Why is it so hard for veterans to make a psychiatric disability VA Claim?
Published March 3, 2023
Veterans who make psychiatric disability claims are often at a disadvantage in getting their VA disability compensation claims paid, but there are some ways to make things easier.
Typical Psychiatric Disability Claims
Common psychiatric disability claims made to the VA include PTSD including combat, personal trauma, MST (military sexual trauma), depression, anxiety, and insomnia.
PTSD symptoms can range from decreases in work efficiency and ability to perform occupational tasks when you are going through periods of significant stress, frequent panic attacks, impaired memory, impaired abstract thinking, suicide ideation, obsessional rituals which interfere with daily activities, impaired impulse control sometimes resulting in violence, delusions, hallucinations, and disorientation to time or place. These are just a small number of possible PTSD symptoms. According to the VA’s National Center for PTSD, an estimated 30% of Vietnam Veterans, 12% of Gulf War Veterans, and 11-20% of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) Veterans have PTSD. Those statistics are obviously based upon data available to the VA and don’t include veterans who have been silently suffering from PTSD but never sought help or disability compensation from the VA. Other research has shown a staggering 75% of service members having PTSD after 9/11.
The rate of MST situations is also astonishingly high. According to the VA’s National Center for PTSD, among Veterans who use VA health care, 23% of women reported sexual assault when in the military (and we all know that many such incidents are never reported during military service). Additionally, 55% of women and 38% of men experienced sexual harassment when in the military.
The bottom line is that a significant number of veterans have some symptoms or conditions that may be characterized as psychiatric disabilities and may be compensable through the VA disability compensation program.
Why is it so hard for veterans to get the courage to seek help related to their psychiatric disability?
As reported by the VA, as recently as May 2022, veterans face barriers to mental health treatment, including stigma, shame, and lack of understanding, not to mention logistical barriers such as long wait times and travel distances and provider assumptions based on demographics.
Unfortunately, these recent studies reflect some of the same findings as a 1995 study which found five different types of barriers to veteran mental health care:
- Concern about what others will think (will people think I’m crazy? will I lose my job? will I lose my top secret clearance?)
- Financial, personal, and physical obstacles to getting diagnosis or treatment or benefits (VA medical facility is hours drive away, its difficult to get an appointment, how can I take care of my financial responsibilities and get treatment at the same time?)
- Confidence in the VA healthcare system (the VA has a well-earned reputation for being slow and ineffective on many levels)
- Navigating VA benefits and healthcare services (if you are struggling with a mental illness, the extensive paperwork and bureaucratic processes can be especially overwhelming)
- Privacy, security, and abuse of services by others (will records really be kept private? can I really talk about the awful things I saw and did or will I get arrested? don’t veterans sometimes go the VA just to get the drugs they then abuse?)
It is not easy to acknowledge to yourself, much less to anyone else, that you are struggling mentally. It is a disconnect with your military training and creeds.
“Improvise, adapt, and overcome all obstacles in all situations.”
“I am disciplined, physically and mentally tough.”
“I will never falter, and I will not fail.”
“I will always be at my station, alert and attending to my duties.”
From the first day of basic training forward, the military told you to just get things done, even if you felt weak or incapable in the moment.
While that is a necessary attitude in service, especially on the battlefield, an entirely different approach is needed in civilian life.
It’s no small feat, though, to make that mental adjustment. What will others think of me, what will I think of myself, if I admit that I’m having a problem, that I cannot seem to hold down a regular job, that I cannot seem to interact with my family without flying into a rage, that I’ve been drinking by myself way into the night because I’m not sure what nightmares may await me if I try to sleep?
Any veteran who takes the first step of acknowledging a problem and then files for a VA disability compensation claim has already taken a brave step. Yes, you are acknowledging that you need help in a way that may seem contradictory to your military training, and yes, the mental issues that are plaguing you actually make it harder to seek assistance, but you have already overcome so much and, with assistance, you can do this too.
The VA disability process is confusing on the best of days and even more challenging if you are already having mental health symptoms. Don’t proceed through a VA psychiatric disability claim by yourself. For your initial claim, seek assistance from a VA-accredited VSO (veteran service officer), and if you are appealing your decision (more about that below), seek assistance from an experienced VA disability attorney.
What do you need when making a psychiatric disability claim?
Successful VA disability claims require a current diagnosis of a psychiatric condition and evidence that something happened during your military service that either caused it or aggravated a previously existing condition. If the VA acknowledges a service-connection between your condition and your service, then they will proceed to determine how serious your condition is (against a list of predetermined symptoms and impact on your life) and assign a VA disability rating number to that (0% – 100% in increments of 10). See a ratings sheet with more details here. Your overall rating number (if you have more than one condition, a percentage rating will be assigned to each, and then through a process of “VA math,” they combine them into a single number) determines what your monthly payments will be.
Unlike many physical injuries, a psychiatric condition and its connection to your military service may be harder to prove. There is a significant hesitancy to acknowledge any type of mental failings while in service. Thus, even if you began showing symptoms during service, your service treatment record may not show it. This is especially true for MST cases which are often not reported for fear of retaliation or other negative consequences. However, there are many ways to locate evidence supporting your claim.
For MSTs and other non-combat personal assaults (which usually fall under a PTSD claim), the VA requests any service medical or personnel record documenting that the MST event occurred, if such records exist, such as DOD sexual assault or harassment reporting forms and/or investigative reports completed during military service.
As you might imagine, those records often do not exist. However, there are other ways to prove the assault occurred. Veterans can submit alternative sources of evidence to corroborate their claim. Some examples of this type of evidence include statements from a chaplain or clergy member in whom you confided, records from a civil counseling facility or rape crisis center, civilian police reports, and statements from family members, friends, or fellow service members who have knowledge of the incident. Other examples are civilian medical reports, personal diaries, and journals. This is not an exclusive list.
Even if you cannot access any of these records, there are other signs that something traumatic happened that may show up in your records or have witnesses to verify. These stress indicators can include the following:
- Change in work performance at the time
- Episodes of the following without clear cause:
- depression, and
- panic attacks
- Pregnancy tests
- Relationship issues, like divorce
- Requests for transfer to another military duty assignment
- Sexual dysfunction
- Substance abuse
- Tests for sexually transmitted diseases
- Unexplained social or economic behavior
The VA may request a medical examination and opinion (C&P Exam) to help in their determination of your claim.
What happens if your claim is denied? Or if the rating is lower than expected?
The VA screws up on disability claim decisions, often, but many of those denials are mistakes or are fixable. The statistics on getting a denial or underrating overturned or remanded (sent back to be further processed) on appeal are much better. Unfortunately, whether through carelessness, understaffing, and just missing things, many errors are made. But those errors are often fixable with an appeal.
If your claim is denied or the rating you get is lower than expected, don’t just refile a claim and hope for a better outcome. This is unlikely to happen, and you will lose your effective date for the start of benefits if you are able to eventually prove to the VA that you were entitled to receive them.
You have one year from the issuance of the ratings decision to file an appeal. VA claim appeals currently come in three different types. One is a Higher Level Review where the VA’s regional office uses more experienced reviewers to take a second look at your file. This may be the best course if all of the necessary information is already in the file, but the VA reviewer just missed it.
Another type of appeal is the Supplemental Claim. This may be the best course if you need to add some additional documentation or other evidence to the file in order for the VA to grant your claim or rate you at the level you think is appropriate.
The third type of appeal is Board Review. This goes to a Veterans Law Judge at the Board of Veterans’ Appeals in Washington, D.C., and will be reviewed by a judge who is an expert in veterans law. It also allows you to have an actual, live hearing so you can explain your case to the judge. This may be the best course if either of the other appeal methods were not successful or in cases where your credibility is not as well conveyed on paper.
What should you look for in a good VA claim attorney?
VA disability compensation appeals are a highly specialized niche law practice, so you’ll want to find a lawyer who has this specific area of experience. You want a law firm that has done hundreds or thousands of cases and spends all their time perfecting their craft.
Unlike certain types of legal cases, this is not the time to look for the most “aggressive” lawyer you can find, but more the most “persistent.” The VA disability claim appeals process is not adversarial, like a courtroom. Your attorney is not going to be “arguing” with the VA, but rather “advocating” on your behalf. The VA knows that they make mistakes and they are duty-bound to correct them, and sometimes do so without a fight. A meticulous, detailed, and persistent lawyer will be able to dig through your records and find out why the VA has denied or underrated your claim and line up the evidence necessary to make it easy for the VA to agree with them. You need someone who understands the dynamics at play, especially with psychiatric disabilities, so they can help you get the right diagnosis documented and all of the relevant factors reviewed.
Worried you cannot afford a good VA disability appeals lawyer? Most VA disability appeals attorneys work on a contingency fee basis – they don’t get paid unless, and until, you get paid. In other words, they work for free, sometimes for several years and often forwarding costs for independent medical exams or other reports needed for your case, until they are able to obtain an acceptable disability decision for you (or explore all avenues for doing so). If the contingency fee is 20% (a much lower percentage than would be expected for personal injury lawyers), you can sign a form authorizing the VA to pay your attorney out of your cash payment at the end of your appeal.
Are you ready to have Veterans Law Group review your psychiatric disability claim and see if we can help you successfully appeal? We have successfully represented thousands of veterans just like you. Click here for your free case analysis.