Veteran PTSD Claims

PTSD symptoms can interfere with a veteran’s capacity to pursue an appeal after a VA claim denial. Our veteran disability claims lawyers can advocate for the rating and benefits you deserve.

Summary

• Veterans may develop PTSD due to trauma from active duty, including combat, witnessing injuries/deaths, and military sexual trauma, qualifying them for VA disability benefits.
• Filing a PTSD claim requires meeting the VA’s criteria, including proving a traumatic event occurred during service and having a PTSD diagnosis from a doctor.
• Disability ratings for PTSD range from 10% to 100%, based on symptom severity, with the possibility of additional Special Monthly Compensation in severe cases.
• Vets can appeal a PTSD claim denial by filing new evidence, requesting a higher-level review, or appealing to the Board of Veterans’ Appeals.
• Attorneys can assist veterans in navigating claims, gathering evidence, and filing or appealing claims to secure disability benefits for PTSD.

Former servicemembers who have served on active duty in the United States military may suffer from a variety of mental health conditions that have a negative effect on their post-military lives. Post Traumatic Stress Disorder (PTSD) can manifest from a variety of mental health stressors on active duty.

It is a valid reason for a veteran to pursue a claim for disability compensation benefits. If you have been diagnosed with PTSD, an experienced mental health attorney could help you pursue a claim for disability compensation or appeal a denial of your veteran PTSD claim.

Veterans PTSD claims must follow a specific procedure, which can make them complicated. Our legal team can help you file a claim, as well as an appeal if necessary, to pursue the benefits you deserve. Reach out to VetLaw at (855) 905-1735 or submit a contact form online to schedule a free consultation.

Common Causes of PTSD for Veterans

Serving on active duty can place great stress on the human body and mind. Continual stress from being on active duty may cause severe mental trauma that can last for months or years after discharge. Understandably, witnessing fellow servicemembers suffer injuries or death may also leave a lasting impression on a veteran’s mental state.

Combat service and the stresses that come from using force, or being threatened with violence, is the main stressor for PTSD. Many veterans, both male and female, have also suffered from military sexual trauma (MST) while on active duty.

PTSD is common after such trauma. It can cause a veteran to endure nightmares, flashbacks, anxiety, or depression. As a result, you have the right as an honorably discharged servicemember to pursue a veterans’ disability claim based on the lasting symptoms caused by PTSD.

UNDERSTANDING THE VA’S AUTOMATIC 50% PTSD RATING

Does the VA Consider PTSD a Disability?

Yes, the VA does consider PTSD as a disability. A person may be eligible for disability benefits based on their symptoms. Based on recent information from the Annual Benefits Report, over 1.3 million veterans receive compensation for post-traumatic stress disorder. This makes PTSD the third most prevalent service-connected disability.

PTSD typically develops as a result of a traumatic event. Based on the VA’s definition, a traumatic event can be a serious injury, personal trauma, sexual violation, or a threat of injury, assault, or death.

Furthermore, for your PTSD to be considered a disability, the following must be true:

• The traumatic event occurred during your service
• You are unable to function normally in your day-to-day life as a result of your symptoms
• Your doctor has diagnosed you with PTSD

As long as you meet these requirements, your PTSD may be considered a disability and you may be eligible for benefits. These benefits can include compensation, health care, and treatment for your condition.

An experienced attorney can review your case and help you successfully file a VA PTSD claim or appeal a denial of service connection for PTSD. Then, you can secure the benefits you deserve to help manage your service-connected disability.

Filing a Claim Based on PTSD

Even if you are already familiar with the VA disability claims process because you receive benefits for another service-connected condition, you will likely still need legal assistance. Filing a VA disability claim for PTSD entails additional steps, which a veteran disability benefits attorney can help you navigate.

Meet Standard VA Service Requirements and Demonstrate Causation

To successfully pursue a veterans’ disability claim, you must prove that the incident leading to the disability occurred while on active duty. Additionally, you need proof that the subsequent medical condition has resulted in a disability.

Beyond the regular requirements for eligibility, veterans claiming service-connected PTSD must submit more detailed information regarding the basis of their diagnosis.

Identify the In-Service Source of Your Post Traumatic Stress Disorder Symptoms

Proving a claim based on PTSD involves an additional step of proving that a specific stressor caused your PTSD.

This can involve suffering a serious personal injury, witnessing another person undergo serious physical injury, enduring a sexual trauma or a sexual violation, or many other unfortunate events. Sometimes, even the threat of personal injury or death may be the PTSD stressor that resulted in your ultimate diagnosis.

Provide Documentation of Your PTSD Stressor and Diagnosis With the Help of a VA Disability Lawyer

Completing VA Form 21-0781 provides information to the VA concerning the specific incident that resulted in your PTSD diagnosis. If you are a veteran suffering from this condition and are disabled as a result, an attorney could help you gather the information needed to prove your claim or file an appeal.

This often involves developing further evidence related to your PTSD diagnosis. We also work with medical professionals, including psychologists and psychiatrists, if further evaluations or examinations are needed.

Establishing the Key Components of a VA PTSD Claim

To receive compensation for your condition, you must first prove that your PTSD symptoms were caused by a traumatic event that occurred during your military service. In some cases, the connection is obvious.

For example, if your symptoms developed due to combat exposure, sexual trauma during your service, or being held as a prisoner of war, PTSD is presumed to be linked to your service. If the connection is not as obvious, you may seek a medical opinion stating that the PTSD is at least as likely as not related to an in-service stressor.

Generally, the VA requires a Compensation & Pension (C&P) exam to determine your disability rating. The VA provider will also assess whether your disability is service-connected. The results of this exam will go to the adjudicator. Then, they will apply the rating formula and assign a disability rating for your PTSD symptoms.

It is important to be as transparent as possible during this examination. The information you provide will be used to evaluate the severity of your condition and whether you qualify for benefits. Once the connection between your disability and your service has been established, you will be assigned a VA rating for PTSD.

What Is the VA Disability Rating for PTSD?

Disability ratings for PTSD are based on 38 CFR § 4.130, Diagnostic Code 9411. The VA rating formula ranges from 0% to 100% and is assigned in increments of 10. VA PTSD ratings can be 10%, 30%, 50%, 70%, or 100% depending on the severity of your symptoms.

VA Disability Rating Schedule for Post Traumatic Stress Disorder

The various PTSD ratings can be characterized as follows:

• A 10% rating will be assigned when symptoms are sporadic or transient, or when medical treatment controls or eliminates symptoms completely. If your symptoms impact your life only occasionally, such as during periods of high stress, you will likely be assigned this disability rating.
• A 30% rating will be assigned when symptoms are worse but manageable. If you struggle with intermittent periods of inability to perform tasks, but your condition does not fully prevent you from working or engaging in social settings, this rating may be appropriate.
• A 50% rating will be assigned when you suffer from specific symptoms of PTSD. These symptoms include frequent panic attacks (weekly or more). Additionally, this rating includes difficulty understanding instructions or maintaining social relationships, and/or impaired speech, judgment, memory, or thought.
• A 70% rating will be assigned when you are generally unable to function in work or social life and suffer from specific symptoms. These symptoms include suicidal thoughts, emotional outbursts, near-continuous panic or depression, and/or obsessive rituals that affect daily life.
• A 100% rating is the highest schedular rating. The VA only assigns it if your symptoms are so severe that you’re completely unable to function in everyday life. To obtain a 100% VA rating for PTSD, you must prove that you have experienced a decline in cognitive and emotional functioning so substantial that you cannot work or perform daily activities. Symptoms including hallucinations, disorientation, or risk of hurting oneself or others are consistent with a 100% disability rating.

Is a PTSD Diagnosis Eligible for Special Monthly Compensation?

In some cases, a PTSD diagnosis may qualify a veteran to receive Special Monthly Compensation.

Designed to account for additional expenses based on the need for another’s assistance, personal inconvenience, social inadaptability, and the severe nature of a condition, Special Monthly Compensation allows a veteran to collect additional compensation beyond the 100% disability rating.

Generally, Special Monthly Compensation is reserved for situations where a veteran is unable to leave their home or requires aid and attendance benefits to function in everyday life.

Criteria to Receive SMC Benefits for PTSD

A veteran with a very severe PTSD diagnosis may qualify for Special Monthly Compensation if they:

• Received a 100% rating for a mental health condition AND a 60% or higher rating for another service-connected disability,
• Are permanently housebound as a consequence of their PTSD symptoms, or
• Require the assistance of another person in performing activities of daily living, also known as the need for regular aid and attendance.

If you can prove any of these criteria, you may secure Special Monthly Compensation for your disability or disabilities. Your attorney can help you file for this additional compensation in your VA PTSD claim.

How Can You Handle a VA Denial for Your PTSD Claim?

The VA denies claims for a myriad of reasons. Insufficient evidence, errors during the application process, and uncertainty with regard to the connection between your condition and military service are all common reasons for VA denials.

If the VA denies your claim was denied or offer a low VA rating for PTSD, don’t quit. There are multiple options for continuing your case:

Appeals Options for Veterans with Service-Related PTSD

Depending on the circumstances of your case, you may:

• File a Supplemental Claim to offer new or additional evidence to support your case. In some situations, providing additional evidence such as federal or state records, medical reports, or supporting statements, can help improve your chances of approval.
• Request a Higher-Level Review to determine whether an error or difference of opinion will change the decision. It is important to note that this appeal option does not allow you to provide new or additional evidence. Rather, you are asking a senior reviewer to re-evaluate your claim.
• Initiate the Board of Veterans’ Appeal process. This option allows you to appeal to a Veterans’ Law Judge in Washington, DC. They will conduct a further review of your case. Here, you can request a direct review, submit additional evidence, or even petition for a hearing.

Ultimately, the right appeal option for you depends on the specific circumstances of your case. This includes the reason why the VA denied your initial claim. An experienced attorney will review your case and help you understand which approach would be most effective to secure approval for your VA PTSD claim.

Hiring an Attorney Near You to Help Appeal Your PTSD VA Claim Denial

Filing a VA PTSD claim requires a great deal of time and effort. Even the strongest cases can be denied for a variety of reasons. While being denied after navigating the long and arduous VA disability claims process can be incredibly frustrating, this is not the end of the road for your claim.

As veterans disability attorneys, we have seen how PTSD affects veterans. Consequently, we are committed to helping them access VA benefits for their condition. At VetLaw, our team of experienced attorneys understands how to successfully appeal unfair denials and secure the benefits you deserve.

To start your free case review, consider contacting us today. You can reach us at (855) 905-1735 or submit a contact form online to schedule a free consultation.

Frequently Asked Questions

Do I need a C&P exam to appeal a VA PTSD claim denial?

It’s a strong possibility that the VA will ask you to submit to a C&P exam at some point during your journey to secure disability benefits for PTSD. Don’t be surprised if you receive a request from the VA, even if you have a diagnosis from another provider. 

Keep in mind that a PTSD C&P qualifies as a mental health exam. Therefore, you can request a male or female VA provider to do the assessment, if that makes you more comfortable.

Can I have PTSD from a non-combat event?

Although most people, civilians and veterans alike, associate PTSD with military combat situations, that isn’t the only source of PTSD. Veterans with service-connected PTSD can make non-combat claims for VA disability benefits. 

For example, a veteran who was sexually assaulted while serving on active duty in an administrative role on a domestic base would have just as valid a PTSD disability claim, even though their in-service stressor is not related to combat.   

How long can I keep my automatic 50% VA PTSD rating?

You can keep your automatic 50% rating for PTSD for six months after the VA assigns it under the provisions for automatic PTSD benefits eligibility. After that, it’s up to the VA to determine whether your PTSD symptoms have improved, remained the same, or worsened. Then, the VA will adjust your disability rating to reflect that.

Who is more likely to develop PTSD from military service?

Currently, PTSD is more common in female veterans as compared to male veterans. There are many factors that could contribute to this gap. For instance, differences in rates of sexual violence victimization, reporting, and treatment seeking.