The Department of Veterans Affairs instated a new regulation for post-traumatic stress disorder claims for military benefits. In what President Obama called a “long overdue step,” the VA streamlined the claims procedure and eliminated a requirement that extended the already long and difficult process of making a post-traumatic stress disorder claim.
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is an anxiety disorder that results from exposure to a traumatic event that presents a direct or indirect threat of death or serious injury. Traumatic events that cause PTSD are called stressors, and they can include:
- Combat or military exposure
- Terrorist attacks
- Sexual or physical abuse
- Serious accidents such as car crashes
- Natural disasters such as fires, hurricanes or earthquakes
Anyone can develop PTSD, but it is especially prevalent among members of the military. Veterans from all major conflicts may experience PTSD, including those who have served in:
- World War II
- Korean War
- Vietnam War
- Persian Gulf War
- The invasion of Afghanistan
- The invasion of Iraq
Returning from overseas and transitioning back to society can be difficult for veterans, particularly those whose lives are disrupted by PTSD. Many struggle to adjust from the state of hyper-alertness that is necessary in war zones; some find their home lives boring or meaningless in comparison to the high stakes they encountered abroad.
Dealing with PTSD is challenging. However, treatment is available and can improve the lives of people it affects. One way for veterans to get assistance with treatment is to file a claim for benefits with the VA.
The Old Documentation Requirement
The VA’s previous process for PTSD claims was often time-consuming and difficult. Unless the veteran applying for benefits was a combat veteran, documentation of exposure to specific incidents such as firefights or bomb explosions that could have caused PTSD was required.
As a result, many veterans faced the daunting task of hunting down obscure records and reliving their nightmares in detail to prove to VA adjudicators that they encountered a stressor while in service.
The New PTSD-Claims Regulation
The new regulation improves the application process by eliminating the documented-stressor requirement. It presumes veterans’ symptoms were caused by their war-time experiences if three criteria are met:
- The claimed stressor is related to fear of hostile military or terrorist activity.
- The claimed stressor is consistent with the places, types and circumstances of the veteran’s service.
- A VA psychiatrist or psychologist or a VA-approved contractor confirms that the claimed stressor is adequate to support a diagnosis of PTSD.
A senior VA administrator said the regulation acknowledges the nature of modern military conflict where stressors may include “constant vigilance against unexpected attack, the absence of a defined frontline, the difficulty of distinguishing enemy combatants from civilians and the ubiquity of improvised explosive devices.”
The regulation also increases services and programs for women veterans and reduces the size of the claim application form to 10 pages instead of 23 pages.
How to Make a PTSD Claim
The first step when making a PTSD claim is to immediately write a claim letter to the VA. The claim letter must provide your name and address, list the problems or symptoms you are having and say that they are service-related or have made you completely disabled.
The date the claim letter is received by the VA is the start date for any benefits awarded to you in the future. Therefore, you should not wait to send your claim letter until you have gathered all potentially relevant documents. You will have later opportunities to provide documents and evidence to the VA.
Usually within 30 to 60 days, you will receive a letter from the VA acknowledging that they have received your claim. If you do not receive a letter within two months, send another letter, along with your original letter, indicating that you have not yet received a response.
After receiving the VA’s acknowledgement letter, complete a VA Form 21-526, which is your formal claim application. This form is available on the VA website or at VA Regional Office. Attach all supporting documents to the Form 21-526, make several copies of your completed application, and mail the original to your VA Regional Office.
The next step depends largely on your individual circumstances. However, it is vitally important to respond to all VA letters and follow their instructions carefully. If you miss a deadline, you may lose your claim completely.
Establishing a PTSD Diagnosis and Service Connection
In all cases, veterans must be evaluated by a VA psychiatrist or psychologist in order to receive VA benefits for PTSD treatment. When you meet with the doctor, he or she will determine if the stressor you recall supports a diagnosis of PTSD and whether your symptoms are related to that stressor.
Then, once you have a PTSD diagnosis, you are only required to show that it is related to your service overall, not a specifically-documented event. This is how the new regulation simplifies the process and makes it easier for you to get the benefits you have earned.
After it is determined that you have service-related PTSD, your percentage of disability will be evaluated. This percentage is then used to calculate the amount of benefits awarded to you for PTSD treatment.
If you need help with the PTSD claims process, had your claim rejected, or disagree with VA adjudicators’ assessment of your disability, contact an experienced veterans’ law attorney. It is possible to appeal or ask VA adjudicators to reconsider your claim; however, because of the complicated procedures and important deadlines, the assistance of a lawyer experienced in veterans’ law is invaluable.