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Delayed Onset PTSD & “LOSS”

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We have seen numerous claims where veterans are seeking a disability rating for PTSD but it occurs years after they are out of the military. There are many reasons why a claim could be filed late.  One is that a veteran had no idea what was wrong with him/her.  Behavior that includes such things as avoidance of social activities or crowds, trigger temper, frequent nightmares, hypervigilance, etc. may not have been understood to be related to PTSD.  Once a person better understands what has been happening to him/her, he/she may file a claim for PTSD.

Others may find that a life changing event exacerbates their earlier PTSD symptoms.  People with PTSD often function best when their lives remain very stable and structured with few surprises.  Life changing events such as loss of a job, retirement, death of a spouse, etc. can bring about a worsening of symptoms.  Even if a vet voluntarily retires, it is not uncommon for PTSD symptoms such as nightmares, intrusive memories, difficulty sleeping, etc. to increase once they have more time on their hands and not be able to “block out” memories by staying busy as effectively as before.  For example, simply having more time to watch TV can expose a person to news on TV or movies about war that help to bring up suppressed memories.

This is often called delayed onset PTSD.  The Diagnostic and Statistical Manual of Mental Disorders (commonly called DSM-V) now includes a description of this phenomenon:

  • Delayed Specification. Full diagnostic criteria are not met until at least six months after the trauma(s), although onset of symptoms may occur immediately.

One researcher found that about a quarter of PTSD cases involved delayed onset.

The VA also recognizes a condition known as LOSS (Late-Onset Stress Symptomatology).  LOSS differs from PTSD in its severity.  The symptoms of LOSS are not as severe or disruptive to the person’s functioning and can actually assist a veteran in reviewing his/her life’s experiences and make sense of them.  Those persons suffering from true PTSD, however, experience more severe distress and symptoms.  The following chart explaining this phenomenon appeared in a 2016 article in Gerontologist, 2016, Vol 56, No. 1, 14-21:

If you end up filing a claim for PTSD, be aware that you must still meet the diagnostic criteria for PTSD to qualify for a disability award.

It is important for veterans who suddenly begin experiencing PTSD symptoms to seek help and use healthy coping strategies rather than rely on substances such as alcohol or drugs to numb their feelings.  The VA offers a number of ways to assist veterans and provide guidance in this area

Does VA always grant PTSD in these instances where there has been a delayed onset?  No, if the veteran’s conditions are not severe enough, they likely will not grant PTSD.  If however, the veteran has had ongoing symptoms of PTSD for years, then that would increase the chance of proving the PTSD disability claim.  The veteran should obtain copies of any past records for mental counseling he/she may have received.  Use of Buddy Statements from friends and family to describe the veteran’s behavior in past years that exemplifies classic PTSD symptoms could also be very helpful.

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