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Military Sexual Trauma and PTSD VA Disability Rating

Military Sexual Trauma and PTSD VA Disability Rating

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Emma Peterson: Hello and welcome to another edition of CCK Live. My name is Emma Peterson and today I’m joined by my colleagues, Michelle DeTore and Matt Fusco. And we are going to be talking about a pretty serious subject, MST PTSD VA disability claims. So, we’re going to be talking about military sexual trauma and post-traumatic stress disorder.

And like I said, a little bit of a heavy topic, so just wanted to give everyone a heads up before we dive in. So, according to the U.S. Department of Veterans Affairs, military sexual trauma, or MST, is a psychological trauma that results from physical assault or battery of a sexual nature or sexual harassment.

And VA defines sexual harassment as repeated or unsolicited verbal or physical contact of a sexual or threatening nature. And if a service member experienced sexual trauma while on active duty, active duty for training, or inactive duty even potentially, they could be considered to have experienced an MST.

Some examples include, what you would think being pressured, overpowered, or physically forced into sexual activities, sexual contact, or activities without your consent. Including when you are asleep or intoxicated. Any type of touching in a sexual manner that made you feel uncomfortable. Comments even about your body or sexual activities that you found threatening and unwanted sexual advances that you found threatening, excuse me. So Matt, how does this relate to PTSD?

Matt: Sure. So, post-traumatic stress disorder, abbreviated as PTSD, is a mental health condition that occurs as a result of experiencing a distressing, shocking, or otherwise traumatic event. Unfortunately, many veterans, develop PTSD from events that they witnessed or experienced during their military service.

And some of the most common symptoms of PTSD include things like re-experiencing their trauma through intrusive distressing recollections of the event, flashbacks, and nightmares. Emotional numbness, and avoidance of places, people, and activities that are reminders of the traumatic event. And also increased arousal, such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and/or angered as well.

Emma: Michelle, can you tell us about the relationship between MST and PTSD?

Michelle: Sure. So V doesn’t consider MST to be a diagnosis. It’s actually, in VA terms, it is a traumatic event or experience. So, therefore you can’t compensate a veteran for MST itself. However, what VA will do is they will grant service connection for conditions that result from MST. The most common diagnosis is PTSD. You’ll often see VA refer to it in their correspondence as PTSD due to MST.

And the difference between filing a standard PTSD claim and an MST due to PTSD claim is that the form is a little different. They actually require the VA Form 21-0781a. And you’ll notice, it’s still the statement in support of claim for service connection for PTSD, but secondary to personal assault, because it has a little bit of different criteria and information that they require for that. Just keep in mind, MST is not related just to PTSD claims, though PTSD is the most common. MST doesn’t always result in the diagnosis of PTSD. It can also be associated with depression, or anxiety, or maybe even a physical diagnosis.

Emma: So, to file a claim for PTSD due to MST, just in general service connection for PTSD requires a current diagnosis of PTSD by a medical professional, evidence of an in-service stressor or stressful event, the event that causes the PTSD, and a nexus or link between the two.

And so in the case of PTSD resulting from MST, the stressor would be the military sexual trauma event. And once service connection is established, VA will assign a rating based on the severity of the PTSD secondary to the MST. It’s important to note that the identity or characteristics of the perpetrator don’t matter. It doesn’t legally matter whether the perpetrator was a service member of any rank, a civilian, a male, female, non-binary, whether he or she or they were on or off base. That is not really what matters. What matters is what happened to you in filing that claim.

So Matt, can you go over the importance of establishing a stressor in MST cases.

Matt: Yes, so establishing a stressor is really essential to MST-related PTSD claims, not only because a confirmed stressor is necessary for granting service connection, but also because a plausible stressor is necessary for VA to order a compensation and pension exam as well.

Sexual assault in general is such a personal and sensitive experience, that it’s often difficult or maybe even impossible for an MST survivor to report or document the stressor when it actually happens to them. Along the same lines, for many valid reasons, veterans often do not report MST events while they are in service, and therefore finding credible supporting evidence of a stressor is often more difficult in military sexual trauma cases than in other types of PTSD claims.

Fortunately, however, VA has recognized that it is unreasonable to expect all MST survivors to have direct documentation of their traumatic event, given the difficulty of reporting. The direct documentation that we’re kind of thinking about here is things like service medical records or an official report of some type of that MST incident actually occurring.

So as a result, the evidence standard for establishing the stressor in certain types of PTSD claims has been liberalized or made easier for claimants. VA allows the claimant to use a wide range of evidence to indicate that the event actually occurred. It is worth noting, however, that since VA adjudicators do not always accurately follow these more liberal standards, it’s important to be aware of them in case you might need to appeal your particular claim if it’s denied on that type of basis.

So, MST-related PTSD claims fall under the category of personal assault for PTSD claims, and for claims that fall under this category, objective documentation of the actual stressor is not necessary. So, VA guidelines instruct the adjudicators of MST claims to look beyond the claimant’s military records alone. And as a matter of law, the veteran’s failure to report the event at the time it occurred can not be used against them in these particular claims.

Emma: Michelle, Matt mentioned that VA is going to look at a wide variety of evidence, you don’t need objective evidence in these cases, he talked to us about markers and how those come into play in verifying a stressor in an MST case.

Michelle: Yeah. So when there’s not objective evidence or documentation that exists the service records, the adjudicators are then supposed to then go searching for markers, which are signs events or circumstances that indicate or mark that a stress or may have occurred. So, there are two types of markers that VA will look for. Records, which are records, in this circumstance, other than service records, and behavior changes.

So, for sources of records, you could have maybe pregnancy test, that should help corroborate the event. Sexually transmitted disease testing, hospital, or physician records. Keep in mind when I say hospital and physician records, they don’t need to be specifically talking about the MST. They could be talking about maybe because of MST, there were additional injuries that occurred, that these corroborate. Maybe after the MST, you had stomach problems and you were consistently going to see the doctor because now you just were so anxious that it was causing stomach problems, having records of that could maybe help.

Right crisis treatment or any mental health center treatment, law enforcement records, police reports. Again, as Emma said, it doesn’t necessarily have to be an in-service person that did it to you. It just happens usually when you’re on active military service. So, there could be outside records that corroborate the stressful event. Lay statements from fellow service members, clergy, family, friends, maybe somebody that knew of the event that you spoke to about, maybe some of that can attest to behavior changes or injuries that were obtained during a certain time, or maybe fear of somebody.

Examples of behavior changes. So, this could be a request for a transfer to another military duty assignment. Poor, a change in performance and work, keep in mind, it doesn’t have to just be poor performance, it could actually be improvements. Sometimes people get so nervous that something else might happen, they don’t want to stand out at all, so they obviously are doing a lot better in their performance. Substance abuse is very common to see. Episodes of depression, panic attacks, anxiety without an identifiable cause, or unexplained economic or social behavioral changes.

So, according to VA’s standard training on MST related claims, any marker appearing during the approximate time frame of the MST stressor serves as sufficient evidence to go forward with scheduling a VA examination. So, if you can show these markers that are not necessarily standard service record showing that the event happened, they should process the next step and schedule an examination. Unfortunately, this doesn’t always happen, but that is what the next step should be.

Emma: And just to back up, because I’m not sure we really hit this, in a general PTSD claim, not MST or personal assault. A veteran will talk about their stressor, VA has to collaborate and verify that that stressor actually occurred. Unlike some other claims, where perhaps just based on your lay testimony and the circumstances of your service, VA will just accept that whatever happened, happened. In PTSD claims, they go out and try to verify that this stressor really occurred.

And so, that’s why it’s so important for a personal assault and MST cases that this relaxed standard exists. Because as Matt mentioned, it can be next to impossible to produce evidence to verify that these particular events occurred. And so along those lines, VA has a long history of incorrectly adjudicating MST claims. An example from the VA Inspector General’s office in 2018 found that in just a six-month period in 2017, one year prior, VA officials improperly refused benefits to more than 1,300 veterans.

So, that’s just a six-month window in one year, most of whom were female. So, due to VA’s failure to follow the liberalized standards for MST-related PTSD claims, special training began all the way back in December 2011 to improve competency. VA retrained all Regional Office personnel who process MST-related claims, as well as the mental health commissions conducting examinations related to these claims.

And this ongoing training focuses on getting VA officials to recognize markers, instead of looking for direct objective evidence to verify a stressor. And so, because all this was going on, VA allows veterans who filed an MST related claim prior to December 2011 to request a re-evaluation from their local VA Regional Office. They will accept new evidence to be reviewed when a claim is re-evaluated, and it’s best to send any new evidence you might have. Military sexual trauma specialists and/or women veteran coordinators can help veterans determine what type of information is best and submit it for re-evaluation.

Veterans who require a re-evaluation should contact their local RO or MST coordinator to determine how to go about filing one of these. You certainly also could reach out to any Veteran Service Organization, an accredited representative, or attorney if you need assistance with that.

All right, Matt and Michelle. Matt first, any final thoughts for those out there watching?

Matt: Yeah, these are just inherently really complicated claims that we are discussing. So, I think this is a situation where we would really underscore considering seeking out the help of an accredited representative attorney or veteran service organization, to kind of consolidate the records that you might need in order to prove one of these cases to VA.

So, that can really put your case across the finish line in terms of making a winning case to kind of, seek out that extra help in order to put the necessary pieces together in order to make your claim a winning claim.

Emma: And how about you, Michelle?

Michelle: I would just say these are extremely underreported. It is not often that you see these documented in service records. And I would say that if this was something that did happen to you, don’t think that that counts you out. Don’t think the fact that you didn’t talk to anybody about it in service counts you out. Obviously, like Matt said, it’s reaching out to somebody since these are complicated cases. But I would just say that if this was something that you experienced just don’t think because there’s no immediate evidence that you see, that you do not have a claim. So, I highly recommend still reaching out and discussing it with someone if you feel comfortable.

Emma: Great, thanks, Michelle. Well, thanks to everyone for tuning in. Please be sure to check out our website for more information on this topic and a wide variety of others. Follow us on social media, and don’t forget to subscribe to our YouTube channel. Thanks so much.