The Vas Duty To Assist
The VA must make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate the claim for a benefit under a law administered by the Secretary. This duty is called the duty to assist and requires the VA to assist in obtaining relevant records and obtaining medical examinations or medical opinions.
This requires the VA to get records such as:
- Service personnel records
- VA medical records
- Private medical records relevant to claim
Suppose the VA receives a PTSD claim, and the file does not confirm the in-service stressor. In that case, they will ask the Veteran to provide details regarding the claimed stressor event, such as:
- A stressor/incident that can be documented
- The location where the incident took place
- The approximate date of the incident and
- The unit of assignment at the time the stressor/incident occurred
Why might the necessary records not be in official documentation? Perhaps the Veteran suffered from personal assault, or there was a traumatic incident in their personal life . It is important to remember that the requirement for service connection is that the event occurred in service and not specifically that the stressor is service-related.
When there is not enough evidence to corroborate the claimed PTSD stressor, the VA will make a formal finding that there was lack of sufficient information to document the occurrence of the stressful event. This formal finding must include the following information:
How To Prove Your Service Connected Ptsd
Stressor verification is a huge deal for VA disability claims for PTSD.
The reality is if the veteran cant prove their PTSD stressor on an at least as likely as not basis, youll likely be denied service connection.
This is also referred to as corroboration of a claimedstressor.
The VA has different rules to assess whether a stressor eventneeds further verification.
But in our experience, I want to make something very clear to veterans seeking service connection for PTSD: The burden of proof is on YOU to show on an at least as likely as not basis that the stressor event happened to YOU.
I literally cannot overstate the importance of this previous statement.
If you cant get at least one Buddy Letter to support the claimed stressor, theres a high likelihood youll get denied service connection for PTSD.
Ill say that again.
If your PTSD stressor is weak and cant be verified by at least one other person in-writing, youll probably be denied service connection.
Wondering if your PTSD stressor is strong enough?
Heres a good litmus test: Did you or did you not fear for your life?
Thus, if you didnt fear for your life and the stressor cant be verified by a buddy, your PTSD stressor event is probably weak, and we recommend the veteran seek additional avenues to service connect their mental health condition.
You could also pursue a VA claim for Depression or Anxiety as aprimary disability, especially if you were diagnosed in-service or shortlythereafter.
How To Prove Ptsd For A Va Claim
The 3 Elements of a Claim
Proving a VA disability claim has three requirements: 1) a current medical condition, 2) an event or injury in the service, and 3) a medical nexus between 1) and 2). Let me explain how this works.
Proving a Current Medical Condition
To prove a current medical condition for PTSD, you should have a medical diagnosis of PTSD and on-going treatment. Without a diagnosis and treatment, it is hard to persuade the VA to look closely at your claim, and they may deny your claim without sending you for a psychological exam. Not always but almost always.
Under VA rules you must be evaluated by one of their own doctors to establish a claim for PTSD, so if they wont send you for an evaluation, your claim will be denied. Thats a big reason why we think you must have a diagnosis and treatment to stand a reasonable chance.
Proving an event or injury in the service?
The second requirement of an event or injury in the service means that you must prove a stressor for your PTSD through a so-called stressor statement. In other words, what happened in the service that is causing your PTSD symptoms? The stressor can be combat related, but can also be a personal experience, such as being assaulted by other soldiers.
Whatever the stressor is, you must prove it happened. If it happened in combat, the VA usually will take your word for it as long as the stressor is the kind of event that is known to happen in combat to soldiers doing your job.
Proving the Nexus
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What Are Some Of The Common Measures Used
There are 2 main types of measures used in PTSD assessment:
Structured interviews
A structured interview is a standard set of questions that an interviewer asks. Some examples of structured interviews are:
- Clinician-Administered PTSD Scale . Created by National Center for PTSD staff, the CAPS is one of the most widely used PTSD interviews. The questions ask how often you have PTSD symptoms and how intense they are. The CAPS also asks about other symptoms that commonly occur with PTSD.
- Structured Clinical Interview for DSM . The SCID is another widely used interview. The SCID can be used to assess a range of mental health disorders including PTSD.
Self-report questionnaires
A self-report questionnaire is a set of questions, usually printed out, that you are given to answer. This kind of measure often takes less time and can be used to support information from an interview . An example of a common self-report measure is:
- PTSD Checklist . The PCL is another widely used measure developed by National Center for PTSD staff. This measure asks about how often you experience each of the PTSD symptoms over a period of time, like a month. Providers may also use this measure to see how your symptoms change over time, such as when you are getting treatment.
Your Post Traumatic Stress Disorder Disability Case
If you are disabled because of Post Traumatic Stress Disorder that is severe enough to prevent you from working, you may be entitled to Social Security Disability Insurance or Supplemental Security Income .
You can learn more by filling out a quick and free evaluation form regarding your case.
Working closely with medical professionals and a qualified Social Security disability attorney or disability advocate to collect and present the appropriate documentation to support your disability claim in front of the Disability Determination Services can help to ensure that your Post Traumatic Stress Disorder disability case will have the highest possible chance of success.
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Can I Work With Ptsd
Awareness of post-traumatic stress disorder has increased dramatically in recent years. Still, some employers may not be aware of how the symptoms can affect an employee’s interpersonal interactions or their job performance. If you are working with PTSD, know that, according to the Americans with Disabilities Act , employers are required to provide you with reasonable accommodations so you can do your job.Some accommodations could include:
- modified break schedule for counseling appointments
- job restructuring
- training in behavior modification techniques
- a flexible schedule, or
- telework or remote work options.
Benefits For Widows Or Widowers With Disabilities
If something happens to a worker, benefits may be payable to their widow, widower, or surviving divorced spouse with a disability if the following conditions are met:
- The widow, widower, or surviving divorced spouse is between ages 50 and 60.
- The widow, widower, or surviving divorced spouse has a medical condition that meets our definition of disability for adults and the disability started before or within seven years of the worker’s death.
Widows, widowers, and surviving divorced spouses cannot apply online for survivors benefits. If they want to apply for these benefits, they should contact Social Security immediately at 1-800-772-1213 to request an appointment
To speed up the application process, complete an Adult Disability Report and have it available at the time of your appointment.
We use the same definition of disability for widows and widowers as we do for workers.
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Gather Evidence A Diagnosis And A Nexus Letter
Do you think your acid reflux symptoms stem from PTSD, PTSD medication, or another direct service connection disability? You can then apply for an increased VA rating.
First, you need to gather evidence of your secondary service connection. Youll first want to get a formal diagnosis for GERD from your physician.
Your doctor should also provide a medical opinion that your acid reflux is due to PTSD symptoms, medication, or another direct service disability.
Sometimes, the VA might ask for additional evidence. This includes statements from family or friends about your GERD symptoms and when they began. A personal statement may also help determine your rating.
Can You Have Ptsd Without Seeing Combat
Yes,Veterans can experience post-traumatic stress disorder without seeing combat. A stressor can still cause debilitating, long-lasting effects if you dont receive the right benefits and treatment.
Non-combat PTSD is a manifestation of stressors that creates anxiety, panic, and distress. Some root causes are related to physical or sexual assault while serving, witnessing a fellow soldiers death or suicide, or motor vehicle accidents.
The non-combat PTSD stressor differs for each veteran. However, the impact of non-combat PTSD stressors tends to generate familiar patterns of symptoms. While PTSD episodes can be debilitating, the first step for many Veterans is to exercise their right to file for a disability claim.
Please keep in mind that the claims approval process depends on the information and evidence you present. You must have some form of proof of your stressors to apply for PTSD disability benefits.
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Is Your Condition Found In The List Of Disabling Conditions
For each of the major body systems, we maintain a list of medical conditions we consider severe enough to prevent a person from doing SGA. If your condition is not on the list, we must decide if it is as severe as a medical condition that is on the list. If it is, we will find that you have a qualifying disability. If it is not, we then go to Step 4.
We have two initiatives designed to expedite our processing of new disability claims:
- Compassionate Allowances: Certain cases that usually qualify for disability can be allowed as soon as the diagnosis is confirmed. Examples include acute leukemia, Lou Gehrigs disease , and pancreatic cancer.
- Quick Disability Determinations: We use sophisticated computer screening to identify cases with a high probability of allowance.
For more information about our disability claims process, visit our Benefits for People with Disabilities website.
Rules For Verifying Stressors
When a stressor needs to be corroborated for service connection, the VA will look for credible supporting evidence of the veterans account of the in-service stressor. According to the Court of Appeals for Veterans Claims, testimony by itself cannot, as a matter of law, establish the occurrence of an in-service stressor when the stressor was not related to combat or fear of hostile or terrorist activity. This restriction results in many claims being denied because the only proof available is the veterans statement. However, this does not have to mean that the claim cannot be service-connected. There are many ways to corroborate a stressor, and the VA is required to assist in doing so.
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Evidence Specific To Mst
Instead of requiring a smoking gun, VA looks for credible supporting evidence. Credible supporting evidence of MST includes:
- In-service pregnancy tests or tests for sexually transmitted diseases,
- Statements from clergy, family members, roommates, or
- Evidence of behavior changes following the claimed assault.
You May Be Entitled To Va 100% Ptsd Due To Mst
The type, severity, and duration of a veterans symptoms will vary based on a number of factors. For example, race, religion, and sexual orientation can affect the impact of MST. Whether the MST happened once or was repeated over time may affect how long the symptoms last. If your PTSD due to MST has caused any of the symptoms in the 100% range, then you may be entitled to VA 100%.
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Cognition And Mood Symptoms Include:
- Trouble remembering key features of the traumatic event
- Negative thoughts about oneself or the world
- Distorted feelings like guilt or blame
- Loss of interest in enjoyable activities
Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members.
It is natural to have some of these symptoms for a few weeks after a dangerous event. When the symptoms last more than a month, seriously affect ones ability to function, and are not due to substance use, medical illness, or anything except the event itself, they might be PTSD. Some people with PTSD dont show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.
What Is A Ptsd Screen
To develop PTSD, you must have gone through a traumatic experience, or trauma. If you tell a provider about this type of event, you might be given a screen to see if you could have PTSD. A screen is a very short list of questions about your thoughts, feelings and behaviors since the trauma. The results of the screen do not show whether a person has PTSD. A screen only helps a provider understand if you should be assessed further. Learn about PTSD Screening Day and take a self-screen at any time.
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Adults With A Disability That Began Before Age 22
An adult who has a disability that began before age 22 may be eligible for benefits if their parent is deceased or starts receiving retirement or disability benefits. We consider this a “child’s” benefit because it is paid on a parent’s Social Security earnings record.
The Disabled Adult Child who may be an adopted child, or, in some cases, a stepchild, grandchild, or step grandchild must be unmarried, age 18 or older, have a qualified disability that started before age 22, and meet the definition of disability for adults.
Example
It is not necessary that the DAC ever worked. Benefits are paid based on the parent’s earnings record.
- A DAC must not have substantial earnings. The amount of earnings we consider substantial increases each year. In 2022, this means working and earning more than $1,350 a month.
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How Can You Prove Combat Ptsd
If your records show you were involved in combat, your statement on VA Form 21-0781 is usually enough evidence to prove service connection to the stressor event causing your PTSD.
In these cases, your statement is enough to establish a service connection for the stressor if you meet one of the following requirements:
- You were diagnosed with PTSD while in service due to events that happened while you were serving
- The stressor occurred while you were in combat
- The stressor happened while you were a Prisoner of War, or
- You dealt with fears of hostile military or terrorist activity as a drone aircraft crew member
The VA will verify that you were in combat by checking your DD-214 and looking for combat medals, awards, or some indication of combat action.
If the VA cannot verify the event by your DD-214 alone, they can also use these documents:
- Service personnel records and pay records
- Military occupation evidence
- Command chronologies and war diaries, and
- Monthly summaries and morning reports.
How to write a description of what happened during your combat PTSD stressor event
You can also prove combat PTSD by making sure your lay statement is detailed and makes sense. Youll want to write your statement in a logical way that explains how the incident happened in your regular line of duty.
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Summary Of The Focal Points In A Ptsd Claim
If you can nail these aspects of a PTSD claim, you will maximize your VA PTSD rating. Get out in front of your VA PTSD claim or appeal and dont wait for the VA to assist you in developing these elements:
1) Know the 4 Pillars of a PTSD Claim and KNOW what evidence is and is not in your C-File already.
2) Know how to prove up your UNIQUE type of Stressor Event.
3) Get a solid Diagnostic Exam.
4) Learn how to provide 5-Star Evidence to get you the Impairment Rating you deserve in a PTSD claim.
Ptsd Can Be A Disability
The severity of the effects of PTSD range from relatively mildonly fairly disruptive to someones lifeto severely debilitating. When PTSDs effects are severely disruptive, PTSD is a disability. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition the American Psychiatric Association warns that PTSD sometimes has extreme consequences regarding someones functioning:
- Social disability
- Absenteeism from work/school
- Reduced educational and occupational success
Typically, PTSD prognosis, or expected outcome, is good. In fact, approximately half of all adults completely recover in about three months however, some individuals live with it for a year or more, and some can live with PTSD for more than 50 years . When the effects of PTSD are severely life-limiting and prolonged, PTSD is a disability, and someone can receive PTSD disability benefits.
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Applying For Mental Health Disability
Many veterans often feel ashamed of their mental health disorders and sometimes under-report their symptoms because they dont want to appear weak or damaged.
It is important to remember that it is OK to ask for help when you need it. The VA recognizes that service in the military can take a toll on mental health, which is why benefits are available for mental health disorders.
To apply for VA disability compensation for PTSD, you need to first file a claim through the VA. If you need help applying for VA disability compensation for the first time, we can help guide you through the process at no charge.
After the VA reviews your claim, you will receive a rating decision letter that outlines your disability rating and your monthly payments. If you disagree with the VAs decision, you can appeal it within one year of the decision date. If you need help appealing a decision, a veterans benefits attorney can help.
In this video, one of our VA disability lawyers talks about the VA rating formula for mental disorders and disabilities like PTSD.