VA Service Connected Rating for PTSD and C&P exams
Recently I wrote about the elements necessary in proving a PTSD claim for VA service connected benefits. But getting the VA to acknowledge that a disability is related to service is just the first battle in the war to get service connected benefits. The reason that you applied for service connected compensation is get paid for your disability, not to get recognized for the disability.
The way that the VA has structured the rating criteria is to compensate veterans for the loss of productivity in the work place due to the veteran’s service connected disability. The more the VA service connected disability interferes with the veteran’s ability to work the higher the rating should be.
Chances are that if you have PTSD, it affects fundamental aspects of your working ability. In the many cases that we have handled regarding PTSD, we have seen how PTSD has severely affected veterans’ home life and working situation. The problem is that the ways that PTSD affects veterans are more subtle than other disabilities.
The main evidence that the VA uses to rate PTSD is a PTSD C&P exam. For more information on the C&P exams please read this post
The VA has had a long history of wrongfully denying and underrating PTSD service connected claims. The VA has difficult with cases involving illnesses that they cannot see or where they cannot measure it in ‘objective’ tests. As a result, even when the VA acknowledges that a veteran has PTSD related to service they still manage to underrate the veteran. The problem starts with the C&P exam.
The main symptom that I see the VA ignore in PTSD service connected cases is anger, also known as impulse control. PTSD affects individuals ability to deal with stress in a normal manner and typically results in veterans lashing out, yelling or becoming violent.
For some reason the VA does not do a good job of discussing these symptoms in the C&P exams for PTSD. I have found that these symptoms are both underreported by the veteran to the VA and under recorded by the VA doctors. What I mean by underreported is that the veterans do not want to volunteer information about when they have lost control. So if a doctor does not specifically ask if the veteran has had problems with anger or violence the veteran is not going to just tell them about it. A lot of times even where I see that a doctor did ask a general question about impulse control the veteran will deny the problem. But when I follow up with the veteran and ask if they lose their temper and yell or even hit walls they will tell me that does happen. When I ask why they did not tell the doctor they typically tell me that the doctor did not specifically ask that question.
As to the under recorded symptoms, when I review C&P exams with veterans on service connected PTSD I will tell them that the doctor noted that the veteran did not have any problems with anger. The veteran will then tell me all the anger problems that he told the doctor but that did not make it into the doctor’s report. I don’t know why that this happens. The VA has been using new forms that do not allow the doctor to just put in notes and the VA has made their C&P examiners perform a lot more exams so maybe they do not have time. Whatever the reason may be, it is important that the veteran order and review a copy of his Claims file so that he can review the exam.
So what can you do to be prepared for a VA C&P exam for a rating of service connected PTSD? It is important that you spend time before the exam considering the effects that PTSD has on you. I would encourage the you to discuss you PTSD with your loved ones and ask them how they see PTSD affecting you. This will be a difficult conversation but an important one because you need to make sure that the examiner gets all the information that he needs to produce an accurate picture of your claim. I also encourage you to bring along a witness that knows your PTSD. I would ask the doctor to speak to this person to get a more full picture of the disability as well.