PTSD: 38 CFR 4.130
If you served in the military and have PTSD, you’re in very good company. PTSD is one of the most common VA claims, and we don’t have to tell you how much it can mess up your life.
image
Do I Have PTSD?
If you suspect you have PTSD but aren’t sure, here are some typical symptoms:
- Flashbacks
- Nightmares
- Avoiding environments or triggers that remind you of the traumatic event (crowds, traffic, noisy movies, etc.)
- Emotional numbness
- Difficulty concentrating
- Difficulty sleeping
- Reliving the traumatic event
- Startling easily
- Rage
- Blocking out memories of the traumatic event
- Survivor’s guilt/shame
- Feeling overly suspicious of the people around you
- Engaging in self-destructive behaviors (using drugs or drinking, driving aggressively, etc.)
If you’re dealing with some of these symptoms, it’s time to seek help and get treatment. It’s also time to seek out a PTSD VA rating so that you can get the benefits that you deserve.
Combat vs. Non-Combat PTSD
When most people think of PTSD, they think of combat PTSD. The military classifies PTSD as combat-related when it is triggered by:
- Engaging in armed conflict
- Engaging in a dangerous duty (such as flying, parachuting, handling toxic fuels, etc.)
- Taking part in activities that simulate combat (such as practicing with live fire weapons)
- Being exposed to instruments of war (such as weapons, chemical agents, etc.)
- Taking part in activities that earn you a Purple Heart
There is also non-combat PTSD. The military considers PTSD as non-combat when it is triggered by stressors such as:
- Accidents during military training
- Serious vehicle accidents (ships, airplanes, helicopters, automobiles, etc.)
- Military sexual assault
- Physical assault
- Harassment (usually from a fellow military member)
- Survivor’s guilt
- Fear and/or stress from an imminent attack or death
Combat PTSD: The Straightest Path to 100%
While it is possible to get a 100% rating for non-combat PTSD, the most direct route to a 100% rating is combat PTSD. Here’s why:
Stressor Is Easy to Prove
PTSD is unique because, unlike other mental health claims, it requires you to prove an in-service stressor. An in-service stressor is an event (or series of events) that triggered your PTSD while you were serving in the military. If you are claiming non-combat PTSD, you will need to provide extensive evidence of your stressor. But if you are claiming combat PTSD, you can simply point to the date and location of the conflict. For example, you could say, “I took fire in Fallujah on [date].”
One mistake that veterans make is that they point to multiple events that triggered their PTSD. If you experienced a combat incident, stop there! Don’t add the time you were harassed by a superior or the time you got into a car accident on a military base. If you mention these non-combat stressors, the military will expect you to back them up with extensive evidence. It will take more time and could potentially bog down your claim. Keep it simple and focus on the combat incident.
No Nexus Letter Required
Another benefit of claiming combat PTSD is that you will most likely not need a nexus letter. The military needs to see a clear connection (or nexus) between your military service and your PTSD. If you are claiming non-combat PTSD, you will need to obtain a letter from a doctor asserting that it is “at least as likely as not” (or similar language) that your PTSD is related to your military service. But in the case of combat PTSD, you rarely need a nexus letter to validate the military-PTSD connection.
100% PTSD Seems Like a High Bar. Can I Really Qualify?
As with other VA mental health ratings, PTSD is rated based on a General Rating Formula.
Here’s the qualifier for a 100% VA rating for PTSD:
“Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.”
A lot of people read the words before the colon—total occupational and social impairment— and stop there. They get intimidated by the “total” threshold and figure they can’t qualify. But keep reading after the colon and think broadly. Chances are, some of these symptoms match up with your life.
For example:
“Gross impairment in thought processes or communication”
Ever jump between topics when you speak or feel your brain trail off mid-thought?
“Grossly inappropriate behavior”
Ever fly into a massive fit of road rage that surprises even you?
“Persistent danger of hurting self or others”
Ever thinking about harming yourself? Or have general thoughts that you shouldn’t be around anymore?
“Intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene)”
Ever go a few days without showering because you just can’t get up the energy or will?
“Disorientation to time or place”
Ever completely zone out while driving and miss your exit?
Don’t let the 100% rating description overwhelm you. When you break it down and apply it with an open mind to your daily life, you may find that you exhibit more qualifying behaviors than you originally thought.
Your Personal Statement: A Key to a 100% PTSD Rating
One of the most important parts of your VA claim is a well-written personal statement (VA Form 21-4138). Your doctor may be able to see the outward manifestations of your PTSD, but they can’t see how it affects you on a daily basis—-and that’s what your PTSD rating is based on.
A good personal statement is vital to a 100% PTSD VA rating. Make sure to “speak VA”—meaning speak to the 100% rating criteria we described above and draw in evidence from your own life.
A good personal statement should include:
- Your name
- Your military stressor
If you are claiming combat PTSD, give a brief description of the combat incident, including the date and the area where it took place.
- Your symptoms
- How your PTSD affects your work
Keep this part to a paragraph or two. You might explain that you get aggravated and lose your temper at your boss or that you have trouble concentrating at work, which has led to your being disciplined.
- How your PTSD affects your relationships
Keep this part to a paragraph or two. You might explain how you fight with your in-laws when they visit, lose your temper with friends, rarely go out, fight with your spouse multiple times a week, or find little satisfaction in intimacy with your spouse.
Other Pointers
Make sure you have a current diagnosis. If you haven’t been seen by a doctor for your PTSD, make an appointment right away. This shows that you are actively seeking care for your condition, which strengthens your claim.
Also, make sure to prepare for your C&P exam (compensation and pension exam). This exam is conducted by the VA to determine 1) if your condition is service-connected and 2) how severe your condition is. The findings of this exam are reviewed by the VA as part of the rating process.
Don’t show up for your visit as if you’re having your best day. Be real. Don’t try to hide the effects of your PTSD. Don’t try to whitewash its effects on you. Bring your medical records. (You may be seeing a contracted doctor, and there’s no guarantee that they’ll have access to your full record.)
We recommend writing your personal statement in advance and reading it at the exam. That way, you make sure you share the most important information without wandering into unhelpful details. And remember, if your PTSD is connected to combat, focus on that. Don’t open the door to non-combat stressors, which are much harder to substantiate.
Need Assistance?
If you need help with your personal statement or with preparation for your C&P exam, contact VA Claims Academy. We provide templates and other plug-and-play resources that are based on what the VA wants to see in order to approve your claim. You can simply drop in your personal information and submit powerful claims without the stress or headaches of reinventing the wheel.
Note: If you are in crisis, call 911. You can also reach out to the Veterans Crisis Line for confidential 24/7 support. Dial 988 and press 1 or text 838255.