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How to File a VA Claim for PTSD
Here's How You can File a VA Claim for PTSD
PTSD (post-traumatic stress disorder) is a long-term mental health condition that affects people who have witnessed or experienced a traumatic event. PTSD symptoms can be debilitating to the mind, and ultimately devastating to your quality of life. Unfortunately, because of the nature of military service, Veterans are uniquely predisposed to suffer from PTSD. However, thanks to advances in the research and treatment of psychiatric disorders, there is now more information and better treatment for post-traumatic stress disorder than ever before. At the same time, a lot of the stigma associated with the condition has faded, resulting in more people seeking treatment and more Veterans filing for mental health VA disability claims. Veterans with PTSD related to their service in the military may be eligible for VA disability compensation. Unfortunately, the process of applying for PTSD disability benefits can often be frustrating and stressful for many Veterans to navigate. There are many reasons that the VA will deny claims, and many Veterans end up needing the assistance of an attorney. Keep reading for information on how to file for a VA disability for PTSD and how Berry Law can help improve the chances of your VA claim being successful.
Is It Hard to Get VA Disability Benefits for PTSD?
Navigating the process of applying for a PTSD claim can be challenging, and you will need to meet certain requirements for the VA to approve your claim. The first thing you need is a proper diagnosis, so you should begin with an evaluation by a psychiatrist or psychologist from a VA medical facility to prove your condition and provide a PTSD diagnosis. You will also need to apply for PTSD disability benefits by either filing a claim via the VA website or submitting VA Form 21-526 application to the Claims center within the Veterans Benefits Administration. Additional documentation will also be needed, such as a Discharge from Active Duty (DD-214), copies of your medical records, and Form 21-4138 Statement to support the claim. The statement could include a letter with information about the PTSD trigger or symptoms you are currently experiencing, along with letters from family and friends you are in contact with, highlighting the impact the condition is having on your life. Over the years, the VA has taken many steps to try to adjudicate PTSD claims sympathetically, passing regulations that help streamline Veterans’ search for assistance. In the past you would have had to provide supporting documentation and evidence verifying the occurrence of the stressor. Current VA disability regulations only require:
- That you must have a PTSD diagnosis
- That your symptoms must be tied to an in-service triggering stressor
- That the stressor happened in the circumstances and locations of your service, with no evidence disputing this fact
- A confirmation from a VA psychiatrist that the stressor was enough to cause PTSD
A significant contributing factor to the success of your case is the PTSD diagnosis, but examiners can sometimes find that your symptoms do not meet the criteria needed to warrant a PTSD diagnosis. If this happens, you can search for a second opinion. While the regulations state that a VA psychiatrist must confirm your diagnosis, they also specify that the VA must consider the opinion of any qualified medical professional outside of the VA that provides you with a diagnosis.
How Do You Prove PTSD Is Service Connected?
For most illnesses or injuries, medical records documenting that the illness or injury occurred while in service is enough to prove service connection. With PTSD, however, showing a service connection can be more difficult. Some cases do not have any medical records, since many Veterans decide not to seek out PTSD treatment because of denial, stigma, or a lack of information. Sometimes your records might not be able to prove that the PTSD is service-connected. Fortunately, there are several alternative steps Veterans can take when in these situations. They could request the VA review their service records and search for mental health issues markers. Mental health issues markers are identified by the presence of various behaviors that developed after the stressor or traumatic event that were not present before. They include behaviors such as:
- Dereliction of duty
- Records of insubordination or going AWOL
- Sudden unsatisfactory performance review scores
- Excessive drinking
- Sudden disciplinary issues
- Request for a change in platoon, company, ship, or duty station
Beyond reviewing service records, other ways to prove a Veteran’s PTSD is service-connected could be through:
- Written statements from other service members, friends, or family who saw the stressor or traumatic event happen, noticed a behavior change, or discussed the experience with you (“buddy statements”)
- Records of any free helplines or support groups you got in contact with for help. Sometimes the incident might not have been reported to military authorities but could have been reported to civilian parties
Scenarios That Wouldn’t Require You to Prove Service-Connection
Fortunately, with the military not always documenting every traumatic event or stressor, the VA recognizes that obtaining proof that the traumatic event happened in service can sometimes be impossible. In response, the VA set aside five scenarios that won’t require you to prove that your PTSD is related to your service. These five scenarios are:
- If the Veteran was a Prisoner of War (POW)
- If the Veteran’s trauma was brought on by in-service assault with separate evidence corroborating their account of the assault
- If the trauma that establishes the Veteran’s PTSD diagnosis is consistent with the hardships, conditions, or circumstance of their service
- If there is proof the Veteran engaged in combat, and that there is a relation between the combat and the stress disorder
- If the trauma is tied to possible fear of terrorist or hostile military activity after experiencing or witnessing an event that involved significant injury, near-death experiences, or actual death
How Long Do VA PTSD Claims Take?
Many Veterans pursuing PTSD claims wonder how long the process will take, but there is no specific answer to this question because every case is unique and includes factors that either shorten or lengthen the review process. The exact amount of time a PTSD claim takes often depends on what type of claim it is, the complexities of the disabilities claimed, and the time it takes the VA to collect the evidence they need to decide on your claim. However, according to recent data, it takes an average of 117 to 124 days for the VA to process your initial claim. Once you file your claim, you will first receive a letter notifying you that your claim has been received. Unless you receive a notification requesting more information from you, there is nothing else you need to do but wait as the VA takes your claim through the many different phases. The first phase your claim goes through is an initial review process. If the initial review is successful, your claim will then move to the evidence gathering, review, and decision phase. If not, the VA will request additional information. In the evidence-gathering phase, the VA will search and review documentation from your records, your health care providers, and other parties you are in contact with related to your post-traumatic stress disorder and the event that caused it. Often, this is the phase that takes the most time, with the possibility of additional evidence being needed before a decision is made. Once a decision is made related to your disability benefits, the VA prepares your claim decision packet, mailing you all the details about the decision.
You have multiple options for appealing a decision if you disagree with it under the AMA. Each appeal option you choose entails different processes. Some cases could last years due to the series of appeals and would likely benefit from an attorney’s assistance to ensure that nothing is left out of the decision. You can take advantage of the initial delay by using that time to put some thought into which option of appeal, and what evidence, will best help your claim. We understand that the ideal scenario would be to have your claim processed and approved quickly, but keep in mind that the main goal is to reach your maximum disability claim, and you will eventually receive back pay for any time that your claim is active while pending a decision.
How Much Does the VA Pay For PTSD?
If your claim is approved, your compensation amount will depend on a VA PTSD rating system ranging from 10% to 100%. High VA ratings for PTSD will result in more disability benefits. A rating agency will assign you your rating, taking into consideration the severity, duration, and frequency of your symptoms, along with the length of your remissions and your adjustment capacity during remission. Social and occupational impairments are also considered. These are the VA disability ratings and the benefits a veteran would earn each month:
- 10% Rating
A 10% VA rating for PTSD signifies that you have minimal symptoms. You may experience some post-traumatic symptoms during stressful periods, making your disability more episodic, meaning your symptoms are not always present and, as such, do not impair your abilities on most occasions. In some cases, your symptoms could also be manageable. In 2020, veterans with a 10% and 20% PTSD VA rating may receive VA benefits of $142.29 and $281.27, respectively.
- 30% Rating
This disability rating reflects a mild PTSD diagnosis that impairs more of your abilities, leading you to miss work more regularly. Your disability does not, however, fully prevent you from functioning or maintaining relationships. Common symptoms include panic attacks, anxiety, and moods of depression.
- 50% Rating
A 50% rating for PTSD describes an increase in the severity, duration, and frequency of your symptoms, resulting in you developing more significant cognitive limitations that could affect your decision making and ability to follow instructions. A person at this rating could also notice their symptoms manifesting physically.
The compensation veterans receive at this rating depends on the presence of dependents. For instance, veterans with a 30%, 40%, 50%, and 60% PTSD rating with no dependents may receive monthly disability benefits of $435.69, $627.61, $893.43, and $1,131.68, respectively. Depending on the number of dependents, however, the disability benefits will be higher. For instance, veterans with a 40% disability rating for PTSD who have a spouse receive a payment of $696.61 per month. On the other hand, veterans with a 40% VA disability rating who have a spouse, two parents, and no children receive monthly disability benefits of $806.61. If a veteran has a 50% VA disability rating and has a spouse, one child, but no parent, he or she would qualify for a monthly payment of $1,043.43.
- 70% Rating
This VA rating signifies further severity, duration, and frequency of the symptoms presented in the lower ratings, and the presence of a wider variety of post-traumatic stress symptoms. Veterans at this PTSD rating could experience additional symptoms like irritability, violent outbursts, or obsession rituals.
- 100% Rating
A veteran with a 100% rating for PTSD is completely impaired, pointing to a significant decline in their emotional and cognitive functions. This considerable decline could result in alterations in behavior such as a disinterest in getting out of bed, taking a shower, or changing clothes.
The number of dependents also plays a role in this rating. A veteran with a 100% rating may receive VA benefits up to $3,106.04 every month. The same veteran will receive compensation of $3,418.20 per month if they have a spouse and one parent. Veterans with a 100% VA rating who have a spouse, one child, and one parent would receive monthly disability benefits of $3,545.02. If a veteran has a spouse receiving Aid and Attendance benefits, or has more than one child, then they will qualify for extra added monthly amounts in addition to the basic disability benefits.
Contact A VA Disability Attorney
Post-traumatic stress disorder is the most prevalent mental health issue that Veterans endure after returning home from military service. You may already know that you should be eligible for a VA PTSD disability claim, but the process of applying for one may seem too complicated without assistance from an attorney. The VA is an extensive bureaucracy that can make incorrect decisions. One of these wrong decisions could cause your legitimate service-related PTSD disability claim to get denied, forcing you down the often long and daunting path of appeals for adequate compensation. At Berry Law, we have a team of VA disability lawyers ready to help Veterans with their PTSD claim, offering the information, experience, and expertise to provide you with a better chance of having a VA appeal for disability benefits approved the first time around. Our law firm can also help veterans with PTSD who have had their claims rejected repeatedly and would like to continue appealing the decision. Focus on your own health by allowing us to fight for you. Contact our law firm today for more information and your free case evaluation.
Established in 1965 by Vietnam War veteran and attorney John Stevens Berry Sr., Berry Law Firm is a team of veterans dedicated to defending, safeguarding, and fighting to protect the rights of veterans. Over the decades, thousands of veterans from across the country and all branches of the military have trusted our firm with their cases and, more importantly, their futures.