Many veterans have claims related to traumatic incidents from the military be it in combat, during physical training, accidents, from terroristic based fear, and even assaults or sexual assaults from fellow soldiers. There are countless different types of stressful events that may have caused a veteran’s PTSD and or other mental health problems. PTSD symptoms differ among veterans but often they re-experience past events, nightmares, flashbacks, emotional distress, dissociation, guilt, depression, social problems, anger, sleep disorders, or drug and alcohol abuse.
How should I file for PTSD?
It’s often advisable to file for PTSD and/or other mental health problems so that the veteran isn’t just limited to that particular diagnosis. Often it makes sense to claim “PTSD” and/or other related mental health problems. This is because although the VA has a duty to sympathetically read a veteran’s claim for PTSD as a claim for any related mental health problem, they may try to deflect the wording and deny PTSD and any other mental health problem by indicating the veteran may not meet all criteria for PTSD. However, if the VA had developed other similar claims for depression or problems such as adjustment disorder a compensable claim could have been found under a more generalized claim application. The important part of filing a claim is to first show that a diagnosed mental health condition exists based on a valid diagnosis. Unlike other types of physical health problems usually it’s insufficient to show that someone has depression just based on lay observation.
Requirements for PTSD
The Veteran needs to show a valid diagnosis for PTSD under 4.125(a), a credible link that is supported by the medical evidence and the stressor from service, and credible evidence that the military stressor in fact occurred. In terms of the PTSD diagnosis there may be differing opinions on this point as different doctors or mental health providers may have come to different conclusions on a PTSD diagnosis since each one of the many criteria have to be met. So long as “it’s as likely as not” that the veteran has PTSD then this part of service connection will have been met even if there is an outlier opinion that indicates that the veteran does not have PTSD. This is so long as the supportive evidence outweighs the evidence that contradicts the PTSD diagnosis. A “clear diagnosis” is not required and any decision that states this is easily appealable.
The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), DSM V, is the clinician’s guide that is used to classify and diagnose various mental illnesses. In the case of PTSD the diagnostic criteria is somewhat different than the prior versions in that aside from directly experiencing the traumatic event, meaning “actual or threatened death, serious injury, or sexual violence”, a person could have witnessed the event even if it occurred to another person. Additionally, even if the person only learned that a traumatic event occurred to a close friend/family this would be sufficient. Also repeated exposure to disturbing details of a traumatic event such as medics treating wounded would also qualify.
PTSD in Service and Combat related PTSD
Next the veteran must prove that a qualifying stressful event has occurred. This would be to prove if the PTSD were diagnosed in service. Though this may be more common now than before this wouldn’t be the most typical scenario among veterans, and indeed most veterans may not be diagnosed until many years following service. Absent this more uncommon scenario there would be quite a few veterans that would have PTSD as a result of a combat related stressor. Generally, combat is considered armed conflict against an enemy force. Generally, no additional proof would be needed to verify such a stressor. This is so long as the stressor is not inconsistent with the nature of the veteran’s service and there’s no clear and convincing evidence that the events did not occur. Obviously, an infantry soldier will have little problem proving this but even one served in non-combat MOS combat can still be proven. VA may contend that no valid combat exists in your case, although if there is simply ongoing fear of enemy activities this would usually constitute a valid stressor under 38 CFR 3.304(f). The stressor does not need to be life threatening. As it is, the cumulative effect of this whole period of service rather than just a singular event should be identified as a stressful series of events and not just one incident.
PTSD based on Terroristic Activity
The fear of terrorist type activity can also be validly linked if a VA psychologist finds that this type of stressor caused PTSD, and the related symptoms are consistent with this. Again, so long as the circumstances of that veteran’s service is consistent with the lay testimony on stressor then it would be generally accepted under 3.303(f). The terroristic threat would generally include an event where a person was presented with an actual threat to life or serious injury due to terroristic activity that often would be some kind of explosive device, rocket, small or large arm fire.
PTSD based on sexual assault is relatively common in the military particularly among women where around six percent indicate they were victims. Most instances of sexual assault would not be reported or otherwise documented but fortunately the veteran need not prove every detail of such incidents. Lay evidence is therefore an important component of such claims as well as markers within a veteran’s file that may. The VA may also try to argue that because the incident was not reported in the file itself that this is evidence against a sexual assault claim, but here the Veteran’s Court has held that this is not a valid basis to reject such a claim. Under VA’s Duty to Assist and under 3.304(f)(5) the VA must inform the veteran that other sources outside of the service records, which normally wouldn’t have evidence of said assault, can be utilized to prove PTSD claims as related to sexual assault. This other evidence would often include hints that such an event occurred such as poor performance reviews, reports of other health problems including mental health, evidence of drug and/or alcohol abuse, or any other kind of evidence that would be consistent with a personal crisis happening.