Appeal The Decision Or File A New Claim
The most straightforward approach is to appeal VAs decision on the original claim. You have up to one year after the first rating has been assigned to do so. If its been past one year, you can simply file a new claim. In either case, its strongly recommended that you present more evidence to bolster your claim and improve your chances of a more favorable decision.
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Getting The Benefits Of A 100% Rating Through Tdiu
Total Disability Individual Unemployability benefits allow veterans who dont qualify for a 100% rating based on schedular criteria to receive cash compensation at the rate of someone who is totally disabled. TDIU benefits recognize that some veterans have conditions that limit their ability to maintain substantial gainful employment even though they are not fully disabling.
A veteran may qualify for TDIU if they have one service-connected disability that is 60% or more disabling. If they have two or more service-connected disabilities, they must have one rated at 40% or more disabling and a combined disability rating of 70% or higher. However, exceptions are sometimes made for conditions that result in frequent hospitalization.
Substantial gainful employment is defined as earning more than a poverty-level wage in a position that does not qualify as a protected work environment. As such, veterans who are self-employed, work for a friend or family member, or perform odd jobs throughout the year may still qualify for TDIU.
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What Is Posttraumatic Stress Disorder
Posttraumatic Stress Disorder is an anxiety disorder. The diagnosis of PTSD is made when a Veteran has been exposed to a traumatic event in which both of the following have occurred:
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How The Va Appeals Process For Ptsd Works
The denial or award letter you received comes with a statement from the VA on how they reached their decision, so make sure you hang on to it. You can use this information to determine what new evidence you should submit with your appeal. Once you get a rating decision from the VA, you have a year to appeal. The general plan for appealing a claim is as follows.
- Have a VA-accredited claims agent or attorney review your claims file.
- Request any pertinent records that are missing from your claims file.
- If necessary, get buddy statements from friends and family, and additional statements from doctors.
- File the appeal with the new evidence and send a brief to your VA Regional Office or the Board of Veterans Appeals.
Not every appeal follows this pattern to a T, so its best to consult with an experienced claims agent to get a better sense of how things will go.
Now lets take a closer look at types of evidence that can help you show that your PTSD rating is in need of revision.
How Can I Get Veterans Disability Compensation For Ptsd
Under VA rules, first you need to meet three conditions:
- you are properly diagnosed with PTSD, and
- the stressor happened during your military service , and
- due to your resulting symptoms, you cannot function in normal life as you formerly could.
Submit a claim that fulfills these demands, and VA will likely find you are qualified to receive disability compensation.
While this may sound straightforward, there are many details that your condition must satisfy before it can be considered service-connected. Your case will go through VAs screening process and you will undergo a C& P exam.
Possible VA ratings for PTSD are 0, 10, 30, 50, 70, and 100 percent, depending on the severity of your symptoms. The VA will consider all your mental impairments together, under the General Rating Formula for Mental Disorders.
Learn how VA rates PTSD and how the C& P evaluation affects your claim in our article: Understand Your PTSD Rating.
Once your condition fulfills all VAs requirements for PTSD, it can then technically be considered a disability for the purpose of veterans compensation.
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Focal Point #: Proving The Ptsd Stressor Event
After knowing HOW to build the 4 Pillars in a PTSD claim, the second most important Focal Point is knowing how much you have to prove to establish and corroborate the stressor event.
If I had a nickel for every-time a Veteran didnt know which TYPE of stressor event he/she was claiming, I could probably buy myself a seat in Congress. Seriously, not knowing what TYPE of stressor you are proving up is one of the biggest reasons for wrongful VA denials of PTSD, and one of the biggest causes of delay in a military PTSD claim.
If your stressor occurred during combat, do you know what evidence you need to prove that the stressor occurred?
What if the stressor occurred in a combat zone, but not during actual combat?
If your stressor event occurred during a friendly fire casualty situation, will the VA consider this combat?
How much 5-star evidence do you need for a non-combat stressor?
Is Military Sexual Trauma your stressor event?
If You Are A Veteran Or Servicemember Suffering Due To Ptsd
Well examine some important issues about VA compensation for PTSD below, but if you are a veteran and are having a crisis you think may be related to your condition, dont wait for your VA appointments to seek help. You can call the Veteran Crisis Line at 1-800-273-8255and press the number 1. You can also send a text message to 838255.
Again, its extremely important to seek help immediately if you are having a personal crisis, even if you arent sure its associated with PTSD. Your VA claims appointments are very important, but you should never delay care when its needed in favor of waiting for the appointment.
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Five Reasons It Is A Challenge To Get The Right Va Ptsd Rating
1) Veterans facing the limitations of PTSD condition are already at their mental limits, meaning it is next to impossible to keep track of the VA red-tape and evidence needed to establish the right VA PTSD rating.
2) PTSD is a latent condition meaning it doesnt always arise on the battlefield. My own grandfather didnt experience this condition it was known as shellshock until years after he fought at the Battle of the Bulge. Because it often arrives later in life after service, it can be hard to convince the VA to service connect PTSD, no less give you the correct VA PTSD rating.
3) The VA regulations governing VA PTSD ratings and PTSD claims are rewritten frequently.
Many of these rewrites are pitched as being Vet Friendly or liberalizing rules to make the process easier. When they are put into practice, it turns out that new VA PTSD rating or service connection rules or regulations make the claims harder and are anti-veteran.
4) The VA has created a bottleneck in VA PTSD claims, by finding PTSD cannot be service-connected until a doctor whose bread is buttered by the VA concludes that there is the requisite nexus.This can dramatically delay the amount of time it takes you to get the appropriate VA PTSD rating.
What Are Common Signs And Symptoms Of Ptsd
PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later.
Your symptoms can also can ebb-and-flow over many years.
If the symptoms last longer than four weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.
Generally, there are 4 types of PTSD symptoms, but they may not be the same for veteran.
Each veteran experiences symptoms of PTSD in their own way.
#1. Reliving the event
Memories of the traumatic event can come back at any time, and they can feel very real and scary.
- You may have nightmares.
- You may feel like you are going through the event again. This is called a flashback.
- You may see, hear, or smell something that causes you to relive the event. This is called a trigger. News reports, seeing an accident, or hearing fireworks are examples of triggers.
#2. Avoiding things that remind you of the event
You may try to avoid situations or veterans remind you of the trauma event.
You may even avoid talking or thinking about the event.
- You may avoid crowds because they feel dangerous.
- You may avoid driving if you were in a car accident or if your military convoy was bombed.
- If you were in an earthquake, you may avoid watching movies about earthquakes.
- You may keep very busy or avoid getting help so you dont have to think or talk about the event.
#3. Having more negative thoughts and feelings than before the event
#4. Feeling on edge or keyed up
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Military Sexual Trauma And Other Non
Weve been talking about combat stressors, but non-combat stressors can also cause PTSD. Non-combat stressors include robberies, domestic violence, and sexual assault essentially any in-service event that caused you to fear for life or limb. These incidents occur all too frequently, but the link to PTSD is less well established.
In the past, PTSD related to Military Sexual Trauma was particularly hard to prove. Incidents of MST were swept under the rug by commanding officers, while Dont Ask, Dont Tell prevented the victims of same-sex MST from reporting crimes out of fear of losing their jobs. Recent media scrutiny has alerted the public to the prevalence of sexual violence in the military, which has led to more cases being reported. In 2012 the VA acknowledged the difficulty of corroborating MST claims and relaxed evidentiary standards, leading to a 20% increase in successful MST-related PSTD claims. Proving PTSD due to a non-combat stressor presents its own unique challenges, but dont be deterred. The absence of service records is not valid grounds to deny a PTSD claim, nor is a veterans failure to report at the time out of fear.
The short answer is: Yes. You are entitled to veterans disability benefits for MST if it caused you to develop PTSD.
How PTSD is Rated by the VA
A 10% ratings means you have an occasional decrease in productivity at work due to transient PTSD symptoms, but only during periods of significant stress.
Getting to 100% with Related Conditions
How Accurate Are Va Disability Ratings
Sadly, the disability ratings given to Veterans by the VA are not always accurate and many conditions, including PTSD, often have their severity incorrectly assessed by the VA. Mental health issues are particularly subjective and lead to inconsistent ratings by the VA. Depression, bipolar disorder, schizophrenia, PTSD, and other mental health issues experienced by Veterans are difficult for the VA to assess properly based on a few pieces of paper, and the raters at the VA are always on the lookout for exaggeration of symptoms.
Many Veterans with PTSD have received a much lower disability rating than they deserve, which is compounded by the fact that PTSD is a condition with symptoms that can worsen over time. As symptoms become more severe, you may need to have the VA re-evaluate your disability rating to get an updated rating. Many Veterans receive much lower benefits than their conditions warrant because they do not get a re-evaluation from the VA when their symptoms worsen.
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General Rating Formula For Mental Disorders
If the VBA determines that a veteran suffers from service-connected PTSD, then they assign a disability rating, expressed as a percentage. This disability rating determines the amount of compensation and other disability benefits the VA provides the veteran. The disability rating indicates the extent to which PTSD has deprived the veteran of their average earnings capacity.
The VA assigns disability ratings based on criteria set forth in the Code of Federal Regulations, Title 38, Part 4Schedule for Rating Disabilities, often referred to as the âVA Schedule for Rating Disabilitiesâ or VASRD. The rating schedule for mental disorders is called the âGeneral Rating Formula for Mental Disordersâ , which specifies criteria for disability ratings of 0%, 10%, 30%, 50%, 70%, or 100%.
Some argue that by relying on the current Rating Formula, âVA uses decades-old regulations developed for mental disorders that do not resemble PTSDâ, and consequently, ârrelevant criteria ⦠may outweigh ⦠more relevant factors, leading VA to undercompensate veterans with valid diagnoses of PTSD.â Similarly, veterans service organizations have argued, for example, that a â⦠veteran service connected for schizophrenia and another veteran service connected for another psychiatric disorder should not be evaluated using the same general formulaâ and have supported efforts to revise the Rating Formula.
Proving A Service Connection
Once you have an official PTSD diagnosis, youll need to be able to prove a service connection for your condition. In essence, a service connection is a specific incident or set of circumstances that could have caused your condition. In the case of PTSD, almost any aspect of military service is enough to be a service connection.
If you served in a combat zone, were taken prisoner, or lost friends in the service, those can all qualify as service connections. Harsh service conditions, such as poor hygiene conditions or inhumane discipline can also qualify. The incident you use as your service connection will need to be something documented in your military records.
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How Can I Present A Strong Ptsd Claim To The Va
Veterans with post-traumatic stress disorder connected to their military service are eligible for VA disability benefits. Although PTSD is one of the most commonly claimed mental health conditions, the process of getting approved for benefits can be lengthy. These tips can help you increase your odds of a successful outcome.
Am I Eligible For Disability Benefits From Va
You may be eligible for disability benefits if you have symptoms related to a traumatic event or your experience with the stressor is related to the PTSD symptoms, and you meet all of these requirements.
All of these must be true:
- The stressor happened during your service, and
- You cant function as well as you once could because of your symptoms, and
- A doctor has diagnosed you with PTSD
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How The Va Rates Mental Illness
While the VA has different diagnostic codes for different mental illnesses, such as 9411 for PTSD and 9434 for depression, all mental health conditions are rated under the same criteria from the Diagnostic and Statistical Manual of Mental Disorders , published by the American Psychiatric Association. These criteria will be explained below.
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Watch: Actual Va Raters Reveal 3 Secret Va Claim Tips
WATCH NOW: Actual VA Raters Reveal 3 *SECRET* VA Claim Tips!
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So, if youre underrated for PTSD, the #1 way to get a PTSDincrease is to show the VA Rater through new and relevant medical evidence HOWyour mental health symptoms have become worse.
The best way to do that is by getting a Disability Benefit Questionnaire for PTSD Review from a private medical provider.
Okay, lets dive right in and explore my 3-step process to increase your VA PTSD rating in more detail.
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Va Disability Ratings: How They Work
When a Veteran is looking to receive disability benefits, the VA will assess the Veterans current condition and determine how much compensation they should receive to compensate. Any Veteran who is granted disability benefits from the VA is given a numeric disability rating between 0 and 100. The higher the rating, the higher your payment benefits from the VA will be.
Getting a 100% disability rating from the VA often requires a combination of multiple conditions related to your military service. If, for example, you have been diagnosed with both PTSD and depression and have a long-term physical injury as well, you have a much higher chance of reaching a 100% disability rating than if you only had one condition.
Another factor that can make you eligible to receive a 100% disability rating from the VA is qualifying for TDIU . If you have service-related disabilities that make it impossible for you to maintain a job, the VA is much more likely to grant you benefits at the level of a 100% disability rating.
Ssas Purpose Is Different From Va
SSA is looking for problems with your capacity to work. It follows a five-step process to decide if you cannot work, and therefore would qualify for disability benefits.
SSA does not require a veterans PTSD or other impairment to be linked to military service or discharge status.
There are no rating percentages of disability. Basically, under SSAs all-or-nothing definition of disability, you no longer have the capacity to work for at least one year, or until death.
Conversely, the objective of VA compensation is to pay veterans who suffered disabling physical and mental health conditions while serving in the military, on a graduated scale, based on the degree of the veterans disability. You can be partially disabled and still receive disability under the VA.
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Physical And Mental Changes To Expect:
While the general symptoms for PTSD are similar, the types and severity of symptoms will differ for each Veteran.
- Physical changes may include: difficulty staying or falling asleep irritability or outbursts of anger physical reactionssuch as profuse sweating, increased heart rate and rapid breathingwhen exposed to internal or external cues or reminders of the traumatic event intense distress when exposed to internal or external reminders of the event such as certain sounds or smells avoiding any activities, places or people that remind the Veteran of the trauma.
- Mental changes may include: recurring and intrusive thoughts about the event recurring and distressing dreams of the event acting or feeling as if it the traumatic event were recurringalso known as having flashbacks being unable to recall an important aspect of the trauma difficulty concentrating and efforts to avoid thoughts, feeling or conversations associated with the trauma.
- Emotional changes may include: intense distress when exposed to internal or external reminders of the event such as certain sounds or smells a noticeable lack of interest or participation in important activities feelings of detachment or estrangement from others limited ability or inability to show affection or love feelings of a bleak future, such as limited career or family opportunities, and shortened life span overly alert or on guardalso known as hyper-vigilanceand/or exaggerated response when startled.