PTSD Guide - Part 4

 

Our PTSD Guide will explain what PTSD is (Part 1), what is needed to get PTSD service-connected (Part 2), what to expect from a Compensation & Pension (C&P) exam for PTSD (Part 3), how PTSD is rated by the VA (Part 4), how to receive Total Disability Based on Individual Unemployability (Part 5), what to do after the VA decision (Part 6), and helpful resources (Part 7).

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What are the required eligibility and Criteria for making PTSD claim with the VA? 

Veterans can have different in-service stressor events that cause their PTSD.  A few examples of the types of in-service stressor events are combat, sexual trauma (MST), incidents during training, or personal trauma.  Per the VA's Annual Benefits Report for Fiscal Year 2023, PTSD is the 6th highest claimed disability of all compensation recipients.  There was over 1,450,000 new claims filed in 2023 for PTSD.  

When the Veteran can show that their PTSD is service-connected the VA will then assign a disability rating to the Veterans PTSD.  The VA uses the medical evidence to determine the level of severity the Veterans PTSD is and then assigns the PTSD rating based on the lost earnings that are caused by the Veterans PTSD.  

It is important to know that the C&P examiners can not and do not rate the Veterans claims.  After the VA receives the C&P report the Veterans claim gets moved to a VA adjudicator.  The VA adjudicator will then apply the rating formula and assign the Veteran a rating for their PTSD.

The VA looks at both the DSM-V and the rating formula when they are evaluating a Veterans PTSD claim.  The VA is allowed to take into consideration other outside factors of the rating schedule.  The DSM-V symptoms are only meant to supplement the PTSD rating formula scale and the PTSD rating formula factors are just examples of the severity of the Veterans PTSD and is not an exhaustive list.

 

Mental Health Rating (604 x 1035 px)


Understanding The General Rating Formula for Mental Health Conditions

It is important to understand that the VA uses the same general rating formula for all mental health disorders. The only difference the VA does is needing proof of the Veterans in-service stressor for PTSD.    

The VA rates PTSD at 0%, 10%, 30%, 70%, or 100%.  It is extremely important for a Veteran to be open and honest about all of their symptoms. The VA is suppose to rate the Veterans PTSD by the highest level of their symptoms. So, if a Veteran has six symptoms at 30%, three at 50%, and two at 70% the VA should rate the Veteran at 70% for their PTSD.

PTSD can cause a Veteran to not be able to work or maintain gainful employment.  When this happens the Veteran can file for what the VA calls Total Disability Based on Individual Unemployability (TDIU). TDIU is a way for the Veteran to get the benefits of 100% with out having an overall rating of 100%.

 

How to understand a VA PTSD ratings?

A VA rating can be anywhere from 0% to 100%, but not all disabilities will include all of that range and some will never get to 100%.  A Veteran can only be rated at 0%, 10%, 30%, 50%, 70%, or 100% for all mental health conditions and they will only have one mental health rating no matter how many mental health diagnosis the Veteran has.

When a Veteran gets a 0% rating for their PTSD, that means that they have been diagnosed and service-connected for PTSD.  The Veterans symptoms are not severe enough to affect them functioning in social or work settings.  When a Veteran gets a 100% rating for their PTSD, that means that they are total occupational and social impairment because of their symptoms.

 

What can a Veteran do if they cannot work because of their PTSD?

If a Veteran can not work or maintain gainful employment because of their service-connected PTSD the Veteran can apply for TDIU. TDIU allows the Veteran to receive the benefits and compensation of 100% without having to have an overall of 100%.  When the VA grants a Veteran 100% via TDIU that means that the Veteran cannot work.

 

If you're a Veteran or you know a Veteran that is suffering with PTSD, remember that there is nothing shameful about PTSD.  PTSD is a disease that can be treated with proper care and treatment. Continue to Part Five, how to receive Total Disability Based on Individual Unemployability, to learn more about how to get PTSD service-connected in order to receive the VA disability benefits you have earned.

PTSD Guide