Post Traumatic Stress Disorder & Traumatic Brain Injuries

Posttraumatic Stress Disorder (PTSD) is the development of certain symptoms after exposure to one or more traumatic life-threatening events such as combat, a natural disaster, a car accident, or sexual assault.  These symptoms include anxiety; depression; nightmares; jumpiness to sounds; trouble getting close to other people; trouble sleeping; trouble concentrating; and using drugs and alcohol to relax.

There is a high incidence of PTSD among Vietnam Veterans.  In many cases, Vietnam was a personal war of survival for each veteran who had served.  Most Vietnam Veterans returned home to hostile reception from the public.  Further, it was not uncommon for Vietnam veterans to be in combat one day and home with their families the next day.  This lack of decompression time may attribute to the high incidence of PTSD among Vietnam veterans.  It is estimated that about 30% of Vietnam Veterans have had PTSD in their lifetime.  Comparatively, PTSD occurs in 11% to 20% of Iraq and Afghanistan War veterans and 10% of Gulf War veterans.

Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to both men and women and can occur during peacetime, training, or war. Among Veterans who use VA health care, about:

23 out of 100 women (or 23%) reported sexual assault when in the military.

55 out of 100 women (or 55%) and 38 out of 100 men (or 38%) have experienced sexual harassment when in the military.

There are many more male Veterans than there are female Veterans. So, even though military sexual trauma is more common in women Veterans, over half of all Veterans with military sexual trauma are men.

How do I get service-connected for Posttraumatic Stress Disorder?

In general, to be service-connected for PTSD, you must:

  1. Have a medical diagnosis of PTSD;
  2. A link, established by medical evidence, between current symptoms and in-service stressor; and
  3. Credible supporting evidence that the claimed in-service stressor occurred.

I don’t have proof that the in-service event causing my PTSD occurred.  Can I still win my service connection claim for PTSD?

Yes.  The VA rules allow for situations in which the veteran’s lay testimony alone, without credible evidence, can establish the occurrence of the in-service stressor.  These situations include:

  1. An in-service diagnosis of PTSD and the claimed stressor is related to that service.
  2. If a veteran’s claimed stressor is related to a fear of hostile military or terrorist activity, such as exposure to improvised explosive devices, small arms fire, or mortar attacks, and a VA psychiatrist or psychologist confirms that the stressor is adequate to support a diagnosis of PTSD, and that the veteran’s symptoms are related to the claimed stressor.
  3. The Veteran engaged in combat with the enemy and the stressor is related to that combat.
  4. Victims of personal assaults and military sexual trauma can use records from police, rape crisis centers, mental health counseling centers, hospitals, and physicians; pregnancy and STD tests; and statements from friends and family. Evidence of behavioral changes following the assault will also be considered.

The Law Office of Edward M. Farmer is experienced in using these special rules to help prove your VA service-connection claim for PTSD.  Contact us today.

How does the VA rate PTSD?

Every mental health condition, including PTSD, is evaluated under a single formula based on the degree of impairment caused to the veteran’s occupational and social functioning.  The formula is below and lists the criteria for disability ratings of 100%, 70%, 50%, 30%, 10%, and 0% and gives examples of the types of symptoms and levels of social and occupational impairment needed for each rating.  In order to receive a certain PTSD rating, you must suffer from symptoms that are listed in the criteria and suffer from the level of occupational and social impairment listed in the criteria.  The VA frequently underrates mental health conditions.  Contact the Law Office of Edward M. Farmer so we can evaluate your service-connected PTSD or mental health rating to determine if you are eligible for an increase.

General Rating Formula for Mental Disorders:

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: 100

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 work-like setting); inability to establish and maintain effective relationships: 70

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: 50

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): 30

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: 10

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: 0

Traumatic Brain Injuries

Traumatic Brain Injury (TBI) occurs when a sudden injury or trauma to the head causes signs such as a loss of consciousness, confusion, or disorientation. TBI is unfortunately considered the signature injury of the wars in Iraq and Afghanistan.  Blasts from Improvised Explosive Devices (IED)s are primarily responsible for the increase in TBI among Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans.  However, TBI is not unique to OIF and OEF veterans and service-connection for TBI may be established for veterans who did not serve in either conflict.  For example, a Vietnam veteran who suffered a head injury during a vehicle accident may be entitled to service-connection for residuals of TBI.

How does the VA evaluate TBI?

In 2008, the VA recognized that the rating criteria used to evaluate TBI was outdated and amended the rating criteria to allow for higher ratings.  However, this new rating criteria still may not go far enough to accurately reflect TBI’s impact on veteran’s lives.  The Law Office of Edward M. Farmer is experienced in helping veterans seeking compensation for residuals of TBI to obtain the evidence needed to increase a rating for TBI.  Contact us now.

You may also be entitled to secondary service-connection for disabilities it believes to be caused by TBI.  These disabilities include Parkinson’s disease, seizures, dementia, depression, and diseases of hormone deficiencies.  However, whether the VA will grant secondary service-connection for these diseases depends on whether the veteran’s TBI could be characterized as mild, moderate, or severe at the time of the injury or shortly afterwards.  How long after the TBI the secondary disability arises will also determine if secondary service-connection will be granted.  For example, depression that manifests within three years of moderate or severe service-connected TBI, or within 12 months of mild service-connected TBI, entitles the veteran to service connection for depression.   Contact us if you need help in determining if you are entitled to service connection for disabilities cause by TBI.

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