Service connection for an injury or illness seems easy to prove; medical records documenting that the injury or illness occurred or was first treated while in service is enough to show service connection. Some are easy such as falling off a ladder and connecting that with later back problems. However, some are much more difficult, especially when there may not be any treatment records at all. The most prevalent of these is PTSD.
Victims of PTSD often do not seek treatment
Because of stigma, denial, not knowing they have PTSD, or other issues, many service members do not seek out treatment for PTSD while they are in service or sometimes for years after discharge. PTSD is the third most prevalent disability claim in the VA system yet is probably the least treated. Many veterans did not seek out mental health treatment in service due to the stigma and possibility of being discharged for mental instability. Often, if they were fortunate, they would seek help at a local community mental health agency or a private doctor whose records could be available to assist with filing their claim, showing in service treatment. However, this is not very often the case. Most often, service members go without treatment altogether. Only about 50% of Veterans with PTSD seek treatment, and then only about 50% of those receive adequate treatment. When Veterans finally do seek services, it is often at a point where they have reached a very low point in their lives. Many have lost relationships, jobs, homes, and even their self-worth before they seek help. Some have been hospitalized, fallen victim to substance abuse, or have legal problems because of the symptoms of PTSD and how they manifest. Unfortunately, many also commit suicide before they can get help, or because they are not getting the help they need quick enough.
What Causes PTSD?
PTSD can be caused by many different issues and can manifest in very different ways for each individual. What may trigger PTSD symptoms in one person, may not cause any symptoms in another. The VA bases their PTSD definitions on the DSM-V Criteria. The criteria for PTSD are: whether the veteran was directly exposed to a traumatic event; if they witnessed a traumatic event; if they learned that a close friend or relative was exposed to a traumatic event (if involving death it must have been violent or accidental in nature); or repeated or extreme indirect exposure to aversive details of the event (such as first responders, medics, firemen, etc.). There are also criteria for intrusion symptoms; avoidance, negative alterations in cognitions and mood; alterations in arousal and reactivity, duration, functional significance, and exclusion. When these areas are reviewed, a determination is then made if the Veteran meets the DSM-V criteria for PTSD.
Because everyone has different coping skills and reactions; someone who sees death and destruction on a daily basis serving as a medic in a war zone may meet no criteria for PTSD, yet someone who experiences a fire in their barracks during basic training may end up experiencing many criteria for PTSD. It doesn’t mean a person is strong or weak, only that their minds have reacted differently to different events and they may have different coping skills to deal with what they are exposed to.
Service Records v. Service Medical Records
One of the first things that the VA does when a Veteran files a claim for PTSD is request service medical records. If the Veteran has experienced a traumatic event that may have caused immediate injury or that the Veteran sought out medical or mental health treatment for, it would be present in their medical records. Also, since the onset of the Gulf War, pre- and post-deployment questionnaires address the questions of mental health issues as a course of record. However, again that stigma is present and someone who may not want to be medically discharged or sent back stateside may not seek treatment or tell the truth on forms in order to keep their job and duty station.
So, if there are no medical records, how can someone go about proving that the incident occurred in service? One way is be requesting that the VA review your Service Records as well as your medical records. By reviewing your service records, there may be what are called markers to PTSD or mental health issues such as sudden disciplinary issues, a sudden drop in performance review scores; a request for a change in duty station or different squad, company, or platoon; records of going AWOL; or other issues such as excessive drinking, dereliction of duty, insubordination, etc. Any types of behaviors that were not present before the incident but become prevalent after may be considered markers of a traumatic event.
Other forms of “Proof”
There are a few other ways to show that a traumatic event happened when you don’t have any “proof” of it. Stressor verification can be determined by:
- Buddy Statements – written statements from friends, other service members, or relatives who either witnessed the event, discussed it with you when it happened, or noticed a behavior change after the event.
- Help Program records – if you called any support groups, helplines, churches, or other programs that offered support and help, document it or try to get copies of your records with those agencies.
- Civilian reports such as police reports if the incident was reported to civilian authorities but not military authorities (for example, a car accident and the Veteran’s best friend is killed while he is home on leave);
A Veteran will also have to fill out a PTSD Stressor Statement form and attend a C&P Exam. There are tips on what to do to prepare for the C&P Exam here.
Getting help with filing your claim helps increase the chances of it getting approved. However, for those with PTSD, it can also relieve some of the stress that Veterans experience dealing with the claims process. If you need help filing your claim, please call your local Veteran’s Organization for assistance or an attorney if you have an initial denial. Professional help increases your chances of winning your claim by almost 25% and can greatly reduce the stress on you.
Most importantly, remember that no matter what happens with your claim, it is vital that you seek help to deal with your symptoms. PTSD is one of the leading causes of suicide among Veterans and seeking help will reduce the risk of suicide. If you are experiencing thoughts of harming yourself or others, please call 911 immediately. Other resources available for Veterans include: