PTSD claims can complicate the already confusing and murky claims process. Even with the new regulations passed in 2010 that make it easier for veterans with PTSD to qualify for VA benefits, a veteran with a PTSD claim will face unique challenges. There are three requirements that make up a claim for PTSD: (1) a current diagnosis; (2) an in-service stressor; and (3) a link between the current diagnosis and stressor.
How do I get VA to believe I have PTSD?
- Current Diagnosis: The first step to receiving VA benefits for PTSD requires the veteran to have a current diagnosis. A psychiatrist, psychologist, licensed social worker, or other mental health care practitioner must diagnosis the veteran with PTSD. Additionally, the diagnosis must conform to specific criteria and it is important the diagnosing doctor provide a report that fully describes why he feels the veteran has PTSD and how the veteran’s symptoms meet the specific criteria. All of this medical evidence must show that it is “as likely as not” that the veteran currently has disabling PTSD.
What is an In service Stressor?
- In-Service Stressor: One of the challenges with a PTSD claim is getting service connection. PTSD is not presumed to be related to service, so a veteran needs more than just a current diagnosis. The veteran must show that the stressful event that caused PTSD occurred during service. This does not mean that the veteran must have engaged in combat. Any traumatic event that satisfies the diagnostic criteria can be a sufficient stressor. However, there are different rules for combat vs. non-combat events. If a veteran can show that they were in combat, then a statement from the veteran may be all that is needed to prove an in-service stressor. Records that may help prove combat experience include:
- Veteran’s DD214
- Certain medals and awards received
- Unit records showing date and location of unit assignments
What other kinds of evidence can a veteran use to show an in service event for PTSD?
On the other hand, if the veteran was not in combat, he must provide more evidence than his statement alone. Sometimes the veteran’s service records can help support the veteran’s claim. But the veteran can also provide other sources of information include details about the people involved, dates, location, and a description of the event. Examples of supporting evidence include:
- Statements from fellow veterans that served with you
- Statements from family and/or friends who knew you before and after service
What is a Nexus for PTSD with the VA?
- Nexus: This is the link between the veteran’s current PTSD diagnosis and his in-service stressor. The veteran’s current diagnosis must be related to his in-service stressor. The veteran must prove the nexus through medical evidence such as an opinion from a qualified doctor. Another great resource for establishing a nexus is records from a Vet Center. Vet Centers have licensed social workers that will document the connection between the veteran’s stressor and their current diagnosis.
Keep in mind that, proving each one of the three requirements above is vital to getting a PTSD claim service-connected. If the proof falls short in one area, service-connection will be denied.
What happens after VA grants service connection for PTSD?
Once a veteran establishes service-connection for their PTSD claim, the battle isn’t over. The veteran must do what he can to make sure the VA gives him the correct compensation. Compensation is based on the rating VA assigns a veteran (for example, 50%). This rating is based on how severe the veteran’s PTSD symptoms are. Because the ratings are based on the veteran’s symptoms, it’s important to have medical records. These records should detail the symptoms the veteran suffers, and how they affect the veteran’s life. Again, this is another area where having medical opinions is crucial to building a strong case. The max rating is 100%, but this is hard to get. A lot of veterans end up with a 70% rating and unemployability because they cannot work.
The VA will use a C&P exam to help them determine what the appropriate rating is. A veteran should review the PTSD rating criteria that VA uses. The veteran should discuss with family and friends how they see PTSD affecting the veteran. This will give the veteran evidence he needs to assure the C&P examiner as a full picture of his problems.