VA Disability Rating for PTSD Related to MST
What is MST?
MST, or military sexual trauma, refers to any sexual activity where a service member is involved against their will, including sexual harassment.
More formally, VA defines Military Sexual Trauma as “psychological trauma, which in the judgment of a mental health professional employed by the Department, 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 or active duty for training.”
Examples of MST
VA provides some examples of MST on its website but the list is not exhaustive, meaning there are many more examples of incidents which could be considered MST. Below are some examples:
- The veteran may have been pressured into sexual activities (for example, with threats of negative consequences for refusing to be sexually cooperative or with implied better treatment in exchange for sex),
- May have been unable to consent to sexual activities (for example, when intoxicated), or
- May have been physically forced into sexual activities.
- Other experiences that fall into the category of MST include unwanted sexual touching or grabbing; threatening, offensive remarks about a person’s body or sexual activities; and threatening and unwelcome sexual advances.
What VA Resources and Benefits are Available to Survivors of MST?
VA notes on their website that they provide several free resources for veteran survivors of MST. Specifically, VA services include:
- “MST coordinator at every VA medical facility to serve as a contact person for MST-related issues and who can assist you in accessing care
- MST-related outpatient services at every VA medical center and many VA community-based outpatient clinics
- Mental health services, including psychological assessment and evaluation, medication evaluation and treatment, and individual and group psychotherapy for mental health conditions associated with MST, like:
- MST-related outpatient counseling through VA’s community-based Vet Centers
- MST-related treatment in VA’s residential (live-in) or inpatient programs for individuals who need more intensive treatment and support.”
Survivors can also receive VA disability benefits for PTSD stemming from MST.
Relationship Between MST and PTSD
It is important to recognize the relationship between MST and PTSD in order to understand how to become service-connected for PTSD based upon MST.
What is PTSD?
Post-Traumatic Stress Disorder is a mental health condition that can affect people who have witnessed or experienced a distressing, shocking, or otherwise traumatic event. Symptoms of PTSD can include:
- Re-experiencing 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
- Difficulty maintaining relationships with others
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.
MST refers to a specific type of underlying trauma that can cause PTSD. As such, VA does not pay benefits for MST directly but rather will pay benefits for PTSD caused by military sexual trauma.
VA Service Connection for PTSD from MST
In order to receive VA disability benefits for PTSD caused by MST, the veteran will need to follow the same protocol for establishing service connection for PTSD. This means the veteran needs to provide:
- A formal diagnosis of PTSD;
- An in-service stressor, which is MST in this case;
- A medical nexus linking the veteran’s PTSD to their service
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
- 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
- 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 MST C&P Exams
When a veteran files a claim for PTSD from MST, VA will sometimes order a Compensation and Pension (C&P) exam. 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.
For some veterans, attending these exams may feel intimidating, especially because discussing PTSD relating to military sexual trauma can be very 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.
At the exam, the examiner will go over the details in the veteran’s file, which they should be familiar with by the time of the exam. They may ask details about the assault and associated symptoms. They may also ask about how the veteran’s PTSD affects their day-to-day life.
After reviewing the veteran’s file and conducting the exam, the examiner will write a medical opinion. The medical opinion is essentially a judgement regarding whether the veteran’s PTSD is related to MST and their service. 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.
Importantly, these exams are not used for treating purposes. Knowing this can help veterans to understand why the exam is being conducted and what they may need to address in order to show how their PTSD is related to in-service military sexual trauma.
As mentioned above, 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%–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%––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 which 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%–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%–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 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, recent events).
10%–Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.
0%–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.
Getting Accredited Representation When Your VA Claim Has Been Denied
VA disability benefits for PTSD related to military sexual trauma can be difficult to win. In many cases, VA fails to use the liberalized evidence standard, and the lack of reporting in instances of MST can often work against veterans.
If your VA claim for PTSD benefits relating to MST has been denied, the experienced team of veterans’ advocates at Chisholm Chisholm & Kilpatrick may be able to help. Contact our office today for a free case evaluation at 800-544-9144.
