How Does the VA Service Connect and Rate Ptsd?

The U.S. Department of Veterans’ Affairs, (VA) has determined that Post-Traumatic Stress Disorder, (PTSD), is the most common mental health issue faced by our soldiers that have returned from combat.

What is PTSD?

PTSD symptoms may appear in you or your loved one after facing an extremely traumatic event that involves being close to real or threatened death, injury, or witnessing events that involve the death or injury to someone else.

Symptoms of PTSD include, but aren’t limited to, angry outbursts, helplessness, suicidal ideation, horror, and/or reliving the traumatic event over and over.

If you or a loved one is suffering from PTSD as a result of your service in the military, you may be eligible for VA disability compensation.

2010 PTSD Regulations

In July of 2010, new regulations went into effect that is intended to streamline the claims process for veterans that suffer from PTSD. For veterans not in direct combat, the regulations allowed them to show that their PTSD stressor is related to being afraid of hostile military or terrorist activity, but only if the stressor is in line with the places, types, and circumstances of the veteran’s service.  These new regulations require that:

1. There is a PTSD diagnosis
2. A psychiatrist or psychologist that works for the VA has determined that the stressor caused the PTSD
3. The symptoms the veteran is suffering from is related to the occurrence of the stressor
4. The stressor is consistent with the veteran’s service record regarding the type, places, and circumstances of the veteran’s military service, and there isn’t any obvious and/or convincing evidence to prove otherwise.

How the Veteran’s Administration Determines the Disability Rating for PTSD

The Veteran’s Administration is now using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-V) to diagnose and evaluate you or your loved one’s mental disability. Before that, the VA was using DSM-IV to diagnose and evaluate your PTSD. One of the major changes is that the Veterans’ Administration used to heavily rely on the Global Assessment of Functioning Score (GAF) to determine a rating for a veteran’s PTSD and other mental disabilities.

Another change in the DSM-5 is the change in the criteria for the diagnosis of PTSD, and the events that qualify for a PTSD diagnosis have been narrowed. It’s now required that veterans have, at a minimum, one ‘avoidance’ symptom. In addition, new subtypes of PTSD have been added that include delayed expression and a dissociative subtype of PTSD.  Note, that in both specifications, the full criteria for PTSD must be met for the application to be deemed warranted.

Below are the criteria for the DSM-5 in regards to PTSD:

Criteria A: Stressor

If the veteran was exposed to death, the threat of death or actual or threatened serious injury, or actual or threatened sexual violence, one of the criteria is required:

1. Direct exposure
2. Must have witnessed the traumatic event in person
3. Learning that a loved one, be it a relative or friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental.
4. Repeated and/or extreme exposure to aversive details of the event. Generally, this would occur in the course of duty. This doesn’t include expose by electronic media, television, movies, and/or photographs.

Criteria B: Intrusion Symptoms

The traumatic event is persistently re-experienced in the following ways: One or more of these is required:

1. Recurrent, involuntary, and/or intrusive memories
2. Traumatic nightmares
3. Dissociative reactions, for example, flashbacks, which may happen in a brief episode to loss of consciousness
4. Intense or prolonged distress after being exposed to traumatic reminders
5. Marked physiologic reaction after being exposed to a trauma-related stimulus

Criteria C: Avoidance

Persistent effortful avoidance of any distressing trauma-related stimulus after the event. One of the symptoms below is required:

1. Thoughts or feelings related to the trauma
2. External reminders such as people, places, conversations, activities, objects, or situations that are trauma-related

Criteria D: Negative Alterations in Cognitions and Mood

Changes in arousal and reaction that began or became worse after the traumatic event.

Two of the following must be present:

1. The inability to remember key features of the traumatic event, not due to head injury, alcohol, and/or drugs
2. Persistent, and sometimes distorted beliefs and/or expectations about themselves or the world that are negative in nature
3. Persistent and distorted blame of themselves or others for causing the traumatic event and/or the consequences that resulted from the traumatic event
4. Feelings of fear, horror, anger, guilt, or shame that are negative, persistent, and trauma-related
5. Significantly diminished interest in pre-traumatic activities
6. Feeling alienated from others
7. Constricted affect: a persistent inability to feel or experience positive emotions

Criteria E: Alterations in Arousal and Reactivity

1. Aggressive and/or irritable behavior
2. Reckless and/or self-destructive behavior
3. Hypervigilance
4. Pronounced or exaggerated startle response
5. Disturbances in sleep

Criteria F: Duration

The symptoms in criteria’s B, C, D, and E must be present for more than a month.

Criteria G: Functional Significance

Symptom-related distress or functional impairment that is significant.

Criteria H: Exclusion

The disturbance is not related to any medication, substance abuse, or other illness.

Specify:  With Dissociative Symptoms

Along with having to meet the criteria for a diagnosis of PTSD, you or your loved one experiences any high levels of the following as a reaction to trauma-related stimulus

1. Depersonalization: the experience of being an observer or feeling detached from themselves.
2. Derealization: experiencing unreality, distance, or distortion

Specify: With Delayed Expression

Although PTSD symptoms can occur immediately, many veterans experience symptoms months or years or decades later. PTSD diagnosed more than 6 months after a traumatic event is referred to as delayed expression or delayed-onset PTSD. A delayed expression can occur for a variety of reasons including the presence of PTSD symptoms that don’t meet the full diagnostic criteria of PTSD.

If you or a loved one is a veteran that has been diagnosed with PTSD and the VA has denied your claim, you may want to seek the help of a qualified attorney who specializes in VA disability law to assist you in appealing your PTSD claim to ensure that you or your loved one receives all the benefits due you. Don’t wait to call After Service, LLC today.