Post-Traumatic Stress Disorder (PTSD)
PTSD (post-traumatic stress disorder) is a Mental Disorder that is caused by experiencing a traumatic event. When defining PTSD for disability purposes, a “traumatic event” is any event where the person experiences “exposure to actual or threatened death, serious injury, or sexual violence” (DSM-5). Traumatic events can include actual or threatened abuse, death, physical injury, sexual abuse/violence, accidents, situations that cause extreme fear, and many more.
Depending on the severity, PTSD can have a huge affect on the ability of an individual to function in normal life. Symptoms can include fear, the inability to concentrate, depression, anti-social behaviors, violent outbursts, anger, nightmares, insomnia, and many more. The symptoms can be constant, worsen over time, improve over time, or can come and go.
Like many mental illnesses, the exact symptoms of PTSD can be very different from one person to the next. Some symptoms can show up immediately following the traumatic event, but most symptoms often develop over a period of time. This can be a few weeks and months to many years after the initial traumatic event.
Because of the naturally traumatic experiences that combat provides, many military members suffer from PTSD. Being exposed to a traumatic event alone, however, is not enough to be diagnosed with PTSD. There are many requirements that a condition must meet before it can be considered PTSD.
Listed below are the different requirements that must be met in 7 different categories before a condition can be diagnosed as PTSD for military disability purposes.
Note: These requirements are strictly for assigning Military Disability Ratings to PTSD for Military Disability. Other organizations, psychologists, etc., may diagnose PTSD on different standards. Regardless, the requirements below are commonly accepted overall as a good general guideline for diagnosing PTSD.
Once the condition fulfills all the requirements, it can then be officially diagnosed as PTSD by a mental health professional for the purpose of Military Disability.
Diagnostic Requirements for PTSD
The condition must meet the requirements in each of the following categories in order to be diagnosed as Post-Traumatic Stress Disorder:
Stressor (the traumatic event): It must be proven that the individual was exposed to a traumatic event in at least one of the following ways:
- Experiencing the event themselves
- Witnessing the event happen to others
- Learning of a traumatic event happening to a close friend or family member. In the case of death, whether actual or threatened, the event must have been violent or accidental to qualify. A family member dying after an illness of 5 months is not considered a traumatic event since there was time to emotionally prepare.
- Experiencing regular or severe exposure to the aftermath of a traumatic event. This would include things like being a first responder to the scene of a bombing, etc.
Intrusive Recollection: The individual must regularly remember or re-live the event in at least one of the following ways:
- Thoughts, memories, and images of the event come to mind unwanted on a regular basis, causing emotional and mental distress.
- Nightmares of the event (or related to the event) occur on a regular basis.
- There are occasions when the individual feels or acts like they are re-experiencing or re-living the event. These experiences include hallucinations and intense flashback episodes and can be accompanied by violent or irrational behavior.
- Significant emotional and mental distress that occurs whenever the individual is exposed to things that remind them of the event. This could be movies, music, sounds, smells, etc.
- Physical distress and reactions that occur whenever the individual is exposed to things that remind them of the event. These physical reactions could include sweats/chills, sensitivity to sounds, increased heart rate and mental processes, etc.
Avoidance: The individual must constantly try to avoid reminders of the event in at least one of the following ways (these behaviors can be conscious—they know they are doing it—or subconscious—they don’t know they are doing it):
- Avoids memories, thoughts, or feelings about the event or similar events.
- Avoids places, activities, conversations, objects, people, etc., that remind them of the event.
Negative Alterations in Cognition and Mood: The individual must show decreased mental and emotional changes, like amnesia, depression, etc., in at least two of the following ways:
- Inability to remember parts of the event. To qualify, this amnesia cannot be caused by physical triggers, like head injuries, or memory altering substances, like alcohol.
- Incorrect or skewed memories of the event that causes the individual to blame themselves or others.
- Intense and long-lasting negative feelings about themselves, others, or life in general. These feelings are often exaggerated, and include things like “Everyone lies,” “I am a bad person,” “You can never be safe,” etc.
- Persistent severe negative emotions like guilt, fear, anger, etc.
- Doesn’t feel interested in or want to participate in significant activities, like celebrating birthdays—such activities no longer seem important.
- Feels detached from others—not able to connect emotionally with them.
- Consistently not able to feel or show various positive feelings like love, contentment, happiness, etc.
Hyper-arousal: The individual must show signs of hyper-arousal. This is when the senses are fully functioning and adrenaline is released into the body. This often occurs because of worry, a need to feel prepared, feeling unsafe, etc. At least two of the following must be present:
- Trouble falling asleep or staying asleep.
- Difficulty concentrating.
- Hyper-vigilance (being extremely and overly aware of things around you, often watching out for any threats).
- Startling very easily. Being startled or caught off guard can also result in a violent physical response.
- Regularly feeling angry and being irritable. Losing their temper easily, often with no obvious reason, that results in physical and or verbal aggression. This aggression can be aimed at people or objects (throwing a computer out the window, etc.).
- Behaving in a reckless or self-destructive manor. This can include taking unnecessary physical risks, binging on substances, sabotaging any positive opportunities, etc.
Duration: All the symptoms noted above must be present for more than one month.
Functional Significance: The symptoms must significantly affect the individual’s social or occupational functioning. It could be that they cause stress within the family, the inability to concentrate properly on work assignments, etc. This is left up to the interpretation of the psychiatrist who is diagnosing the condition or the Rating Authorities.
How will the VA rate my PTSD?
The VA uses the Psychological Rating System to rate PTSD based on the symptoms it causes. Check out our Mental Disorders Ratings page for the exact codes and ratings.
My PTSD wasn't diagnosed until after I was discharged. Can it qualify for VA disability?
Yes. As long as there is clear evidence that the traumatic event that triggered the PTSD is service-related, then it can qualify for VA Disability at any time.
How do I apply to receive my ratings?
If you are still in the military, then you can request your military physician to refer you to the MEB and start the IDES process. If you are already a veteran, you can submit a VA Disability Claim along with evidence of service-connection and all medical records regarding the conditions on the claim.
Are my conditions eligible for a rating?
Your conditions are eligible to be rated by the VA if they are the result of your military service. You must be able to show proof of service-connection for each condition. For the DoD, they will rate your service-connected conditions as long as they also make you Unfit for Duty.
If my claim is approved, what benefits will I receive?
If you are rated 20% or less from the DoD, then you will receive a single separation payment. If you are rated 30% or more, you will receive full retirement benefits. From the VA, you will receive a monthly payment as well as full medical care from the VA for the qualifying conditions.
How long does it take to receive my disability benefits?
Brand new claims usually take 3-6 months to process. Once processed, you will start receiving payments in 1-3 months.
How are the rating percentages assigned to my conditions?
The rules of the VA's Schedule for Rating Disabilities (VASRD) are used to assign rating percentages to conditions. The VASRD gives rating rules for conditions based on their symptoms, treatment options, and the resulting level of disability they cause.
My conditions have worsened. How do I increase my rating percentages?
If your conditions have worsened since you last applied and now qualify for a higher rating, you can submit a new claim, checking the box for an increased evaluation.