- Ways to prove your stressor occurred
- Finding evidence to support your stressor
- Prisoners of War (POWs)
- Military Sexual Trauma (MST) and “marker” evidence
- Diagnosing PTSD
- PTSD combined with other mental conditions
- How does VA rate PTSD?
- Common Mistakes in VA’s PTSD Ratings
- The Effects of Psychiatric Medications in VA Ratings
- GAF Scores
- PTSD Rating Reductions
- Split Decisions from the Board of Veterans Appeals
- Secondary Conditions Related to PTSD
- TDIU (Individual Unemployability) for PTSD
- Special Monthly Compensation (SMC) for PTSD
- Discharge Status and Eligibility for VA Benefits
- Final Thoughts and Tips
In the coming days, we will publish an accompanying blog post on PTSD Claims & Ratings. We’ll post that here when it’s ready to go, but for now, check out our overview of Getting VA Disability for PTSD.
Robert: Good afternoon. This is Robert Chisholm from Chisholm Chisholm & Kilpatrick. We’re coming to you live from Providence, Rhode Island today. Joining me today is Christian McTarnaghan to my immediate left and next to him is Michelle DeTore and we’re going to talk to you today about post-traumatic stress. Post-traumatic stress disorder is a very complicated issue in terms of VA benefit world and we’re going to be pretty much limiting our discussion today to VA benefits. We’ll touch on a couple of other areas where post-traumatic stress disorder can have an impact in the VA claims world, but primarily that’s what we’re going to be focusing on. We’re going to first talk about how you prove the stressful event occurred to the satisfaction of the VA. So I’m going to throw out the first question to Michelle and say I’ve been doing this for about 25 years. You’ve been here a little less than that.
Robert: But this theme of proving the stressful event actually occurred and I don’t mean to say that in any light way because it’s proving it actually occurred to the satisfaction of the VA can be a challenge. So can we go through some of the ways that one can prove the stressful event they experienced that leads to the diagnosis of post-traumatic stress disorder?
Michelle: Yeah, sure. So some of the ways you can prove to VA that your stressor did occur is first, and I’d say the easiest is usually combat. So if your stressor is combat-related usually you’re able to prove just by being in combat. So if you were in the war or combat zone during a combat time period that automatically is usually presumed to be combat exposure. Another way you can do it is usually by-
Robert: So let’s just stop.
Robert: Just pause there for a second. Let’s go through that. So in that situation a veteran’s lay statement, that is what they either say or what they write, is usually sufficient.
Michelle: Yup, it’s sufficient enough to prove it. VA will usually check your DD-214 in a combat situation just to see if you were like I said in the combat zone but also if you got hazard duty pay or imminent danger pay as well as if there is any combat medals.
Robert: And Christian, one of the challenges we have seen with some of the decisions from the Board of Veterans’ Appeals is there might not be the extrinsic evidence that is the DD-214, the hazard pay, and the veteran still says I was in combat. Would that be sufficient?
Christian: It should be. Sometimes it’s a challenge I think to get VA to recognize that it’s sufficient but according to the regulation, like Michelle noted, that should be evidence enough to prove that the stressful incident, the stressor did in fact occur.
Robert: Good. Michelle, let’s go to another way that one can prove a stressful event.
Michelle: Sure. So another way that veterans have stressful events is fear of hostile military or terrorist activity. So this way, a lot of times, it’s the same thing you’re using a lay statement but with this form you actually need a psychiatrist or a psychologist from VA to say that you have a diagnosis of PTSD and that that diagnosis of PTSD is a result of the in-service event. So if you do have that and then your lay statement is consistent with the circumstances, places, and types of your service at the time then VA will usually concede your stressor.
Robert: This was a fairly recent amendment to the VA’s regulation to acknowledge the fact that combat isn’t always easy to prove but this might be –
Michelle: It’s hard.
Robert: – an easier way for veterans to prove their case but the way they sort of add an extra step, if you will, is the fact that it needs to be a diagnosis and a link to your service by a VA professional.
Michelle: VA doctor.
Robert: And I believe this issue has been litigated in the Court of Appeals for Veterans Claims as well already.
Christian: Yeah, absolutely.
Robert: And it’s been upheld as far as I understand it up to this point. It has always struck me as not fair frankly, because your treating doctor may not be a VA doctor and that’s the one that probably knows you best but you actually need to get a Compensation and Pension Exam as well, or VA C&P exam, to win those type of claims.
Michelle: Yup. Yes, you do.
Robert: Okay. There is other ways we can prove the stressful event occurred.
Michelle: Yup. So usually you like to get a little creative. Sometimes it’s just as simple as Googling some things and finding some articles that support it. You can also get statements from fellow service members to prove your stressful events in service. Sometimes you just even looking up to see what records that you may not have but are public record. Even there are service records like the Department of Defense sometimes has some stuff that can help verify some events that may have happened like plane crashes. Sometimes we’re able to verify deaths of fellow service members by looking up obituaries and newspaper articles about them.
Robert: So we’ve talked about the first one is you’re in combat, the second one is fear of military — I’m sorry. Give me a second to get the exact language. Where is that?
Michelle: Fear of hostile military or terrorist activity.
Robert: Fear of hostile military or terrorist activity. Then the next one is you don’t meet those two, but you’re still saying a stressful event happened in service. So now what we’re talking about is you need something else. You need an extrinsic piece of evidence. Your statement alone isn’t going to be sufficient and in those cases the question is what evidence is going to help the veteran prove the stressful event for the post-traumatic stress diagnosis actually occurred. So lay statements from buddies who were there with you, newspaper articles, photographs could do it. You’d be surprised how many of our clients have photographs of some of the things that happened in service that have been successful winning their claims. What other kinds of things are we talking about?
Michelle: You also have stuff for, unfortunately, another stressors is military sexual trauma.
Robert: Let’s leave that aside for a moment because that’s a whole separate path that we can go down. Is there any other sort of things that you can think of Christian? And I’m not trying to put you on the spot.
Christian: Sure, no. Well, I mean Michelle alluded generally to service records but deck logs. If a ship was fired on when it was in service sort of other things like that, because I guess I think the real overarching point with all these different types and pieces of evidence is it doesn’t need to be an A, B, C, D equals stressor, right?
Christian: A veteran will say, “I had this terribly stressful incident when I was in Vietnam. My friend died.” So the VA will take that, which we refer to as a lay statement because it’s not from a medical professional, we’ll take that statement and we’ll look at it and we’ll try to see if there’s some way other than just that single statement that they can show that that happened and finding an obituary or some sort of corroborative anything that your friend did in fact die in combat in Vietnam will work to help you prove or corroborate, I think is the word that VA uses, show that your stressor actually happened. So it doesn’t need to be something like a letter from your commanding officer or something to that effect saying, “Yes, this absolutely happened on this day at that time.” Just some sort of evidence to try to show that you’re telling VA the truth.
Robert: So we have troops in combat right now all over the world and we’re in the world of social media and the world of social media, people text things, people use Facebook, people use Twitter, Instagram. Are any of those things possibilities for extra evidence to prove the stressful event actually occurred if someone blogs about it, texts about it?
Christian: I don’t see why not.
Michelle: I don’t see why not.
Robert: Okay. We haven’t seen any cases like that, but I don’t see why not either to be honest with you. I think that’s immediate evidence that an event actually occurred. It could be a reporter that’s embedded with troops as well talking about a specific incident as well.
Christian: And for whatever reason VA tends to lend a little bit more credence to that contemporaneous assertion or contemporaneous recording of something because in the world of social media, like it or not, everything is date and timestamped. So that actually would probably be helpful.
Robert: All right. I want to move now to POWs. They’re a special class of veterans when it comes to post-traumatic stress disorder. What’s the general rule with POWs?
Michelle: So with POWs, it’s somebody that was forcibly detained in the line of duty by an enemy government or hostile force. So with POWs, we don’t often see too much of these which is a good thing because they’re basically presumed most conditions at any point in time after service to be presumed related to being a POW. So VA does these ones well.
Robert: So their statement alone would be sufficient. They do not need extrinsic evidence.
Robert: All right. Before we move on to MST, I want to just introduce ourselves again. This is Robert Chisholm from Chisholm Chisholm & Kilpatrick. We’re talking to you today about post-traumatic stress disorder, with me is Christian McTarnaghan and Michelle DeTore. If you have any questions about PTSD, please reach out to us on Facebook and we’ll try and answer your questions live during the presentation and if you have questions after and you’re viewing the video just shoot us a message through Facebook and we’ll answer to the best of our ability. So Michelle, a completely different class of stressful events are those that happen around military sexual trauma, MST. Military sexual trauma could result in a diagnosis of PTSD but it doesn’t have to, but those claims also have a specific path in order to prove that the assault or the stressful event actually occurred. What is that path?
Michelle: So the good thing about — MSTs are very sad and very difficult cases for the veteran to be dealing with but the good thing is VA understands that in some ways and that they do not expect a veteran to have reported it in service. Regulations actually note that a veteran is not presumed to have reported it, so they can’t use that…
Robert: So I’m going to stop you right there because that is definitely true now.
Michelle: Yes. It’s true now.
Robert: When I started practicing 25 years ago they expected some kind of evidence that was simultaneously recorded and that’s no longer the case and this has been a big change for MST cases. So I didn’t mean to interrupt you –
Michelle: No, it’s fine.
Robert: – but that has not always been the world for VA claims.
Michelle: Yeah, and I think it’s also good for people to know that it’s changed and that VA does grow with the times and does understand that sometimes things do need to change. So with that being said is that you don’t need to have reported it. You don’t need to show that your service record show the assault. They will actually use other forms of evidence in order to show that maybe it did happen. Like they’ll use pregnancy tests or actual pregnancies, actual in-service pregnancies, any sexually transmitted diseases, a law enforcement authority reports. So if you did report maybe the rape to somebody else or something did happen. Rape crisis centers are also a big thing, any mental health treatment and other examples such as that.
Robert: So the other thing they’ll sometimes rely on and we’ve seen this in some cases that we’ve taken to court, Christian, is evidence of a change in behavior in service. So can you talk a little bit about how that might come up?
Christian: Yeah, absolutely. So unlike all the other concepts of how to corroborate or show that the stressor actually happened where usually we’ve been talking about submitting something, submitting a lay statement, submitting a picture. VA under this specific stressor concept has a duty to look at your service treatment records kind of anew with a fresh set of eyes. Behavior changes can be poor performance evaluations, Article 15s, bad conduct, potentially some sort of just write up for bad performance, being insubordinate to your superiors, and that it was different than your prior period of service. That sort of shows that there was something going on psychologically and some sort of result of trauma that changed this individual’s behavior while he or her were in service.
Robert: And I think you said service medical records but those can be in the service records as well –
Robert: – like a request for transfer for example. It could be another evidence.
Robert: Person wanting to get away from a situation that impacted them. So I think those are really important points when we’re talking about MST cases is that you can use almost any kind of extrinsic evidence to help prove your claim. In fact, you could also use the diagnosis from 8 years later as the extrinsic evidence. Although VA tends to deny those claims we have had some success even using a doctor years later where the person for the first time explains to a doctor what happened to them in service. And it can be very sad and VA tends to not give credence to those cases but that could be the evidence to win the claim. Do we have any questions yet?
Robert: No questions yet. All right, so we’ll continue on. So far we’ve talked about post-traumatic stress disorder in terms of proving the stressful event actually occurred but let’s talk about diagnosis just for a moment and when we’re talking about diagnosis, the VA or the treating doctor has to actually diagnose what?
Michelle: They have to diagnose that the veteran has PTSD essentially. So what they do is they — You either have to be diagnosed usually by a psychiatrist or psychologist using the DSM-5 which is the diagnostic manual for mental disorders. What they do is they want to see if you meet these certain criterias. It’s criterias they have A through H and usually they’ll go through, it’s the stressor, whether there’s intrusive memories or recollection of the event, there’s avoidance because of the event, negative cognitions or mood due to the event, altercations in arousal or reactivity, how long it’s been going on that you’ve experienced the symptoms, so duration, functional significance, and exclusion. So those are the criterias that they’ll be seeing if you meet in order to properly diagnose you with PTSD.
Robert: What if it isn’t just a diagnosis of PTSD? What if the doctor says you have PTSD, you have anxiety, and you have depression, what happens in those situations?
Michelle: It’s very common for people with PTSD to have comorbid diagnoses and unfortunately for most of the conditions you can’t actually separate the symptoms. And VA does acknowledge that in a lot of cases is that you won’t be able to separate the symptoms that your PTSD causes versus your anxiety because PTSD is common to have anxiety with it. So it would be hard to separate the symptoms to rate them separately.
Robert: Christian –
Christian: And before we move on from the diagnosis, I just want to make one quick point about the stressor. And as Michelle mentioned, criteria A is the first criteria of a diagnosis of post-traumatic stress disorder and that is when a medical doctor assert or some of sort of qualified mental individual asserts that this stressor caused post-traumatic stress disorder. So I just don’t want people to think that you have to fit into one of those four categories that we just talked about in order to be able to be service connected for your post-traumatic stress disorder. These are certain special rules that apply to certain situations but if your stressor caused post-traumatic stress disorder and that stressor happened in service you can be service connected for post-traumatic stress disorder.
Robert: That’s a really good point and I guess the only other one I don’t think we actually covered is if you’re diagnosed in service with PTSD and you have it after service, you’re not going to have any trouble getting service connected in most cases in that specific situation. So that’s a really good point. I guess the other question I had about multiple diagnoses or comorbid diagnoses is that you could have all these diagnoses due to your event in service. It doesn’t necessarily –
Robert: -have to just be PTSD. It could be depression. It could be anxiety. Sometimes the VA will only focus on one and not the others. Sometimes they’ll focus on the anxiety and not the PTSD, or the PTSD but not the depression. And we’ve seen instances I think from the Board of Veterans’ Appeals where they’ll remand the issue of PTSD but deny the issue of depression or the deny the issue of anxiety and we have to take those to court because they could be link to the PTSD ultimately.
Christian: Absolutely. VA is supposed liberally looked at claims and I don’t think, under VA law, a veteran isn’t expected to know exactly what’s going on with them.
Christian: So under VA law if you ask for service connection maybe for post-traumatic stress disorder by name, and you end up being diagnosed with anxiety and these other sort of symptoms that can also come from stressful time in service, they’re supposed to think about it in terms of service connection for just a mental health disability. So when they parse it out like that there can be issues with that that, appealable issues because they’re supposed to be looking at all of that kind of at once as one claim for all of these types of disabilities.
Robert: And that’s a really good point because if you’re having issues with mental disorders, you’re not the expert. You don’t know.
Robert: You know how it’s impacting you obviously, but you’re not the one that can put the diagnosis on it and that’s for the professional to do. And the VA needs to look at this as you said in a liberal way that is in a way that benefits the veterans –
Robert: – to the maximum ability. So that’s a very good point. Anything else we wanted to hit in terms of defining PTSD in terms of the diagnosis?
Christian: Not that I can think of right now.
Robert: Okay. So let’s move on to rating. Let’s say the VA has found that the PTSD, or for that matter the MST, is due to service. How do they rate these claims?
Christian: Well, they rate all mental disabilities under a single rubric. They rate them based on the severity, duration, and frequency of all of the symptoms that you have and it’s catered towards an analysis of social and occupational impairment. So basically the VA is supposed to look-
Robert: All right, when you say that, you’re saying look you need to show a certain amount of social impairment and, more importantly, occupational impairment and the more of the occupational versus the social the higher the rating’s going to be-
Robert: -at the end of the day.
Christian: Because VA can’t just rate solely on the basis of social impairment so although they’re both intertwined it all relates back, overall, to your occupational impairment.
Christian: And so the more severe your social and occupational impairment is, the higher your rating should be and there are sort of telltale symptoms that VA uses to try to best rate an individual. Suicidal ideation, for example, connotes a higher disability rating. Sort of sleep impairment alone might be a little bit of a lower rating.
Robert: And there’s a specific diagnostic code that deals with all these and it’s 38 CFR 4.130 and the main schedule is what 94– What is it? 9400, is it?
Michelle: I think each mental health one gets their –
Christian: I forgot.
Michelle: – specific one.
Christian: I just cited 4.130
Robert: 4.130. And to be candid, in looking at the actual words of the diagnostic code, and that’s what the VA uses to rate the claim, it’s hard to distinguish between the different levels.
Christian: You’re not alone in that.
Michelle: You’re not alone.
Robert: Between the 30 and the 50 and the 50 and the 70 and the 70 and 100 and I’ve been doing it for quarter of a century, I still have to go to it each time –
Robert: -and to look at what the doctor said with respect to that and it can be challenging. And many times, and this is what I’d like you to talk about Christian, what are some of the challenges with these ratings?
Christian: Yeah, so I was thinking about this a little bit today I can, at this point obviously I haven’t been doing it as long as you have Robert, but I’ve probably had a hundred of these cases. They’re a large part the majority, or large part of our court work and I think overall it’s just VA fails to look at how your mental health disability really impacts your life. As Robert said, the diagnostic code or how the VA needs to rate it, it list a bunch of symptoms. And so what I tend to see VA doing is they’re looking solely for the symptoms that are part of the higher rating and when those symptoms aren’t there, they’re denying the higher rating but that’s sort of losing the whole concept. They don’t look to see how the mental health disability affects the veteran. A 30% rating specifically notes sleep impairment but some of my clients haven’t had a good night’s sleep since Vietnam. That is a really really long time to have such a severe long lasting symptom, and VA, they try to do the best they can but when they see sleep impairment in the 30% rating, they’re going to link it with the 30% rating. They’re not going to take that step back and ask them how does this really impact every single aspect of this veteran’s life. So they kind of check boxes as opposed to looking at it holistically and when we represent veterans at all levels, in court or at the agency, we try to remind VA, “Look, this is how all of these symptoms impact this veteran’s life, every aspect of this veteran’s life.”
Robert: So you raised a really good point about not looking at the big picture, because Michelle sometimes, many times I should say, veterans that have psychiatric disorders, mental disorders are prescribed medications and those medications can impair functioning as well. And VA has to consider the effects of the medication in the overall rating as well.
Michelle: They do, they have to consider it and unfortunately, actually if you read the diagnostic criteria it only considers continuous medication in I think it’s the 10% rating criteria. They don’t actually list the effects of medication really in the rating criteria but they have to consider it so I think sometimes what happens is VA doesn’t really take the full effects of the medication into effect and honestly sometimes they do the opposite. If the medication is helping the veteran they’ll say that, “Well, it’s improved. It’s better.” But they’re not supposed to be using the actual alleviations that the veteran gets from the medication as a reason to give a lower rating.
Robert: So that’s a really good point. I wanted to transition a little bit to this thing called GAF score, GAF scores, because under the previous versions of the DSM, the VA would use GAF scores. But after 2014 the DSM-5 doesn’t use GAF scores. So where are we on those? Because I do see in some doctors’ reports, they’re still referring to them and is the VA supposed to use them now or in the past and the answer may be we don’t know the answer to this yet.
Christian: Well, we’re going to get a better answer soon because we actually have a case that we’re going to argue on that exact issue. But in terms of GAF scores, they’re really not supposed to be considering them after the August 2014 date because since the DSM-4 only applies to cases that were certified to the Board or basically ready to be decided by the Board before that time when the DSM-4 applied, they can consider it then but not afterwards.
Robert: So I’m going to pause for a second again and say that this is Chisholm Chisholm & Kilpatrick coming to you live from Providence, Rhode Island. We’re talking about post-traumatic stress. If you have any questions please reach out to us on Facebook. Are there any questions at this time or should we continue on?
Robert: We’ll keep going. Okay, so we’re talking about GAF scores. We’re talking about rating. The question I have is can a veteran be reduced from a rating, say from a 70% to a 50 or a 50 to a 30 and how does that work, Michelle?
Michelle: So often it happens because of a VA examination so a veteran will attend a VA examination and maybe it was just a good day for the veteran and they reported their symptoms to be slightly better than what they’ve been previously rated at. So VA will come back and say that their condition has improved and they will propose to reduce the veteran and it’s often unfortunately incorrectly done based on one VA examination. The veteran is supposed to show that they’ve continued to maintain that improvement over an extended period of time, but unfortunately it does happen. And VA usually will propose it and give them 60 days to submit evidence to the contrary that it should not occur.
Robert: Okay. Hold on one second here. So we’re talking about post-traumatic stress disorder as a diagnosis, anxiety as a diagnosis, and maybe depression as a diagnosis. What if the Board as I said does one of those split decisions where say they deny anxiety disorder but remand PTSD. What’s our general practice in those cases when we go to court?
Christian: If it were my case, I would argue that the Board — Remanding could be a little tricky mostly I see a denial of one and a grant of another and I would argue that they’re supposed to consider all of it kind of together because it’s all related to the stressor. But if one issue is remanded and the other is decided I would typically argue they were both supposed to go back together. Because before VA has a clear picture of how all the disabilities, whether it be anxiety or post-traumatic stress disorder, their origins, all that development is done, the Board really didn’t know exactly everything that was going on with the case and under VA law they’re not supposed to make a decision until that happens.
Robert: Okay. All right. We have a question from Shawn. Are the effects of medication and whether the effects should not be rated in VA regulations or manuals? So I don’t know that it’s in the regulation directly or in the manual directly to be honest with you. The short answer is they do have to consider the effects of medication. That I am clear on. And if you developed secondary conditions due to the medication you’re on, and we did a presentation recently on secondary service connected conditions, this is a good point to transition to this topic here. So for example, if your medication causes you to gain weight and there are problems as result of gaining weight, that should be rated. If the medication causes you to say, have headaches and you can show a direct link between the medication and the headaches, the headaches should be rated and things like that. So let’s talk a little bit about secondary conditions associated with PTSD and do you want to talk about this Michelle a little bit?
Michelle: Yeah, one we argue a lot is sleep apnea secondary to PTSD because your sleep is usually impaired or affected by your PTSD, which in turn then affects your sleep apnea or aggravates it, so that’s a common one we use. A lot of times, like Robert was saying, is medication will cause things like you have hypertension. Also the stress and anxiety can also affect a heart condition, so coronary artery disease or any heart condition is often something you see a lot of times secondary.
Robert: And unfortunately heart attacks and those are all unfortunate side effects of post-traumatic stress. Question, can you get TDIU for your post-traumatic stress disorder? Total disability based upon individual unemployability.
Christian: Absolutely. If your post-traumatic stress disorder keeps you from being able to work, you are entitled to TDIU or a total rating for unemployability because of that impairment.
Robert: Okay. There’s a special benefit for special monthly compensation, and one of the criteria for SMC(s) is housebound, right?
Robert: And what does housebound mean and is it something that a veteran could receive for diagnosis of PTSD, assuming their condition was severe enough?
Michelle: It certainly could. Sometimes agoraphobia comes with your psychiatric condition so that you don’t actually leave your house due to the severity of the psychiatric condition and, therefore you’re housebound because of the psychiatric condition. So it’s something they could definitely meet and we do see it a lot of times in psychiatric conditions.
Robert: And housebound doesn’t mean 24/7 in your home. You might still be able to go out to a doctors appointment, emergencies, and things like that, but primarily you don’t leave the home is what it means in that situation and we have seen that and we have filed for that. And VA sometimes misses that in medical reports unfortunately, where the symptoms are that severe. I’d like to go back briefly and touch on one other topic if we could and it’s related to VA benefits but it really has to do with the discharge of a veteran. And there are certain discharges that make you eligible for VA benefits and certain discharges that make you ineligible for VA benefits. And when we’re talking discharge, we’re talking discharge from the service here, but let’s say someone has a less than honorable discharge and let’s say they were serving in 2001 and let’s say that they have diagnosis of post-traumatic stress disorder. Is there anything that they can do now to upgrade that discharge? And I’m just going to say this upfront this is not our area of expertise.
Michelle: It is not.
Robert: But we bump up against it because you’re always looking at the discharge status to see whether they qualify as a veteran in order to receive VA benefits so that’s why I just throw out the question there.
Michelle: Yeah, sometimes a veteran is dishonorably discharged and they know of- or there problems or issues in service. So a veteran can come back and try to get the discharge upgrade by saying that the psychiatric condition that they are now diagnosed with started in service and is the reason for their dishonorable service. We do argue that and we do have some cases where we’ve done that before and been successful in it. So if that is the case for you, I recommend doing it.
Robert: And there’s been some change in the law that has been favorable to veterans in this area. A high percentage of veterans in the current conflict have been diagnosed with either traumatic brain injury or post-traumatic stress disorder and receive less than honorable discharges. You should definitely apply for, in whatever way possible, an upgrade so that you would then qualify for VA benefits. I do think they’re providing medical care right now for those veterans even if it’s a less than honorable discharge which is a step in the right direction in my opinion.
Michelle: I’ve definitely seen it where they’ll approve for treatment purposes but deny for actual benefits which is it’s definitely doing a service to the veterans.
Christian: Sure. Absolutely.
Robert: Before we have our closing remarks are there any other questions? Nope, okay. Any closing thoughts here on post-traumatic stress disorder claims and or MST claims?
Michelle: I’d probably just say that just because you don’t have a diagnosis now, don’t be afraid to apply because you think you have a diagnosis. A lot of times a VA examiner can come back and give you that diagnosis or you can go out and get a private opinion that says that later on but just don’t be afraid to apply just because you don’t have a diagnosis yet.
Christian: I think that was well said. I think we’ll leave it at that.
Robert: I’m just going to add one more thing to it. Keep appealing your decisions. If you’re denied and many of these claims are denied the first time, take your claim to the Board of Veterans’ Appeals. Ask them to give you an exam if you haven’t got an exam, and you’ll have a better chance the second time around at the Board of Veterans’ Appeals even though it sometimes takes a while to get to that level. So I’d like to thank Michelle and Christian for joining us here today. This is Robert Chisholm from Chisholm Chisholm & Kilpatrick. You can reach out to us on Facebook if you have any questions after seeing this video. Also visit our website at cck-law.com. Thank you.