Suicidal ideation is a symptom included in the VA rating schedule for mental health conditions. The VA considers the presence of this symptom when determining a rating decision for PTSD, major depressive disorder, schizophrenia, anxiety disorder and other mental health conditions.
In a recent decision by the Court of Appeals for Veterans Claims (Bankhead v. Shulkin, No. 15-2404), the Court provided a more detailed description of suicidal ideation.
The Court first cites Dorland’s Illustrated Medical Dictionary definition of “ideation” as “the formation of a mental concept, image or thought,” then cites the Centers for Disease Control and Prevention definition of “suicidal ideation” as “thinking about, considering, or planning suicide.”
The Court clarified that suicidal ideation can be passive, such as a wish not to awaken in the morning or a belief that others would be better off if the individual were dead, or it can be active, which may include transient but recurrent thoughts of committing suicide or a specific plan of ending one’s own life.
According to the Court, the main distinction between active and passive suicidal ideation is that passive entails thoughts such as wishing for death whereas active entails thoughts of self-directed violence and death.
Why is this important?
The VA has historically only awarded a 70 percent rating to those whose symptomatology is more consistent with active suicidal ideation. However, the Court ruled that suicidal ideation alone (active or passive) is sufficient to meet the symptom requirement found in a 70 percent rating.
Bankhead v. Shulkin makes it crystal clear: The VA must grant a veteran a 70 percent rating if suicidal ideation is present.
Combat veterans are often exposed to multiple traumatic episodes throughout their military careers. While some studies have found that combat trauma is related to suicide, others have not, meaning that a heightened risk of suicide risk may depend on how intense and how often a veteran experienced combat trauma. Some service members can experience traumatic events and walk away unscathed; others are haunted forever. Everyone has a different experience during their time in service and no two veterans are the same.
Studies show that suicide risk is higher in veterans with PTSD. Guilt related to combat is the single biggest cause of suicidal ideation. Many veterans have disturbing thoughts that bring them back to the original traumatic experience and some feel guilty about the actions they took in a time of crisis. And these experiences don’t have to be combat-related: some veterans experience PTSD caused by a traumatic sexual experience that took place far from the front lines.
The annual number of suicides among veterans and active service members is much higher than the average among those who have never served in the military. The crisis is particularly acute for servicewomen – Per 100,000 population, 28.7 female veteran and active service members commit suicide annually, more than 5 times as many as their civilian counterparts (5.2 per 100,000).
While traumatic events of the past cannot be undone, there are multiple ways that veterans can get help for their service-related suicidal thoughts. Seeking assistance is an important first step in recovery and treatment.
The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-TALK. Veterans can also visit the Veterans Crisis Line online or text them at 838255.
Suicidal ideation is a serious symptom of a mental health disorder. If you are appealing a claim for PTSD and feel that the VA did not adequately consider the available evidence or your personal statements about your symptoms, contact Berry Law. We help veterans appeal VA disability claims throughout the United States and can provide you with a free consultation to discuss your options.
Our monthly newsletter features about important and up-to-date veterans' law news, keeping you informed about the changes that matter.