Lawyers for Veterans With PTSD

Veterans who engaged in intense and prolonged combat face an especially high risk of developing PTSD, according to the National Center for PTSD.

PTSD has probably been around as long as soldiers have fought in combat. In the past, PTSD has been called “shell shock” or “battle fatigue.” However, it wasn’t until after the Vietnam War that PTSD began to receive the attention it deserved.

In addition to combat, other causes of PTSD include:

• Sexual or physical assaults
• Terrorist attacks
• Serious accidents such as car crashes
• Natural disasters such as fires, tornadoes, hurricanes, floods, or earthquakes
• Sexual or physical abuse as a child

Women in the military have seen a rise in PTSD diagnoses in recent years. During OIF/OEF women frequently served in combat roles. It was not unusual to see women serving as gunners on convoys engaged in firefights. Also, women in combat support and combat service support units were often the victims of IEDs, ambushes, and attacks. Furthermore, the increase in Military Sexual Trauma (MST) has increased over the past two decades.

PTSD is not just a diagnosis for those who went outside the wire. Veterans who never left the Forward Operating Base (FOB)—or even those who never served overseas—have been diagnosed with PTSD after experiencing a specific traumatic event. In recent years, the military has recognized that drone operators may experience PTSD even though they are physically removed from the battlefield.

Consider the following PTSD statistics from the National Center for PTSD:

• Roughly half of Americans experience a traumatic event in their lifetime.
• About 4 percent of men will develop PTSD after a traumatic event, while 10 percent of women will develop it.
• In a given year, between 11 to 20 percent of Operation Iraqi Freedom and Operation Enduring Freedom Veterans suffer from PTSD.
• An estimated 12 percent of Gulf War (Desert Storm) Veterans have PTSD in any given year.
• About 30 percent of Vietnam War Veterans have suffered from PTSD at some point in their lives.

If you think that you may suffer from PTSD, you are not alone. The key is to recognize and understand the symptoms and seek treatment. At Berry Law we have represented Veterans in serious criminal matters who waited too long to seek help for their PTSD. Had some of these Veterans sought timely treatment for PTSD symptoms they may have avoided criminal charges

If you are a Veteran who was exposed to a traumatic event while in service, pay close attention to the common symptoms of PTSD. They generally fall within four categories:

• Reliving – You may experience “flashbacks” or suffer from nightmares or insomnia.
• Avoidance – You may try to stay away from people or situations that remind you of the traumatic event. You may also try to stay obsessively busy to keep from thinking about the event.
• Arousal – You may frequently feel on edge, jittery, or “on guard,” especially when you get into situations that remind you of the event.
• Negative thoughts and feelings – You may feel numb, helpless, withdrawn, or detached from friends and family. You may also experience feelings of guilt or shame.

Some Veterans experience symptoms of post-traumatic stress immediately or soon after an event. Other Veterans do not show symptoms until months or even years later. The symptoms may appear after the Veteran is discharged from military duty.

According to the National Center for PTSD, you should seek medical help if symptoms persist for longer than a month or impair your relationships or ability to work for a living.

The danger is that untreated PTSD makes you more likely to engage in conduct that jeopardizes your health such as drinking heavily, abusing drugs, or driving aggressively.

An assessment is a multi-phased, highly specialized process. It is set up to reduce the risk of a patient either exaggerating or denying his or her symptoms.

Generally speaking, structured interviews by medical and psychological professionals are combined with questionnaires to form a blended psychological assessment. Your spouse or partner may also participate in the assessment.

The goal of the assessment will be to determine the frequency and intensity of the symptoms. It may consist of one session or multiple sessions held over several days or weeks.

Therapy – An individual can go through one-on-one talk therapy sessions or counseling in group settings.

Medication – The principal drugs prescribed for the condition are SSRIs [selective serotonin reuptake inhibitors] such as Prozac and Zoloft.

PTSD can impact your relationships, work, education, and enjoyment of daily life. But it is more than a mental condition or anxiety disorder. PTSD affects you biologically as well. It can change the way you process memories and respond to fear. It can cause heightened sensitivity of the startle reflex and increase sleep abnormalities. Neurobiological changes may also occur in your hormones.

Additionally, PTSD commonly causes lingering headaches, gastrointestinal complaints, immune system problems, trouble remembering, feeling depressed, dizziness, chest pain, and discomfort throughout the body. For some, it may cause suicidal thoughts. Without a PTSD diagnosis, the underlying cause of these illnesses will go unaddressed.

Veterans may seek PTSD treatment through the VA Medical Center or a mental health professional in private practice.

• You have a current diagnosis of PTSD.
• You experienced a traumatic incident or in-service “stressor.”
• There is a link, or “nexus,” between your current PTSD diagnosis and the in-service stressor.

Except in certain situations—for example, combat, threat of hostile activity, or being a prisoner of war—a Veteran’s own statements about an in-service stressor are not enough to meet the requirement. Additional evidence is needed in most cases.

Once PTSD is shown to be service-connected, the VA will assign a disability rating based on how much your PTSD affects your work and social life.

For instance, if you suffer from nightmares or flashbacks that cause significant problems and keep you from working or hurt your ability to interact with others, you may likely qualify for financial compensation. However, if you suffer from disturbing memories alone that do not affect your ability to work or your relationships with others you may not be entitled to compensation.

After you apply for benefits, the VA may order you to undergo a Compensation and Pension Examination, or “C&P exam,” at your local VA medical center. It is very important that you attend this examination. Failure to attend will likely result in a denial of your claim. If you are unable to attend due to extenuating circumstances, it is important to submit a written explanation to the VA so they can reschedule you.

During the C&P exam, a VA or third-party mental health professional will determine whether your PTSD is related to service as well as the severity of your condition.

The VA will use the medical professional’s report to determine the severity of your PTSD and give you a disability rating.

If the VA does not find that you suffer from service-connected post-traumatic stress disorder or refuses to provide a C&P exam, you have the right to submit your own Independent Medical Examination (IME).

During the IME, a private doctor will give an opinion on whether you suffer from service-connected PTSD. The doctor’s statement will carry more weight if the doctor indicates that he or she reviewed your service medical records and other medical documentation.

In addition to providing the VA with your complete medical records when you apply for PTSD-related disability benefits, you may also:

• Ask your doctor to submit a Residual Functional Capacity Form (RFC). In this form, the doctor will assess your health and state why you should qualify for disability benefits.
• Ask others to provide “lay statements” or “buddy statements.” These are statements from people who have first-hand knowledge of and can verify the traumatic event that caused your PTSD.
• Submit news reports or other documentation of the traumatic event that caused your PTSD.

Here’s a summary of the possible PTSD ratings and what they mean:

• 100 percent – Completely unable to function socially and at work with symptoms such as severely inappropriate behavior, ongoing hallucinations or delusions, severe mental anguish, the consistent threat of harming self or others, unable to remember basic information such as names of close relatives, severe confusion and disorientation, and/or inability to care for self.
• 70 percent – Unable to function in most social and work areas with symptoms such as obsessive behaviors, illogical speech, depression, and panic so persistent that it interferes with the ability to function, suicidal thinking, inability to control impulses (including becoming violent without provocation), angry outbursts, frightening thoughts, neglecting self-care such as hygiene, inability to handle stress, and/or inability to maintain relationships.
• 50 percent – Some impairment in the ability to function socially and at work with a lack of reliability and productivity, due to symptoms such as trouble understanding, memory loss, poor judgment, mood disturbances, trouble with work and social relationships, and/or having one or more panic attacks weekly.
• 30 percent – Some trouble functioning socially and at work, occasionally inefficient with work or unable to perform work tasks, but generally able to take care of self and speak normally. Symptoms can include depression, anxiety, chronic difficulty sleeping, mild memory loss, suspiciousness, and panic attacks (can be less than once a week).
• 10 percent – Mild symptoms creating work and social impairment when under significant stress, or mild symptoms managed successfully with continuous medication.
• 0 percent – Diagnosis of mental illness but symptoms so mild that they don’t require continuous medication or don’t interfere with social and work functioning.

The VA must consider all of your PTSD symptoms when assigning a disability rating—not just the specific examples of symptoms listed above. For example, hypervigilance is a common PTSD symptom and should be considered when assigning a Veteran’s disability rating even though it does not appear in any of the rating criteria.

If the VA finds that you do not have a 100 percent disability rating, you may still qualify for benefits at the 100 percent rate if you can show that you cannot obtain or maintain “substantial gainful employment” due to your service-connected PTSD or due to a combination of your service-connected disabilities. This is called a total disability rating based upon individual unemployability benefits, or a TDIU. Sometimes a Veteran cannot receive a 100 percent disability rating for PTSD because they do not have total social impairment, but they have total work impairment and therefore may qualify for a TDIU.

At Berry Law, we work extensively with Veterans who wish to appeal the decision made on their claim for PTSD-related disability benefits. Many clients appeal because the VA denied their service connection, awarded benefits at a low disability rate, or made a mistake on the correct effective date for the start date of their benefits payments.

Click here to learn more about the disability benefits appeal process.