What VA disability claim documentation is needed for PTSD?
VA disability benefit payments are available to veterans with service-connected PTSD. Maybe you or your loved one are entitled to receive them.
The VA recognizes that PTSD in veterans is a widespread issue. This article discusses the VA disability claims process, focusing on what claim documentation is needed for a PTSD claim. There is no average VA rating for PTSD or any VA psychiatric disability claim, but veterans who believe that their claim was improperly denied or were underrated for their PTSD can utilize the VA disability appeals process to try to change the outcome.
If you have already been denied or underrated for your VA disability compensation claim, you can get a free review of that decision by experienced attorneys at Veterans Law Group.
If you or your loved one are in imminent danger of harming themselves or others, 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.
What does the VA consider when evaluating PTSD claims?
The VA evaluates PTSD claims similarly to how it evaluates all disability claims. They look for a current disability (as opposed to a past injury alone) and a connection to something that happened in service. If they find both elements, they then assign an effective date (the starting date for benefits, often the date of filing the initial claim application) and an overall disability rating (from 0% – 100%) that determines the amount of monthly benefit payments.
For PTSD claims, they fall into two categories – combat-related and non-combat-related. The first category of VA claims assumes that if you were in combat, that it could be a trauma that later causes PTSD. The second category includes MSTs (military sexual trauma) and other traumas that happened in service. This second category requires some additional documentation, including a stressor statement explaining what happened.
A medical diagnosis of PTSD is also helpful, although even if you don’t have a formal diagnosis, the VA will schedule an examination to look into that.
The VA usually schedules a C&P Exam (compensation and pension exam) to get additional information about your stressor (the trauma that triggered your current condition) and your current symptoms and impact on your work and personal life. There is a special DBQ (Disability Benefits Questionnaire) for PTSD cases that includes more detailed questions than other mental health conditions.
VA disability ratings for PTSD range from 0% to 100% depending on the severity of symptoms and impact on your work and personal life.
What documentation do I need for a VA disability claim for PTSD?
For all disability benefit claims the VA looks for a current condition (and at some point, a diagnosis), evidence that something happened in service, and then a nexus, or connection, between the two. The evidence supporting each of these three factors comes in different forms depending on your unique situation.
Among the types of evidence that the VA reviews will be your service treatment records (did you report any PTSD or traumatic stressor during your service), your medical records (does it reflect a current diagnosis of PTSD?) and anything that shows a connection between the two.
For PTSD from a non-combat trauma, a stressor statement document is required where you explain what happened to you in-service that you believe was a trauma that led to your PTSD.
A medical diagnosis of PTSD is also helpful, although even if you don’t have a formal diagnosis, the VA will schedule an examination to look into that.
Medical evidence is going to be an important part of documentation for a PTSD disability claim. Medical records, whether a private physician, VA doctor, or in-service treatment will be a way to demonstrate the frequency, duration, and severity of symptoms. Sometimes employment records can be used to show how the condition and symptoms are affecting your daily life, at work, at home, or in social situations.
Sometimes lay evidence, or buddy statements, may also help build the necessary picture of your mental condition. Sometimes spouses or family members that interact with you regularly may see even more to your condition than you do. The goal is to assemble the records necessary to show your current condition and how it connects to your prior military service.
Claim documentation for PTSD caused by an MST is probably some of the more comprehensive projects. Sexual harassment and assault is often not reported in service and therefore the veteran’s service record doesn’t show the occurrence. However, there are many ways to compile evidence that an MST happened, including contemporaneous informal reports to friends, family, priests or others, civilian medical records, rape crisis center records, and more. There are also a variety of “markers,” indications of a trauma occurring that are only obvious if you know what you are looking for. See here for a more detailed description of how to prove an MST case.
What happens if your PTSD claim is denied? Or if the rating is lower than expected?
You are not alone if your initial disability claim for PTSD has resulted in a denial or underrating. Many other veterans have found themselves in the same position, but that should not be a reason to give up. Within one year of your ratings decision you can appeal. There are three different types of appeal available, and some allow you to submit additional evidence to supplement your claim.
Aspects of VA disability decisions that are most often appealed are a denial of service-connection for your condition, too low a disability rating percentage, or improper effective dates. Statistically, VA claim appeals are successful on some level at least 70% of the time, with the highest success rate among veterans represented by private attorneys.
What should you look for in a good VA claim attorney?
A good VA claim attorney will be experienced and patient in navigating the bureaucracy and idiosyncrasies of the VA. The VA disability process is not like a court case. The VA’s purpose is to help veterans and the disability process is explicitly a non-adversarial process; it is not an “us against them” framework. Yes, the VA often gets things wrong, but can patiently be brought around to agree with the veteran with the guidance of an experienced VA disability appeal attorney.
VA disability attorneys are required to be state-licensed (as with all other attorneys) and also be accredited by the VA (you can check status here).
You also want an attorney experienced in handling VA disability benefit appeals, lots of them. Although prior results for other clients cannot be guaranteed in your case, prior experience gives them a wealth of knowledge of similar cases to help plot a course for success for your VA disability appeal.
In terms of cost, most VA disability claim attorneys work on a contingency basis – they get paid only when and if you get paid. They will not require any upfront payment from their veteran clients. Some law firms will also foot the bill for any necessary independent medical examinations (IMEs) or vocational rehabilitation reports.
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.
