Post-traumatic stress disorder (PTSD) is a mental health condition that can develop in individuals who have experienced or witnessed traumatic events, such as military combat or life-threatening accidents. When you serve in the military, you may be exposed to different traumatic events than civilians. The war you served in may also affect your risk because of the types of trauma that were common. War zone deployment, training accidents, witnessing a service-member's death, and military sexual trauma (or, MST) may lead to PTSD.
Recognizing the significant impact PTSD can have on the lives of veterans, the Department of Veterans Affairs (VA) has established a rating system to determine the level of compensation and support veterans are entitled to receive. This blog post will delve into how the VA rates PTSD, as well as the criteria used for evaluation and the process of applying for benefits.
The number of Veterans with PTSD varies by service era. The data below are from a large study of Veterans across the country:
Understanding PTSD and Its Symptoms
PTSD is a complex mental health disorder that affects individuals differently. Common symptoms include:
Re-experiencing the trauma through flashbacks, nightmares, or intrusive thoughts
Avoidance of situations, places, or people that trigger memories of the traumatic event
Negative changes in thoughts and mood, including feelings of guilt, shame, or detachment from others
Hyperarousal symptoms, such as increased irritability, difficulty sleeping, and being easily startled
These symptoms can significantly impair daily functioning, making it difficult for veterans to maintain relationships, hold down jobs, or engage in social activities.
The VA Rating System for PTSD
The VA utilizes a rating system under 38 C.F.R. § 4.130 entitled the "General Rating Formula for Mental Disorders" to assess the severity of a veteran's PTSD, ranging from 0% to 100%. This rating determines the level of compensation and benefits a veteran is eligible to receive. The criteria for each rating level are as follows:
0% rating: PTSD has been diagnosed, but the symptoms are not severe enough to warrant compensation. In other words, the symptoms do not interfere with occupational and social function or require continuous medication.
10% rating: Mild or transient symptoms which decrease work efficiency and the ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by medication.
30% rating: Symptoms which cause occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. The veteran may struggle with a depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).
50% rating: PTSD that lead to a reduction in work efficiency and productivity. The veteran may struggle with a flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.
70% rating: Symptoms which cause deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood. The veteran may be struggling with suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.
100% rating: Total occupational and social impairment due to extreme PTSD symptoms. The veteran may be completely unable to work or engage in any social activities. The veteran may show symptoms such as gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.
Understanding the Combat & other PTSD Presumptions
Special treatment is afforded to combat veterans and veterans with specific in-service events, which is mainly contained in two provisions, 38 U.S.C. § 1154(b) and its implementing regulations 38 C.F.R. § 3.304(d) and (f). These special rules lower the burden on the veteran to show that the injury, disease, or event during service that the veteran claims led to the current disability in fact happened.
In other words, lay or other evidence of service incurrence or aggravation of such injury or disease, if consistent with the circumstances, conditions, or hardships of such service, would be sufficient to prove your in-service event notwithstanding the fact that there is no official record of such incurrence or aggravation in such service. Veterans have used this presumption to obtain service connection despite the fact that there is no explicit documentation that the in-service event occurred in the following circumstances:
If PTSD is first diagnosed in service
If the veterans stressor is related to the fear of a hostile military or terrorist activity
If PTSD is based on combat
If the veteran was a prisoner-of-war
If PTSD is based on in-service personal assault
Applying for PTSD Benefits
To apply for VA disability benefits for PTSD, veterans must:
Obtain a formal diagnosis of PTSD from a qualified healthcare professional.
Provide evidence of a traumatic event that occurred during military service.
Establish a clear link between the traumatic event and the development of PTSD.
When rating a veteran's mental disorder, the VA will consider the following factors:
Medical documentation: This includes the veteran's medical records, treatment history, and evaluations from healthcare professionals. These documents should provide detailed information about the veteran's symptoms, their severity, and the impact on daily functioning.
Private nexus opinions: The Veteran may procure a private opinion form a mental health expert who can take the time and care required to fully review your claims file, lay statements, and evidence and prepare a well-rationed report to establish the link between the in-service traumatic event and the development of PTSD.
Personal statements and buddy letters: The veteran may submit personal statements or letters from friends, family members, or co-workers to provide additional evidence to corroborate the in-service event and show the mental disorder's impact on their daily life.
Service treatment, personnel records, and other evidence: The veteran's in-service event may be documented in the service treatment or personnel records. The in-service event may also be corroborated circumstantially by providing evidence of changes in behavior such as through post-service arrest records, educational difficulties, deterioration in work performance, etc.
The VA will review the application, medical records, and any additional documentation provided. They may also request the veteran undergo a Compensation and Pension (C&P) examination to further assess the severity of the PTSD and its impact on daily functioning.
Conclusion
The VA rating system for PTSD is designed to ensure that veterans receive the appropriate level of compensation and support based on the severity of their symptoms. Understanding this rating system and the process of applying for benefits can help veterans navigate the system more effectively and receive the assistance they need to improve their quality of life. If you or a loved one is a veteran struggling with PTSD, consider reaching out to a VA-accredited attorney for support and guidance.
Commentaires