time or place;
• Memory loss for names of close relatives, own occupation, or own name.

70% VA Rating for PTSD from MST

Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as:

• Suicidal ideation;
• Obsessional rituals that interfere with routine activities;
• Speech intermittently illogical, obscure, or irrelevant;
• Near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively;
• Impaired impulse control (such as unprovoked irritability with periods of violence);
• Spatial disorientation;
• Neglect of personal appearance and hygiene;
• Difficulty in adapting to stressful circumstances (including work or a work-like setting);
• Inability to establish and maintain effective relationships.

50% VA Rating for PTSD from MST

Occupational and social impairment with reduced reliability and productivity due to such symptoms as:

• Flattened affect;
• Circumstantial, circumlocutory, or stereotyped speech;
• Panic attacks more than once a week;
• Difficulty in understanding complex commands;
• Impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks);
• Impaired judgment;
• Impaired abstract thinking;
• Disturbances of motivation and mood;
• Difficulty in establishing and maintaining effective work and social relationships.

30% VA Rating for PTSD from MST

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation being normal), due to such symptoms as:

• Depressed mood;
• Anxiety;
• Suspiciousness;
• Panic attacks (weekly or less often);
• Chronic sleep impairment;
• Mild memory loss (such as forgetting names, directions, and recent events).

10% VA Rating for PTSD from MST

Occupational and social impairment due to mild or transient symptoms that decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.

0% VA Rating for PTSD from MST

A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning OR to require continuous medication.

Do You Need Assistance with Your VA Military Sexual Trauma Claim?

VA does not always adjudicate MST claims properly.  VA adjudicators often narrowly interpret which diagnoses are considered related to MST and some have limited ideas about what counts as evidence, despite VA’s intentionally liberalized standards.  Additionally, some VA staff minimize the importance of reports from non-VA healthcare providers.

If VA denied your MST-related claim, Chisholm Chisholm & Kilpatrick LTD is here to help.  Our team of experienced and dedicated veterans’ advocates may be able to help you gather evidence and secure the compensation you deserve.

Call CCK today at (800) 544-9144 for a free case evaluation with a member of our team.