PTSD and VA Disability Claims

Approximately six percent of individuals in the United States will experience posttraumatic stress disorder, or PTSD, at some point in their lives. For Veterans, this number is even higher. Although PTSD was not formally recognized as a diagnosis until 1980, the condition has been known by other names like “battle fatigue,” “shell shock,” and “Soldier’s heart” since the Civil War.

PTSD is the sixth most common disabling condition and the most common mental health condition among Veterans applying for disability benefits. At Capovilla & Williams, our experienced and dedicated legal team of VA disability lawyers is equipped to assist you with your claim. Get started by writing to us online or calling 866.951.0466.

What Is PTSD?

Although the general public may associate PTSD with military Veterans, any person who experiences a traumatic eventis at risk of PTSD. This includes combat Veterans as well as survivors of:

• Physical or sexual assaults
• Natural disasters
• Accidents
• Serious illnesses
• Combat

Any situation that you perceive to be life-threatening can lead to PTSD. What is more, it is possible to develop PTSD by witnessing a traumatic event, even if it does not directly affect you. Veterans who have watched a fellow Soldier, Marine, or Sailor die in combat can experience PTSD, even though they were never in physical danger themselves.

How Common Is PTSD Among Veterans?

Roughly 7% of United States Veterans report symptoms related to PTSD at some point in their lives, higher than the 6% of civilians who do. However, a Veteran’s likelihood of experiencing PTSD can vary significantly on their age, whether they participated in certain conflicts, and even whether they are currently being treated by the VA.

Thirteen percent of female Veterans will experience PTSD in their lifetimes, compared to approximately 6% of male Veterans. Approximately 23% of Veterans who are actively being cared for by the Department of Veterans Affairs report PTSD symptoms.

Upwards of 30 percent of Veterans who fought in the Vietnam War experienced PTSD in their lifetimes, whereas about 21% of Veterans who fought in the Persian Gulf War (Operation Desert Storm. Among Veterans of Operations Iraqi Freedom & Enduring Freedom (post -2001 conflicts), PTSD impacts approximately 29 percent of Veterans.

What Are the Symptoms of PTSD?

The Diagnostic and Statistical Manual of Mental Disorders (5th Edition) recognizes 20 core symptoms of PTSD. These symptoms are generally categorized into four main clusters:

1. Intrusive thoughts: You experience vivid flashbacks in which you relive the traumatic moment as if it were happening again. Or you might have nightmares that interfere with your sleep. These thoughts can occur without warning and negatively impact your daily life.

For example, you may notice that you are having fitful, restless sleep because of nightmares, which in turn makes you drowsy during the daytime. Or intrusive thoughts during the day can affect your attention and make completing tasks at work or home difficult.

2. Avoidance behaviors: You make a conscientious effort to avoid people, places, and things that you associate with the traumatic event. You may also avoid discussing or thinking about topics that remind you of the trauma. 

If you experienced trauma watching a friend pass away at a hospital, you might avoid driving near or going into hospitals or doctors’ offices. Similarly, if you were the victim of military sexual trauma (MST), you may avoid being around people who remind you of your attackers.

3. Mood swings and disorders: People with PTSD may become moody, withdrawn, irritable, or easily angered following the traumatic event. These changes in mood make maintaining friendships and intimate relationships challenging. Close friends and even family members may report feeling distant and disconnected from you, even when spending time with you.

Common examples of mood swings and disorders include persistent feelings of shame or blaming yourself for the traumatic event. You might also feel detached from daily life and have trouble experiencing positive emotions.

4. Changes in reactivity: Individuals with PTSD have reported experiencing feeling as if they must always be on guard or alert for potential dangers, even in objectively safe environments. You may be at home and yet be unable to relax fully, or you might misinterpret benign comments and actions from others as threats.

For instance, you might notice that you have trouble falling asleep or remaining asleep following a traumatic event. Minor inconveniences, such as someone forgetting to run an errand, might provoke a disproportionate, angry response.

Experiencing brief symptoms immediately following a traumatic event does not always mean they have or will develop PTSD. However, any symptom that affects your quality of life or that persists or worsens over time warrants a visit to a medical professional who can evaluate you and determine if you have PTSD.

How Veterans Obtain VA Disability Benefits for PTSD

As with any other disabling condition, your PTSD must be connected to an in-service event — something that occurred during your military service — to be eligible for VA disability benefits. The entire process looks like this:

1. Formal PTSD diagnosis: If you suspect you have PTSD, your first step is to see a mental health provider like a licensed psychiatrist or qualified psychologist. This can be a professional in your local community or someone through the VA. During your evaluation, the professional will interview you and have you complete several questionnaires to determine if you should be diagnosed with PTSD. You should bring any notes or records you may have from previous doctors’ visits you attended for this concern. 
2. Complete VA Form 21-0781: Along with VA Form 21-526EZ: Application for Disability Benefits and Related Compensation Benefits, many Veterans with non-combat PTSD claims need to complete Form 21-0781 (or Form 21-0781a for military sexual trauma or personal assault). On this form, your VA disability lawyer with Capovilla & Williams will describe the in-service event or events that caused your PTSD. This could include non-combat experiences, exposure to toxic substances, or military sexual trauma (MST). For MST or personal assault, our attorneys will help you locate and collect evidence of “markers,” described in 38 C.F.R. § 3.304(f)(5), such as changes in your duty performance, transfer requests, and documented behavioral changes. These “markers” can help show that a traumatic event happened during your military service where definitive evidence may be lacking.
3. Collect evidence of PTSD’s impact: The amount of your disability benefits for PTSD depends on how the condition affects your daily life. In addition to your personal statement, we will help you gather letters from friends and family, work performance letters, and other documentation to show the VA the impact your PTSD symptoms have on your ability to work and enjoy life.
4. File your claim: We can help prepare and submit the requisite paperwork to formally start the claims process with the VA. Our attorneys know to complete this step as expeditiously as possible, as the VA uses the date you submit an Intent to File or formal claim to calculate the start date of your VA benefits.
5. Attend the Compensation and Pension exam: The C&P exam is where a doctor formally assesses the impact of your PTSD and leads to the assignment of a disability rating between 0% and 100% by a Rating Veteran Service Representative (RVSR). The higher the disability rating, the greater your benefits amount:

6. Appeal adverse determinations: If the VA denies your claim, we will assist you in appealing that denial through one of three appeal lanes: filing a supplemental claim, asking for a higher-level review, or requesting a hearing before a Veterans Law Judge.

Three Lanes for Appealing a Denied PTSD VA Disability Claim

You have the right to appeal a denial of your PTSD disability claim if the VA initially denies it, so long as you do so within one (1) year of the denial. The way our attorneys would take this appeal depends on the reason why the VA denied your claim:

• Supplemental claims submitted on VA Form 20-0995 under 38 CFR § 3.2501 are appropriate where the VA does not believe the record contains enough evidence linking your PTSD to an in-service event or if there is some other evidentiary deficiency. A supplemental claim adds additional documentation to the record for the VA’s consideration.
• Higher-level review filed using VA Form 20-0996 is appropriate if we believe someone with additional experience at the VA would reach a different conclusion in your case. This option does not add anything new to the record but instead asks a more senior claims reviewer to re-examine what was already submitted.
• Board appeal using VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement) asks a Veterans Law Judge with the Board of Veterans’ Appeals (BVA) to review your case. The BVA is the highest level of administrative appeal within the VA. The Veterans Law Judge considering your appeal can review the evidence and documents you already submitted, consider supplemental evidence you provide, or hold a hearing where we can appear with you to make arguments and present evidence.

Experienced Legal Representation Can Make a Difference

You fought hard and served your country; you should not have to fight hard for the VA disability benefits you need to address your in-service PTSD. We at Capovilla & Williams will come alongside you wherever you are in the VA disability claims process and be your voice before the VA and beyond. Reach out to us through our website or call 866.951.0466 to enlist our help today.

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