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January 15, 2019

How to file a VA Claim for PTSD

Last updated on April 5, 2021

The purpose of this article is to give tips on how to file a VA claim for PTSD, so you can get the rating and compensation you deserve. Many Veterans are denied VA benefits for PTSD due to a lack of medical evidence with no clear in-service stressor.

 

We’ll cover applying for PTSD, appealing a PTSD rating, PTSD evidence requirements, in-service stressors and PTSD stressor examples, the best strategies to ensure your PTSD claim gets service-connected and rated at the appropriate level based upon your current symptoms and level of occupational and social impairment.

 

If you need help with your PTSD VA claim, PTSD increase claim, or other mental health conditions claim, feel free to complete the free 3-step intake below. You’ll get an Independent Psychological Evaluation by a U.S. Board Certified Psychologist, a Medical Nexus letter for PTSD, and documented Symptoms on either the PTSD Initial DBQ, PTSD Review DBQ, or Other Mental Health Conditions DBQ.

 

==> VA Claims Insider Elite medical consulting program: www.vaclaimsinsiderelite.com

 

PTSD VA Claim Eligibility for Veterans

 

1. Medical diagnosis of PTSD or Other Mental Health Condition (e.g., Major Depressive Disorder)

 

2. The disability was caused or made worse by your active duty military service (“Nexus”)

 

3. Persistent and reoccurring symptoms of PTSD or other mental health condition(s) into the present day (severity of symptoms)

 

What Are PTSD Stressors?

 

PTSD ALWAYS has in-service stressor(s), such as:

• Exposure to death

• Threatened death (fear or hostility)

• Actual serious injury

• Threatened serious injury

• Actual sexual violence

• Threatened sexual violence

 

What Are PTSD Combat Stressors for my PTSD VA Claim?

 

PTSD-combat in-service stressor(s) examples:

• Rocket attacks in Afghanistan

• Enemy ambush in Vietnam

• IED event in Iraq

• Flight deck plane crash in Gulf War

• Seeing another service-member killed while deployed

 

What Are PTSD Non-Combat Stressors for my PTSD VA Claim?

 

PTSD non-combat in-service stressor(s) examples:

• Military Sexual Trauma (MST)

• Service-member suicide

• Serious car accidents

• Training accidents

• Victim of rape

• Witnessing a rape

 

Evidence Requirements: First-Time Filer of PTSD:

 

• In-service stressor(s) – what are they for you?

• Dates, description, geographic location, unit assignment, dates of assignment

• Statement in Support of Claim for Service Connection for PTSD

• Statement in Support of a Claim – VA Form 21-4138

Buddy letter(s) HIGHLY RECOMMENDED!

• C&P Examiner will complete the DBQ for PTSD Initial

 

Evidence Requirements: PTSD Increase

 

• DBQ for PTSD Review – completed by a U.S. Board Certified Psychologist

• Statement in Support of a Claim – VA Form 21-4138

– You’re already service-connected; are your symptoms worse?

• Buddy letter(s) HIGHLY RECOMMENDED!

– VA Raters rely heavily on first-hand witness testimony

 

Evidence Requirements: Other Mental Health Conditions

 

• DBQ for Other Mental Health Conditions – completed by a U.S. Board Certified Psychologist

Medical Nexus letter first-time filer – “more likely than not”

• Statement in Support of a Claim – VA Form 21-4138

• Buddy letter(s) HIGHLY RECOMMENDED!

 

Crucial Tips for Your VA PTSD Claim

 

• Service-connection, is the Nexus clear?

• Pre-existing issues…

• Do you have a medical diagnosis?

• Are you actively seeking treatment?

• Do you take medications?

• What is your level of occupational and social impairment?

 

PTSD VA Claim Rating Criteria

 

PTSD claims are rated on a scale from 0% to 100%. The level of occupational and social impairment is what determines your overall rating under the law.

 

0% Rating Criteria for PTSD:

A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.

 

10% Rating Criteria for PTSD:

Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.

 

30% Rating Criteria for PTSD:

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).

 

50% Rating Criteria for PTSD:

Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.

 

70% Rating Criteria for PTSD:

Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.

 

100% Rating Criteria for PTSD:

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.

 

How to Get a Higher VA Disability Rating for PTSD

 

• Get an Independent Psychological Evaluation with a U.S. Board Certified Psychologist

• Obtain a DBQ and Nexus letter (if needed) for PTSD or Other Mental Health Conditions

• Don’t limit yourself to just the one diagnosis

– Is it possible to differentiate symptoms?

– Secondary Mental Health Claims

 

C&P Exam for PTSD Tips

 

1. Know what’s in your medical records!

2. Review your Disability Benefit Questionnaire (DBQ)

3. Review the eCFR, Title 38, Schedule 4 for PTSD and other mental health symptoms and ratings

4. Do NOT have your best day

5. Be uncomfortably vulnerable…

6. Know your true story cold…and potential in-service stressors that caused or made your PTSD and/or other mental health conditions worse.

 

Need Help With Your PTSD VA Claim?

 

We have a full medical staff of U.S. Board Certified Psychologists, ready and available to assist you with the medical evidence you need to “service-connect” your PTSD or Other Mental Health Conditions claim (DBQ, Nexus, Symptoms).

 

VA Claims Insider Elite medical consulting program for PTSD VA Claim, it’s free to start:

==>> www.vaclaimsinsiderelite.com <<==

 

FAQ: How To Win Your PTSD VA Disability Benefits Claim

 

Can I get VA disability compensation and benefits for PTSD VA Claim? Yes. The Department of Veterans Affairs will pay veterans with service-connected PTSD monthly compensation.

 

Is PTSD considered a disability? The Department of Veterans Affairs recognizes PTSD as a mental condition that may be related to service, and PTSD is therefore compensable.

 

What is the disability rating for PTSD? The VA will give you a disability rating based upon the severity of your PTSD, specifically related to your level of occupational and social impairment. If you are considered service-connected, you will receive a VA disability rating for PTSD of 0%, 10%, 30%, 50%, 70%, or 100%.

 

How much does the VA pay for PTSD? If your PTSD claim is approved, you may receive up to $3,350.87 per month. That is currently the max that the VA will pay veterans with PTSD, if at the 100% rating criteria for PTSD. 100% rating for PTSD.

 

Can PTSD be permanent? Some veterans may receive a permanent and total rating. If your PTSD is not expected to improve, you may obtain the status of permanent disability.

 

Can the VA reduce your disability rating for PTSD? Yes. Unfortunately, sometimes the VA will lower a veteran’s PTSD rating. If that happens to you, file an appeal with new and material medical evidence for PTSD and challenge the VA’s decision.

 

How can I get 100% VA disability for PTSD? Your PTSD must be severe enough to warrant a 100% rating. Many veterans do obtain a 100% rating for PTSD using the VA Claims Insider proven proprietary medical consulting process. Get started for free here.

Become an Insider

We’re Veterans helping Veterans Worldwide™, and since 2016 we’ve helped 10,000+ Veterans just like you INCREASE their VA disability rating!


About the Author

About VA Claims Insider

VA Claims insider is an education-based coaching/consulting company. We’re here for disabled veterans exploring eligibility for increased VA disability benefits and who wish to learn more about that process. We also connect veterans with independent medical professionals in our referral network for medical examinations, disability evaluations, and credible Independent Medical Opinions & Nexus Statements (Medical Nexus Letters) for a wide range of disability conditions.

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