Tax-free monthly monetary payments are available to veterans who have service-connected PTSD. PTSD in veterans if finally being recognized as a real problem for those who have served in the military. Whether you are a veteran or a friend or family member of veteran with PTSD, this article explores the VA disability process, what disability ratings may be expected for this type of VA psychiatric disability claim and, if necessary, options to change a denial or underrating through the VA disability appeals process.
If you have already been denied for VA disability compensation, you can get a free review of that decision.
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.
What does the VA consider when evaluating PTSD claims?
When evaluating VA claims for PTSD, they look at the same basic factors as all claims, but with a few tweaks. All successful VA disability claims have the elements of a current disability + connection to something that happened in service. In the case of PTSD, claims tend to fall into two categories – combat-related trauma or non-combat trauma. Non-combat trauma includes personal assault, MSTs (military sexual trauma), and other traumas that happened in service.
For non-combat trauma an additional 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.
The VA often also 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) form that the medical professional fills out that covers information needed to compare your condition to a Rating Schedule. This Rating Schedule (discussed in more detail below) lists symptoms and occupational and social impairment levels. They issue a rating percentage number based on how close your condition matches up with that Rating Schedule.
What VA Disability Rating should I expect for PTSD?
The disability rating that the VA applies to a service-connected PTSD claim is based upon a comparison of your symptoms and occupational and social impairments versus a Rating Schedule, and assigning a percentage that most closely matches. You may not have all of the symptoms described at any one rating level.
VA disability ratings for PTSD claims range from 0% (formal diagnosis, but symptoms are not severe enough to interfere with occupational and social functioning or to require continuous medication), with intermediate steps at 10%, 30%, 50% and 70% up to 100% (total occupational and social impairment).
The description for a 10% rating is this: “Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication.”
The description for a 30% rating reflects more significant impairment and some specific symptoms. “Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal). Due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, or mild memory loss (such as forgetting names, directions, recent events).”
A 50% rating is described this way: “Occupational and social impairment with reduced reliability and productivity. Due to such symptoms as: flattened affect, circumstantial, circumlocutory, or stereotyped speech, panic attacks more than once a week, impaired judgment, impaired abstract thinking, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty in understanding complex commands, impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks).”
That all sounds pretty complicated, but these are things that your doctor, and a doctor assigned by the VA to evaluate you, should be asking you. Something to keep in mind with all mental health ratings, the VA will apply the criteria that most closely relates. What that means is you are not required to meet every item in the evaluation for that percentage to be assigned.”
A 70% rating is described like this: “Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. Due to such symptoms as: suicidal ideation, obsessional rituals which interfere with routine activities, speech intermittently illogical, obscure, or irrelevant, spatial disorientation, 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), neglect of personal appearance/hygiene, difficulty in adapting to stressful circumstances (including work or a work-like setting), inability to establish and maintain effective relationships.”
Finally, a 100% rating has the following description: “Total occupational and social impairment. Due to such symptoms as: gross impairment in thought process or communication, persistent delusions/hallucinations, grossly inappropriate behavior, disorientation to time or place; memory loss for names of close relatives, own occupation, or own name, persistent danger of hurting self or others, intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene).”
Can you adjust your PTSD claim as things get worse?
Yes. The VA understands that PTSD symptoms are rarely static and often change over tie. If your condition gets worse after filing your initial claim, you can request that your disability rating to be increased. Depending on the specifics of your situation, you may raise this within the VA claim appeals process (within one year of your ratings decision), or later as a claim for increased disability compensation.
Whatever the situation with your VA disability claim process, don’t hesitate to get direct help if you are in a crisis situation. If you or your loved one is in danger of harming yourself/themselves, reach out for immediate help. 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.
Additionally, 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. This service also does not require prior enrollment in the VA system.
What happens if your claim is denied? Or if the rating is lower than expected?
If your initial disability claim for PTSD has resulted in a denial or underrating, don’t give up. You can appeal (there are three different types of appeal available) and get the VA to reconsider. 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. 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, you can 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 as discussed above. See the PTSD ratings sheet here.
What should you look for in a good VA claim attorney?
Frequently veterans will hire a law firm to assist them with a veteran, someone to help them navigate the VA process and be able to explain to the VA how they got the decision wrong.
A good VA disability attorney should meet some basic requirements – be in good standing with their state bar association, and be accredited by the VA (you can check status here). Beyond that you want an attorney experienced in handling VA disability benefit appeals. This is a small niche of attorneys; general practitioners don’t have the necessary knowledge to handle VA disability appeals, no matter how brilliant they are in other areas of the law.
Prior results for other clients 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.
In terms of cost, most VA disability claim attorneys will not require any payment from their veteran clients until a successful outcome is achieved. Most frequently these law firms only get paid when you get paid and often at a 20% of your backpay award. This type of contingency arrangement aligns your interests and theirs 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.
