If you peruse our blog on a regular basis, you know that Post-Traumatic Stress Disorder (or PTSD) is a subject that is frequently discussed. PTSD is a mental health condition triggered by a traumatic event in the life of an individual. When you are seeking VA benefits, the regulations refer to the traumatic event as a stressor. For your claim to benefits to be successful, your PTSD claim must have three things:
- A current PTSD diagnosis;
- Evidence of a stressor in-service; and
- A medical nexus opinion linking the current diagnosis to the in-service stressor.
If one of the above is missing from your claim, it will be denied. Today we are going to focus on how to meet the evidence requirement for a claim of PTSD. In regard to proving the stressor occurred, the VA specifically requires “credible supporting evidence that the claimed in-service stressor occurred” to establish that the veteran experienced it during service.
However, as with any rule, there are exceptions. These exceptions to the rule are as follows:
- Receipt of a diagnosis of PTSD while still in service
- The stressor occurred while the veteran was in direct combat with the enemy; or
- The stressor was related to fear of hostile military or terrorist activity.
In regards to the third exception above, the veteran needs to have a VA psychiatrist or psychologist confirm that the stressor is sufficient to support a PTSD diagnosis. When there has been an in-service diagnosis or a combat stressor the veteran’s testimony alone is sufficient to prove the occurrence of the stressor.
Proof of Stressor
When a veteran files a claim, the VA has the duty to “make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate the claimant’s claim for a benefit.” This is referred to as the Duty to Assist and requires that the VA assist in retrieval of relevant records. Usually, these are in the form of medical records, service records, VA medical records and private medical records. However, the Duty to Assist can also extend to obtaining both medical examinations and opinions.
In their attempt to gather the necessary records to substantiate a veteran’s claim for benefits, the VA may ask the veteran to submit a statement providing the details of his claimed stressor including:
- A stressor or incident that can be documented;
- The location of the incident ;
- The approximate date (within a two month time period) of the incident; and
- The veteran’s unit at the time of the stressor/incident.
When providing a statement, the more information you can supply, the more helpful that statement will be. When the stressor or incident is not something that would be present in the records that the VA has already collected, a detailed statement can point them to the necessary records outside of their initial search.
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 (i.e. loss of a spouse/significant other, child, or close friend). 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.
The duty to assist requires the VA to obtain medical examinations or opinions when there is insufficient evidence in the veteran’s file to determine if a veteran’s disability is service related. But in the case of PTSD, the VA must first corroborate the veteran’s claimed stressor. Once corroborated, the VA can schedule an examination to determine service connection. This examination may determine that the PTSD is not service connected. However, it is only the beginning of the fight.
Thank you for your service.