You’re not “crazy.” Experiencing nightmares, flashbacks, overly negative thoughts, decreased interest in activities, irritability or aggression, risky or destructive behavior, hypervigilance, feeling isolated, heightened startle reaction, difficulty concentrating, difficulty sleeping, and much more, is completely normal for someone who has gone through trauma.
Veterans have suffered psychological trauma for centuries, though it wasn’t called PTSD until recently. It was not until 1980 that PTSD was formally recognized as a diagnosis and not until 2013 the description of PTSD was put in its current form. (See more about the history of PTSD as a formally recognized condition here).
PTSD was not even formally recognized until decades after WWI, WWII, and Vietnam veterans returned home different from when they left, with residual effects of the trauma from their service. They have largely suffered in silence, sometimes with vague references to having “shell shock,” “battle fatigue,” or other similar words. Even post 9/11 veterans struggle with lack of understanding, diagnosis, treatment, and compensation for the residual effects of trauma suffered while in the military.
Whether you are a veteran or a friend or family member of a veteran with PTSD, this article explores some of the symptoms of PTSD and some things you can do to get treatment and compensation for service-connected residual effects of trauma with a VA psychiatric disability claim and, if necessary, VA disability appeals process.
If you have already been denied for VA disability compensation, you can get a free review of that decision.
Common Signs of PTSD for Veterans
PTSD is rooted in a trauma, being exposed to death, serious injury, sexual violence (or the threat of any of these), through direct exposure, witnessing the trauma, learning that a relative or close friend was exposed to a trauma, or even indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics).
Sometimes the effects of exposure to trauma last for a few days or weeks, and then you return to a more normal state. Sometimes its effects linger longer, much longer, and sometimes effects come and get you months or even years after the trauma.
In PTSD, the traumatic event is persistently re-experienced. This could be in the form of unwanted and upsetting memories, nightmares, flashbacks, emotional distress or physical reactivity when reminded of the trauma.
Those who suffer from PTSD also take steps to avoid trauma-related stimulus, avoiding trauma-related thoughts or feelings, or trauma-related external reminders. A common example is avoiding watching Fourth of July fireworks because it sounds like gunfire.
Another issue that is part of PTSD is negative alterations in cognitions and mood. What that means is negative thoughts or feelings that began or worsened after the trauma, such as the following:
- Inability to recall key features of the trauma
- Overly negative thoughts and assumptions about oneself or the world
- Exaggerated blame of self or others for causing the trauma
- Negative affect (internal feelings)
- Decreased interest in activities
- Feeling isolated
- Difficulty experiencing positive affect (internal feelings)
PTSD also involves alterations in arousal and reactivity (how you react to things). What that means is trauma-related arousal and reactivity that began or worsened after the trauma, such as the following:
- Irritability or aggression
- Risky or destructive behavior
- Hypervigilance
- Heightened startle reaction
- Difficulty concentrating
- Difficulty sleeping
Three other things about PTSD – symptoms last for more than one month, create distress or functional impairment (such as interference with your social, family, or work activities), and the symptoms are not due to medication, substance use, or other illnesses. (A little more about substance use in the next paragraph). Some PTSD also involves depersonalization (experience of being an outside observer or being detached from oneself) or derealization (feeling things are unreal, distant, or distorted). You can see the formal DSM-V criteria for PTSD here.
A word of clarification about substance use should be made. It is quite common for veterans with PTSD to “self-medicate” with alcohol or other substances. There is no need for you to diagnose yourself with either PTSD or a substance use problem. If you are dealing with distress of any sort, even if you haven’t sorted out the details, get help.
What steps can you take when you suspect you have PTSD?
PTSD can be very serious and impact your life and the lives of those around you in many negative ways. If you are a friend or family member reading this, you probably already know this all too well. Sometimes a veteran suffering from PTSD may, because of their condition, not be aware of the full scope of the impact of their PTSD symptoms. Maybe they have been using alcohol or drugs to help them deal with the symptoms. If you or your loved one are struggling, don’t worry about getting a formal diagnosis. There are steps you can and should take first.
First, if you or your loved one are in crisis, in danger of harming themselves, get help immediately. Call 911 or you can reach the VA’s Veteran Crisis Line by dialing 988 then pressing 1. This is available 24/7, confidential, and you don’t have to be enrolled in VA benefits or health care to connect.
Also, as of January 17, 2023, veterans in suicidal crisis can go to any VA or non-VA health care facility for free emergency health care at no cost – including inpatient or crisis residential care for up to 30 days and outpatient care for up to 90 days. Veterans do not need to be enrolled in the VA system to use this benefit.
If you or your loved one are not in immediate crisis, but still need help, there are a variety of resources available. You can call the VA Health Benefits Service Center toll free at 1-877-222-VETS or explore My HealtheVet, which provides veterans help with VA health care information, services, and locations. There are also a number of organizations, such as the Wounded Warrior Project, that can connect you with resources for doctors, therapists, support groups, or other types of help. There are a number of PTSD treatments that have shown some success, and research is ongoing to better help veterans with PTSD.
You should also file a claim for VA disability compensation benefits, tax-free monthly payments that are available to veterans with service-connected PTSD, whether from combat or non-combat trauma. Getting financial compensation can help mitigate the impact that your PTSD is having on your work life, maybe freeing up more time to focus on your own treatment.
Pursuing a VA disability claim can also have some additional benefits, opening up doors for more free or low-cost treatment, and also can be part of a rehabilitation process if your PTSD has led to some involvement in the criminal court system (an unfortunate side effect of the trauma from military service). The VA disability process can be confusing and VA claims are too often initially denied, so get help. There are VSOs located in every county that can help walk you through the claims forms.
If you have already filed a claim, but either been denied or underrated (a VA disability rating is a percentage from 0 – 100% loosely reflective of the seriousness of your condition), you have a year to appeal that decision and change it.
What steps can you take to make sure that PTSD treatment is paid for by VA Disability?
Currently, veterans in suicidal crisis can access help, from the VA or any non-VA health care facility for free emergency health care at no cost. There is no need to enroll in VA healthcare for these emergency services.
For other medical issues, veterans may be eligible for VA healthcare. If you served on active duty, and did not receive a dishonorable discharge, it’s worth checking out the various eligibility requirements here. There are also many other resources for veterans with PTSD, some for free. A good starting place is the Wounded Warrior Project but there are many others as well.
One of the requirements for enhanced eligibility status (a higher priority group for receiving benefits) with the VA is if you receive financial compensation (payments) from the VA for a service-connected disability. Although there are other avenues of getting access to VA medical care, filing a VA disability benefits claim can be an important process to getting your PTSD treatment paid for by the VA.
Can you adjust your claim as things get worse?
Yes. PTSD and other conditions are likely to change over time. If your condition gets worse after filing your initial claim, there are opportunities to ask for your disability rating to be increased because your condition has gotten worse. This can be done through an appeal process within one year of your ratings decision, or later as a claim for increased disability compensation.
What happens if your claim is denied? Or if the rating is lower than expected?
If you have filed an initial disability claim for PTSD or other conditions, and it is denied, know that you are not alone, and that you have the ability to appeal and get your claim granted. You have one year from the date of your ratings decision to file an appeal.
If your disability rating is lower than expected, and if you believe that your condition warrants a higher disability rating, that is another basis for you to file an appeal. There is no average VA rating for PTSD; claims are rated from 0% to 100% based upon predetermined criteria that focus on symptoms and affect on your personal and work life. See the PTSD ratings sheet here.
If you have had your VA disability benefits claim denied, the rating is lower than expected, or you disagree with the effective date of the claim, these are all reasons to check out your options for filing an appeal, and perhaps also retaining a law firm experienced in these appeals to help you. VA claim appeals require showing the VA where it made a mistake, basically lining up the evidence to make it easy for the VA to accept your position on the claim.
What should you look for in a good VA claim attorney?
A good VA disability attorney should be accredited by the VA (you can check status here) and experienced in handling VA disability benefit appeals (attorneys rarely handle initial claims because, by law, they cannot charge veterans for that work).
Look for a law firm that has an established track record of handling VA disability appeals. Prior results for other clients obviously cannot be guaranteed in your case, but look for a law firm that can articulate a plan of how to obtain a successful outcome for you. Most VA disability claim attorneys only get paid when you get paid, and that tends to align your interest in obtaining the same goal – the maximum benefits to which you are entitled from the earliest permissible effective date.
Have you been denied or underrated for your PTSD or other mental health claim with the VA? Veterans Law Group has helped thousands of veterans obtain millions of dollars in backpay and may be able to help you too. Request your free consultation now.
