How does VA rate PTSD?
Once a veteran’s PTSD has been service-connected, the VA will assign a disability rating. A disability rating is based on the earnings loss due to the PTSD. VA will use medical evidence to determine the severity of the disability. VA will nearly always get a C&P exam. It is important to note that C&P examiners do not rate claims. Exam results go to a VA adjudicator to apply the rating formula and provide a rating for the veteran’s PTSD.
When the VA is evaluating a PTSD claim, it looks to both the rating formula and the DSM-V. In evaluating ratings, VA can consider factors outside of the rating schedule. However, the DSM-V symptoms are not meant to replace, but supplement, the rating formula criteria for PTSD. Additionally, the rating formula factors for PTSD are examples of severity of the condition, not an exhaustive list.
What are the VA ratings for PTSD?
The VA rating formula goes from zero percent to 100 percent, in increments of 10. Not every disability includes each rating percentage. For example, a veteran’s PTSD can be rated at 0, 10, 30, 50, 70, or 100 percent debilitating. A zero percent rating means that “PTSD has been diagnosed. The symptoms, however, are not severe enough to interfere with work or social functioning or to require continuous medication.” A 100% rating is for “total occupational and social impairment” due to specified symptoms.
What if the veteran cannot work do to PTSD?
Another way to get to 100% is for veteran to receive unemployability (IU) for his PTSD. Unemployability is not on the PTSD rating schedule. IU is a way for the veteran to receive 100% without meeting all the requirements on the 100% rating. VA grants IU ratings when a veteran annot work due to his service-connected disabilities. When the VA gives an Unemployability rating for PTSD it means a veteran cannot work due to his PTSD. As a result, a veteran receives 100% for the PTSD due to unemployability.
What if symptoms of two PTSD ratings apply to me?
Where two evaluations may apply VA must grant the higher evaluation if the disability picture is closer to that rating. Otherwise VA will assign the lower rating.” If a veteran fits criteria for both the 50% and 70% ratings, VA should grant the 70 percent rating. Similarly, there is the issue of IU and PTSD. If a veteran has a 70% PTSD rating and does not meet the 100% rating his PTSD could cause IU. If that is the case then VA should grant 100% through IU for the PTSD.
As the chart above shows, symptoms that the VA considers when rating PTSD include, but are not limited to:
- impairment in thought processes or communication,
- grossly inappropriate behavior,
- persistent danger of hurting self or others,
- suicidal ideation,
- intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene),
- memory loss,
- panic or depression affecting the ability to function,
- impaired impulse control (getting angry very quickly),
- chronic sleep impairment,
- decreased work efficiency.
During the VA’s rater’s evaluation, multiple issues must be considered:
- frequency, of psychiatric symptoms
- severity of psychiatric symptoms,
- duration of psychiatric symptoms;
- length of remissions;
- veteran’s capacity for adjustment during periods of remission.
What evidence does VA consider for a PTSD rating?
The VA should assign a rating based on all evidence in the record. The record for the rating relates to a veteran’s work and social impairment. A rater, however, cannot assign a rating based solely on social impairment. Again, the purpose of VA disability benefits is to compensate veterans for the loss in earning capacity. Therefore, you must emphasize how the PTSD symptoms impair your ability work and maintain gainful employment. If you cannot work at all due your PTSD, you may be eligible for individual unemployability. As discussed, IU is way to get to a 100% rating if the PTSD doesn’t meet a 100% schedular rating.
Continue to Part Five to learn more about how to receive a 100% rating individual unemployability.