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Top 10 Stressors for PTSD Claim

Top 10 Stressors for PTSD Claim

Obtaining Service Connection for Post-Traumatic Stress Disorder: Stressors

Anyone can develop Post-Traumatic Stress Disorder or PTSD; all it requires is a stressor. A stressor is an event that is so traumatic it alters a person’s life and their brain. These stressors can permanently change a person’s view on life and the way they react to a variety of situations. Veterans are especially susceptible to developing PTSD because of the nature of their service. They are often removed from their friends and family for months at a time, put in stressful situations, and often left to think they must deal with their mental health on their own. The most publicly known stressor that causes a veteran to develop PTSD is experiencing the traumas of war. While this is one of the most common ways, there are several just as common stressors.

To obtain service connection, a veteran must show they were exposed to a stressor in service, they currently suffer from PTSD, and their current PTSD resulted from that stressor. Since stressors are one factor to service connection, it is important for a veteran to understand what constitutes a stressor and how they can prove they suffered from one while in service.

There are four main categories of stressors:

  • Combat Related Stressors– Experiencing a stressful event like a direct firefight or an IED explosion, even if the person is not actually injured, can cause significant trauma. When a veteran’s record proves they were involved in direct combat, the VA acknowledges that veteran faced a variety of situations that could qualify as a stressor. Because of the chaotic nature of combat and the difficulty of documenting every incident, the VA understands not every event is included in a veteran’s personnel file. So, the VA will often presume the veteran’s PTSD is the result of the veteran’s confirmed direct combat with nothing more than a lay statement and evidence of combat.
  • Fear of hostile military or terrorist activity– Not every traumatic situation qualifies as direct combat. Also, not every unit documented direct combat situations in each veteran’s file. However, if there is evidence the veteran’s unit or base was exposed to hostile enemy activity such as news articles of a firefight or a report about the base in which the veteran was stationed suffered a mortar attack and evidence shows veteran was assigned to the unit or base at the time, the VA can acknowledge the incident as the stressor. The key for hostile military or terrorist activity is that the VA typically requires a nexus letter written by a psychiatrist or psychologist. This nexus letter should say that the veteran’s reported stressor is “at least as likely as not” to cause PTSD.
  • Non-Combat PTSD Stressors- If a veteran was never in combat or neverwas exposed to hostile enemy activity, they can still develop service-related PTSD. Since non-combat stressors are not well documented in military personnel files, the VA requires more information and evidence. The VA will typically ask for more details about the stressor so the VA can investigate. Information like dates, locations, and descriptions of the event are very important to provide to the VA. It is also important that the veteran and their representative does their own research. Obtaining public records like obituaries, news articles, photos, police reports, and personal letters to loved ones at the time or shortly after the incident are often critical to prove a veteran’s stressor occurred. A nexus letter from a psychiatrist or psychologist is also required.
    • In-Service Personal Assault or Trauma- A special subcategory of Non-Combat PTSD Stressors is personal assaults or traumas. These are incidents that are not directly related to a veteran’s MOS or activities while on the job. These types of stressors include military sexual trauma (MST), robbery at gun point, kidnapping, assault in the barracks, and repeated racial and physical discrimination, among many others. These can be very tricky to prove particularly when a claim has been pending for several years. The VA usually requires documented reports (beyond lay statements) of the stressor incident and a nexus letter.
      • MST– There are countless studies showing victims of sexual trauma are unable or unwilling to report these incidents. That number is significantly higher for members of the military. Often, the perpetrator is a superior, the victim feels the military’s culture does not support reports of sexual trauma, or the victim did report the incident but nothing happened, or worse, they were ridiculed and punished. Historically, the military has not been a victim friendly environment, so incidents went unreported and/or undocumented for decades. The VA acknowledges this and has reduced the burden of proof to prove a MST stressor. In most situations, a veteran’s record should have documented evidence of a stressor, but in incidents involving sexual trauma, the VA will accept more circumstantial evidence such as a sudden change in work performance, emergency reports with pregnancy or sexually transmitted disease tests, request for a duty assignment transfer, unexplained economic or social behavior changes, among many others. There is an endless list of things that could be considered a stressor. Again, the key is to have a favorable nexus letter confirming the veteran’s reported stressor is “at least as likely as not” to cause PTSD. Even if a veteran provides all the evidence needed to prove a MST, VA employees do not understand how to properly process these claim. This resulted in the VA improperly processing 49 percent of all MST claims in fiscal year 2017 alone.

There are hundreds of situations that can be considered a stressor, and everyone reacts differently to a particular incident. However, in serving so many veterans, Berry Law Firm sees common stressors among clients. The ten most common stressors Berry Law Firm sees include:

  • Combat Related Stressors
    • Involvement in an improvised explosive device (IED) explosion
    • Watching a service member injured or killed
  • Fear of hostile military or terrorist activity
    • Involvement in a mortar attack
    • Medical personnel working on several trauma patients every day
  • Non-Combat PTSD Stressors
    • Involvement in a serious car accident
    • Involvement in a training accident
    • Learning that a close friend or relative was exposed to trauma
    • In-Service Personal Assault or Trauma
      • Suffering an assault
      • Being exposed to a threat of violence
      • Military Sexual Trauma

After proving a stressor, a veteran must show they are currently suffering from a mental health condition. Attaching a PTSD diagnosis and current mental health treatment records to a new claim for service connection for PTSD is the best possible option when seeking a service connection. However, a diagnosis is not necessary. If a veteran can show symptoms of a mental health condition, the VA should provide that veteran with an examination. Many veterans have very negative experiences when they attend a VA examination, so the earlier a veteran can obtain current mental health treatment the better. While a licensed psychiatrist or psychologist is best, these options are often expensive. There are other great options for veterans, such as a VA medical center or a Vet Center. A local peer group would also be a great start. Even if a veteran is not seeking service connection right away, having a history of mental health treatment can be tremendously helpful down the road.

The last thing a veteran must prove for the VA to grant service connection for PTSD is a nexus. For combat veterans, this is not always needed. But most other veterans will need a psychiatrist or psychologist to confirm that veteran have a PTSD diagnosis and the veteran’s reported in-service stressor “at least as likely as not” caused their PTSD. This last step is why veterans should start seeking mental health treatment as soon as possible. The more records showing a link between service and their PTSD, the more weight a positive nexus letter has. Likewise, the more records there are showing this link, the harder it is for any disinterested or disingenuous VA examiner to provide a negative nexus.

Once a veteran obtains service connection for PTSD, or any other mental health condition, the claim may not be over. The VA often awards a lower rating than a veteran is entitled to. Additionally, PTSD and other mental health conditions can cause a variety of other issues such as sleep apnea, headaches, hypertension, and sexual dysfunction, among many others. Since these conditions could be caused by a veteran’s service-connected mental health, it is possible to obtain secondary service connection for those conditions.

Obtaining service connection for PTSD can be an uphill battle. Certain types of stressors require more attention and evidence development. Establishing a solid stressor is the first step to obtaining service connection. If you need help service connecting your PTSD, Berry Law Firm can help by discussing your case with you, reviewing your records, assisting with evidence development, and advocating for what you deserve. If you believe you have PTSD due to your service and the VA refuses to provide the benefits you earned, please contact Berry Law Firm so we can assist you with your claim.

Berry Law

The attorneys at Berry Law Firm 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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