Reasons Why the VA Denied Your PTSD Claim

Reasons Why the VA Denied Your PTSD Claim

If you’re trying to get VA disability benefits for post-traumatic stress disorder (PTSD) due to your military service, it may feel like banging your head against a wall. There are strange and confusing rules for VA disability compensation that apply only to PTSD claims, and they often trip up not only Veterans, but VA reviewers too!

If you’re having trouble figuring out this confusing issue, reach out to experienced attorneys who can take on the effort for you.

What you need for service connection for PTSD

Generally, you need to show three things for service connection:

  1. A current disability,
  2. An event, injury, or disease during service, and
  3. A causal relationship between the event in service and the current disability.

For PTSD, however, there’s some extra legal requirements. Instead of the three things above for any other claim, PTSD claims require:

  1. A clinical diagnosis of PTSD,
  2. Corroborating evidence—other than the Veteran’s own statements—of an in-service traumatic stressor, and
  3. Medical evidence of a link between the stressor and the current PTSD.

As you can see, each of the three elements for service connection becomes more difficult to prove for PTSD. Why? Who knows.

But instead of just showing current symptoms and diagnosis in your records, VA wants to make sure that the diagnosis conforms to certain standards. And instead of just any credible evidence of an in-service event, VA wants additional evidence from somebody other than the Veteran. And instead of any evidence of a connection to service, VA wants a medical opinion confirming the connection.

Why Was Your Claim Denied?

Your PTSD claim could be denied by the VA for a wide range of reasons. These reasons aren’t necessarily your fault, but understanding them could help you file a successful disability appeal with the help of knowledgeable attorneys.

You Didn’t Send in the Right Paperwork

You may not have sent in the correct paperwork for your PTSD disability benefits application. Some examples of the paperwork you’ll need to have with your benefits application include:

  • Documentation of your military service. The VA needs to know where and when you served so that it can determine if your service correlates with your PTSD symptoms’ first appearance or exacerbation.
  • Documentation of your PTSD symptoms, such as diagnosis paperwork of your PTSD from a licensed medical professional. You can provide documentation from a medical doctor or a psychiatrist.
  • Documentation of your C&P exam. This is an official exam ordered by the VA, during which you’ll be interviewed and examined by a contracted medical professional to determine whether you have PTSD, the severity of your symptoms, etc.

Gathering all of this paperwork can be very difficult alone. Knowledgeable attorneys can help ensure you have all of your paperwork ducks in a row before you file your benefits application.

You Lack the Proper Paperwork

In other cases, you may simply not have all the proper paperwork for a successful benefits claim. If you haven’t yet had your PTSD medically diagnosed by a professional, be sure to do this before filing an application for benefits. 

Contact a licensed psychiatrist in your area and have them provide you with their professional medical opinion. If they believe you have PTSD, ask them to document it and provide you with a copy of that documentation.

Alternatively, you may not have a copy of your military service records. You can request these from the VA and send them in with your benefits application.

You Made a Filing Error

Filing a successful VA disability benefits claim can be tricky, especially since there are numerous errors you can make regarding which paperwork you file, the dates you fill out, and the like. Your best bet is to work with knowledgeable attorneys right from the get-go. 

The right attorneys can ensure that you file your disability benefits application correctly and that there aren’t any filing errors that can delay your benefits or cause the VA to make an incorrect decision.

You Need a Second Medical Opinion

The medical professional hired by the VA may not necessarily feel that you have PTSD or that your symptoms are severe enough to warrant disability benefits. They may be wrong, but the VA will take their opinion seriously.

In such circumstances, you may need to contract a second medical opinion from a private medical examiner, like your personal psychiatrist or another medical doctor. This can be a valuable tool in both securing successful disability benefits upfront and in appealing a rejection from the VA.

If your disability benefits request is rejected by the VA, a second medical opinion may be the only way for you to secure disability benefits going forward.

In short, your PTSD claim was probably denied because the evidence VA obtained didn’t conform to the more difficult evidence standards for PTSD claims.

What To Do After Your Claim is Denied

The best thing you can do is hire an experienced attorney to review the case for you. VA often makes mistakes in PTSD claims and it takes a knowledgeable expert to identify and appeal the issue in most cases.

Aside from that, you should try to develop additional evidence to submit to VA. Read your rating decision carefully to try to identify which of the three elements above VA says are missing, then offer whatever you can think of to prove the missing piece.

This evidence can be statements from people who witnessed your traumatic stressor event or noticed your changes in behavior afterwards, a medical opinion from your treating physician or psychiatric specialist, a thorough description of your symptoms and when they began, newspaper articles about the traumatic stressor, or anything else you can think of to support the three elements above.

If you haven’t filed a claim yet . . .

If you haven’t yet filed a claim for PTSD, don’t wait. Just because you don’t have all the necessary evidence right now does NOT mean you should wait to file. The longer you wait to file, the less backpay you can get if and when you win.

When you file a claim for PTSD, be sure to include as much information as you can about the traumatic event in service. Use VA form 21-0781 to provide this information and be as specific as you can about people, places, and dates. This information will trigger a legal requirement for VA to try to obtain more evidence to support your claim.

And if you don’t have a diagnosis for PTSD yet, it’s usually helpful to submit a statement explaining your symptoms in as much detail as possible. This will often trigger VA’s duty to provide you with an examination to determine your diagnosis.

VA says I have something other than PTSD

If VA says you have a different mental-health disorder, like anxiety or depression, that’s actually usually a good thing! Remember how we learned that PTSD has more difficult evidence standards than every other kind of claim? If the VA says your psychiatric condition is actually something other than PTSD, then it’ll be easier for you to prove a connection to service!

And don’t worry; in almost every case your symptoms will receive the same disability rating whether VA calls them PTSD or something else. So in most cases you won’t lose out on any money just because VA doesn’t recognize your condition as PTSD specifically.


VA Claim Exam (C&P Exam) | Veterans Affairs

NIMH » Post-Traumatic Stress Disorder

About VA Form 21-0781 | Veterans Affairs

Berry Law

The attorneys at Berry Law are dedicated to helping injured Veterans. With extensive experience working with VA disability claims, Berry Law can help you with your disability appeals.

This material is for informational purposes only. It does not create an attorney-client relationship between the Firm and the reader, and does not constitute legal advice. Legal advice must be tailored to the specific circumstances of each case, and the contents of this blog are not a substitute for legal counsel.

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