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Step 1: Medical Diagnosis of PTSD
As I described earlier you must have a medical diagnosis
of PTSD under the diagnosis criteria of DSM-IV. So if you have a diagnosis of PTSD in is a good idea to get a report from
your doctorthat explains how he came to this conclusion under DSM-IV criteria. This step can often be complicated when
the veteran is given a diagnosis for his mental condition of other than PTSD by another doctor. This is why it is important
that the doctor who diagnoses the PTSD fully describes in a report why he feels this way and how it meets the criteria under
DSM-IV.
Step 2: In-service stressor
(traumatic event(s) while serving)
The veteran must also show evidence of a stressor in
service. This means the stressful event that cause the PTSD must have occurred while he was in service. It is important
to note that combat is not the only stressor that can occur in service and cause PTSD. Any traumatic event that satisfies
the diagnostic criteria in DSM-IV is acceptable. However, I should note there are special rules and it is significantly easier
to prove an in-service stressor if the veteran was in combat or a former prisoner of war. I should also note it does not have
to be one stressor that caused the PTSD in service it can be multiple stressors and the veteran should note all of the stressors
in his claim for VA compensation. Many veterans may lose their PTSD claim due to a technicality so it is very important
that a veteran complete VA form 21 -- 0781, statement in support of claim for service connection for post tramatic stress
disorder. I have seen many decisions where the VA claims they did not receive this form and; therefore, it did not allow them
to verify the veteran's stressor. Many veterans who have been denied for this reason tell me that they sent it in but this
is why it is important to send everything into the VA certified mail so that you have proof that you have done so. The following
is taken from one of these cases that was denied for this reason and explains what is required. "The US armed services
research center for research of unit records (SASCRUR) has provided Department of Veterans Affairs with a booklet entitled,
Guide for Preparation and Submission of Post Traumatic Stress Disorder Research Requests for guidance in requesting confirmation
of alleged in-service stressful event(s) reported in conjunction with claims for service connection for post traumatic stress
disorder. The US Armed Service Center for Research of Unit Records cannot conduct proper research to confirm these stressors
without certain specific details to include names of any casualties known and Units to which assigned (down to the company
level); dates of events (minimum month and year); unit veteran as assigned to when the claimed event or incident occurred
(down to the company level); names of particular campaigns involved with at the time of the event or incident; and specific
locations where the events where incidents occurred. You fail to provide any specific information capable of verifying any
of the claimed events or incidents; therefore, your claim is denied for lack of a verifiable stressor." As I stated
earlier, there are two separate rules in determining in-service stressors. I will first discuss combat stressors.
Combat in service stressor
If it is shown that the veteran was in combat then the
veteran statements by themselves may establish the occurrence of the claimed in-service stressor in the absence of clear and
convincing evidence to the contrary and provided that the claimed stressor is consistent with the circumstances conditions
or hardships of the veteran's service. The rules are essentially the same for POWs. The veterans DD 214 can be extremely
helpful in showing the veteran engaged in combat. It may be shown by certain medals received, the veteran specialty, the unity
was assigned to and during what dates. If the information and the veterans file is not enough to show the veteran was in combat
there are many ways to get supporting documentation to show combat experience and it would be a good idea at this point to
get a lawyer or representatives help to get the supporting evidence needed.
Non-combat stressor
If the veteran did not engage in combat then proving
the stressor can be more difficult. The veteran must supply credible supporting evidence that the claimed in-service stressor
occurred. In this case, the veterans statements by themselves are not enough to establish an in-service stressor. It is important
that the veteran be specific as possible as to the stressful event or events that occurred including as much detail about
individuals involved, dates, location and what the events were. The events can many times be corroborated by the veterans
military service records but it can also come from other sources. It is always a good idea to get written statements from
others in service who you served with who may have experienced the event or events or who you are in contact with shortly
after the stressful event. This may even include letters or e-mails to home that the event occurred. It is a good idea to
get as much supportive evidence as possible but remember the standard of proof is still "at least as likely as not."
Rape, Domestic Violence, Harassment, Physical or Sexual Assault
Another type of case which fits under the non-combat
in-service stressor category but is treated a little differently is those who suffered from rape, physical assaults, domestic
violence, robbery, mugging, stalking, and harassment. Although this type of claim is most commonly associated with female
veterans it also occurs in large numbers to male veterans as well. Because of the nature of these crimes it can often be difficult
to produce supporting evidence of this type of trauma. So even if your military records do not documenta personal assault
you can still show the in-service stressor occurred. Some examples of evidence that can show the in-service stressor occurred
in a PTSD claim for compensation are police records, records from mental health or rape crisis centers or other hospitals
or physicians. It can also include statements from fellow veterans, family members and even clergy. What can be obtained from
these sources that can help your claim is behavioral changes, a request fortransfer to another assignment, an indication
that you were performance has declined, treatment for other psychiatric conditions following the alleged event such as depression,
social behavioral changes and even substance-abuse. In other words if you can show by supportive evidence that after the assault
occurred significant negative effects occurred in your life or you took steps to remove yourself from the situation you can
prove your in-service stressor of assault. The decision makers at the regional office frequently misapply these rules.
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