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HOW TO: Proving Your PTSD VA Disability Claim

Unsurprisingly, post-traumatic stress disorder (PTSD) is more common in veterans than in the general population. Rates of PTSD among veterans are especially high among those who served in Operation Iraqi Freedom, Operation Enduring Freedom, and Desert Storm. While the rate among the general population is about 6%, these veterans have been diagnosed with PTSD with the following frequency

Operation Iraqi Freedom and Operation Enduring Freedom

15% of veterans have had PTSD within the past 12 months, and 29% at some point in their lives.

Persian Gulf War (Desert Storm)

14% of veterans have had PTSD within the past 12 months, and 21% at some point in their lives. 

These rates are significantly higher than the general population and even more significantly higher than veterans of the Vietnam War, World War II, and the Korean War. 

PTSD is Not Presumed Service-Connected

Despite the high rate of correlation between serving in certain wars and being diagnosed with PTSD and the high likelihood of exposure to traumatic events, there is no presumptive service connection for post-traumatic stress disorder. That means that veterans seeking VA disability benefits for PTSD must demonstrate three things:

• That they have been diagnosed with post-traumatic stress disorder
• That they experienced a traumatic event (stressor) during military service
• That there is a medical nexus between the in-service trauma and the PTSD diagnosis

Establishing Your Claim for Veterans Benefits for PTSD

PTSD Diagnosis

 You must have a diagnosis of post-traumatic stress disorder from a psychiatrist, psychologist or medical doctor. The VA will not accept a diagnosis from a licensed clinical social worker, therapist, or other counselor you may be working with. And, a diagnosis from a medical professional is not automatically sufficient. The VA will look at medical records and other documentation to ensure that the diagnosis meets the criteria for PTSD listed in the DSM-5. To support a diagnosis of PTSD, the medical professional must find a minimum number of symptoms from each of several categories. If the medical records don’t fully support the diagnosis, the VA may deny the claim for disability benefits. 

At Least One In-Service Stressor

The claimant must provide evidence of at least one stressor that occurred during service. The only exception is when PTSD was diagnosed during military service in connection with a qualifying stressor. Less evidence is required to establish that the stressor occurred if the veteran served in combat or was a prisoner of war. If either of those is true, the veteran needs to show only that the stressor was related to the combat or POW experience and was consistent with the conditions of service or imprisonment. If those criteria are met, the stressor will be established unless there is clear and convincing evidence to the contrary.

For those who didn’t serve in combat and weren’t prisoners of war, or whose claimed stressor is not related to that experience, additional evidence will be required. This may be found in service records or other documents containing information about the event and those involved. Statements from other veterans who served with the claimant or friends and family members who knew of the event at the time may also serve as evidence. This latter type of evidence is especially important if the incident was of a type that may not be documented in military records. 

The Connection Between the Stressor and the PTSD 

As with any claim for veterans disability benefits that is not based on a presumed service connection, a veteran claiming benefits for PTSD must establish a medical connection (nexus) between the in-service stressor and the diagnosed condition. This is typically established with a medical nexus letter from a physician. 

There’s More to Your PTSD Claim than Getting Approved

Most people think only in terms of getting approved for veterans disability benefits. Of course, that’s the most critical element when you’re pursuing benefits. However, your disability rating is nearly as important. PTSD is rated under the schedule for general mental disorders. A veteran diagnosed with service-connected PTSD may be rated 10%, 30%, 50%, 70% or 100%. That’s a significant range. For example, in 2023 a veteran with a 10% disability rating receives $165.92/month in monetary benefits. At a 50% disability rating, the veteran receives $1041.8/month, and at a 100% rating, $3,621.95. 

The differences extend beyond the monthly check, too. For instance, at 30% and above, benefits are increased if the veteran has qualifying dependents. Below 50%, the veteran is entitled to VA health care only for service-connected conditions. Above that point, they receive general health care benefits. And, at the 100% level, there are direct benefits for dependents, such as medical coverage and education benefits. 

The Code of Federal Regulations sets forth the requirements for each disability rating, and it is up to the veteran to provide adequate medical and other documentation to prove that they meet that rating. 

An Experienced Veterans Disability Benefits Advocate Can Help

Receiving VA disability benefits for PTSD requires a wide range of evidence. You must prove that you experienced a stressor during military service, establish a connection between a stressor that may have occurred long ago and your current condition, and then provide sufficient medical documentation to ensure that you receive the most appropriate disability rating. 

This process can be daunting, and small mistakes or omissions can result in a denial, or significantly delay the process. Whether you are just starting to put together your claim for veterans disability benefits for PTSD, you have been denied and want to appeal, or your benefits were approved but you believe your disability rating is too low, Veterans Help Group is here for you. Our experienced VA disability benefits advocates understand what type of evidence is necessary to establish your claim, and how best to present that evidence to the VA.

 To learn more about how we can help you put together the strongest VA disability claim or appeal possible, call 855-855-8992 right now, or fill out our contact form here and we’ll reach out to you.