Post-traumatic stress disorder, or PTSD, affects about seven percent of US military veterans.
Here, we go over how the Veterans Administration (VA) decides what your PTSD monthly disability benefit is, and how you can make a claim to receive a VA disability rating for PTSD.
The VA has a special PTSD rating scale to set your PTSD VA rating. The VA will assign one of five VA rates: 0, 10, 30, 50, 70, or 100 percent.
Here are some VA PTSD rating criteria for each PTSD VA rating:
0% – This is a formally diagnosed mental condition but symptoms are not severe enough to impact your occupational or social functioning or to require continuous medication.
10% – You experience occupational or social impairment due to mild or transient symptoms which decrease your work efficiency and your ability to perform occupational tasks, but only when you are under significant stress; or your symptoms are controlled by continuous medication.
30% – You can generally perform satisfactorily in routine, low stress settings, but you still suffer from occupational and social impairment. You experience occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks due to symptoms like depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).
50% – You suffer from occupational and social impairment with reduced reliability and productivity. You symptoms might include 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, impaired judgment, impaired abstract thinking, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships.
70% – At this level you experience occupational and social impairment with deficiencies in most areas including work, school, family relations. Your judgment, thinking, or mood can be influenced by symptoms like suicidal ideation, obsessional rituals which interfere with routine activities, speech that is intermittently illogical, obscure, or irrelevant, near-continuous panic or depression affecting your ability to function independently, appropriately, and effectively, impaired impulse control (including unprovoked irritability and violence), spatial disorientation, neglect of personal appearance and hygiene, difficulty in adapting to stressful circumstances (including work or a work-like setting), and inability to establish and maintain effective relationships.
100% – This is total occupational and social impairment from symptoms like gross impairment in thought processes or communications, persistent delusions or hallucinations, grossly inappropriate behaviors, persistent danger of hurting yourself or others, intermittent inability to perform activities of daily living like minimal personal hygiene, disorientation as to time or place, memory loss for names of close relatives, your own occupation, or even your own name.
The monthly disability compensation that the VA pays for a PTSD-related disability uses the same rate tables as for any other service-connected disability.
The VA rate tables are extensive and cover many variables, mainly based on who is living with you: a spouse, dependent parents, and dependent children.
As an example, let’s consider a veteran the VA has diagnosed with a 50 percent PTSD-related disability rating and no other compensable disabilities. The veteran has a spouse, two children under the age of 18, and one dependent parent.
Using the appropriate VA disability ratings table, first find the dependent status that matches the closest to your dependent situation.
Here, because the rating table only covers one child (you add more in a separate table), we start with the row for you, your spouse, one parent, and one child:
Next, we refer to the VA table to add additional dependents to find the additional disability amount for your second child:
Add the $51 here to the $1,338.16 sum above, and $1,389.16 is your disability benefit.
If you have other service-connected compensable disabilities, you would take your PTSD rating here and combine it with your other disabilities into a combined disability rating, as you would do normally.
To find out more about how a PTSD-related disability fits into your combined disability rating, see our VA Disability Benefits Calculator page.
The VA uses a three-part test to see if you are eligible to apply for post-traumatic stress disorder (PTSD) disability benefits:
The VA states that a stressor is a traumatic event that happened to you, one that has such an impact on your life that it affects how you live and your ability to cope with certain situations because of it.
The VA considers the following to be traumatic events:
Your stressors are unique to you. Chances are that they will fall into one of three kinds of traumatic events.
Here are three of the major kinds of stressors for VA PTSD disability claims, and the kind of proof the VA requires for them.
Perhaps the most commonly-recognized stressor you can experience in your military service is exposure to combat.
You do not have to be physically injured or to harm anyone else to experience battle-related PTSD. Being in the presence of combat can be enough.
You can prove this kind of stressor with evidence that you were engaged in direct combat.
If you received any award or commendation for the experience, the VA will likely accept that evidence as conclusive.
If you can provide any other evidence that you were engaged in combat, then the VA will be inclined to accept your PTSD stressor claim based on your word as long as no clear and convincing evidence to the contrary exists.
The same is true if you were held as a prisoner of war by the enemy.
You can also experience a service-connected PTSD stressor outside of combat exposure.
A few examples of how you can experience stressor events during your service are being the victim of an assault or a violent crime, being part of a motor vehicle or training accident, being informed of a serious medical diagnosis, or being subject to repeated discriminatory treatment as part of your service.
Non-combat stressors require more formal proof than exposure to combat stressors do.
This often means that you will need to show documentary evidence of the stressor, like a police report, photos, correspondence, and public records proving the event happened and a letter from a relevant medical professional like a psychologist or psychiatrist that supports a connection between the stressor and your PTSD symptoms.
The fluidity of the modern battlefield, and the range and lethality of modern weapons, means that there can be no such thing as a completely safe place anymore.
You can be subject to attack at any time, anywhere: an IED ambush on your unit while it is traveling in a supposedly secure area, or a rocket or mortar attack on your base at night, are a couple of examples of PTSD stressor events that can have a lasting psychological impact.
You can prove this kind of stressor to the VA through a combination of evidence of the attack and that you were present with your unit or assigned to the base that was subject to it.
You will likely also need a letter from a psychologist or psychiatrist stating that your PTSD symptoms are at least as likely as not to be caused by the stressor event.
Once you have shown the existence of a service-connected stressor, the second thing you need to do is to show that the stressor is still affecting you today, post-service, through symptoms that negatively affect your quality of life.
The physical, emotional, and mental health symptoms of PTSD you might suffer can occur in two ways.
One way is by experiencing persistent symptoms, like insomnia, recurring nightmares, general anxiety, avoidance behaviors, and depression.
The other way symptoms can manifest themselves is when you experience a triggering event.
A triggering event is usually a sensory stimulus that your brain is associating with the stressor. Triggers can be a sight, sound, or smell, or a place that reminds you of the stressor. Sometimes other people can be triggers. Responses to trigger events often include physical reactions like becoming easily startled, hyper-alertness, sudden mood swings, or flashback experiences.
As we will see later, the severity of these symptoms in interfering with your quality of life will be important when the VA calculates your PTSD disability rating.
The easiest and most persuasive way to prove that you are being adversely affected by the stressor is to show that you are receiving treatment for it.
Records of informal treatment you received before being diagnosed with PTSD can be helpful to establish your claim, but eventually the VA will require you to show that a mental health professional like a psychologist or a psychiatrist has diagnosed you as having it.
Your VA PTSD disability claim begins the same way as any other disability claim: you file a claim for disability compensation online, in person, or by mail.
Depending on the nature of the facts of your claim, you will need to fill out one of the following forms with your claim:
In many mental health conditions, you might experience symptoms that fall under multiple disability ratings.
For example, you could simultaneously experience suicidal ideations (a 70% symptom), mild memory loss (a 30% symptom), and a flattened affect (a 50% symptom).
There is, however, no way to split the disability ratings; your PTSD VA rating can only be rated at one of 0, 10, 30, 50, 70, or 100%.
In these cases, the VA should consider sympathetically your entire disability picture and choose the highest rating that most closely approximates the disability rating.
Unfortunately, many veterans are under an incorrect impression that PTSD results in an automatic 50% rating. This is not true.
You are only entitled to an automatic 50% PTSD disability rating if you developed a mental disorder while in service, it was the result of a highly stressful event, and the mental disorder is severe enough to bring about your release from active duty
If those conditions are met, the VA will assign a 50% disability rating and schedule an automatic re-evaluation in 6 months.
While many mental health conditions are considered to be related to PTSD, such as anxiety, depression, or insomnia, the VA rates all mental health conditions on the same overall schedule of mental health disorders.
Thus, if you are diagnosed with insomnia and PTSD, but both conditions cause chronic sleep impairment, you would only receive one rating for that symptom.
Because mental health symptoms frequently overlap, you generally cannot receive additional compensation for mental health symptoms without encountering the “Rule Against Pyramiding”.
That is, that the VA cannot compensate you multiple times for the same manifestation of a disability.
Thus, if you are diagnosed with insomnia and PTSD, you may only receive one rating for their mental health condition.
If you cannot obtain or maintain substantially gainful employment because of service-connected PTSD, then you may be eligible for a 100 percent PTSD VA rating based on individual unemployability (TDIU).
You would qualify for PTSD-based TDIU disability in the same way that you would with any other single or combined disability.
You must have at least one service-connected disability rated at 60% or more, or one service-connected disability rated at least 40% and a combined disability rating of 70%.
The VA understands that the schedule of PTSD VA disability rates does not always accurately or completely account for how a disability may affect your ability to work. In these circumstances, you may still be eligible for TDIU even if you do not meet the eligibility criteria above.
We know that veteran PTSD claims can be frustrating, confusing, and at times, intimidating.
This is especially true if the VA denies your claim or assigns you a lower disability rating than you think is right.
Our expert VA disability attorneys at Stone Rose Law are ready and willing to assist you in obtaining the benefits you deserve for your service-connected disabilities.
Have questions? Don’t hesitate to give us a call at (480) 630-2765, or schedule a free consultation with us.
Many veterans experience a traumatic event while in service. This can range from a personal assault, a sexual assault, direct combat experience, or natural disasters. However, many veterans find their claims for PTSD get denied. This can be extremely frustrating, especially when the veteran has been diagnosed with PTSD by their VA medical care provider or is even being treated for PTSD by the VA!
PTSD is a mental health condition that develops after exposure to traumatic experiences. According to the DSM-5, which the VA uses for diagnosing mental health conditions, PTSD requires:
Service connection for PTSD is a little more nuanced that service connection for a condition like a low back strain. Under 38 C.F.R. § 3.304(f), service connection for PTSD requires:
Evidence needed to establish the occurrence of the in-service stressor depends on the type of stressful event that lead to the development of PTSD, as well as when and how the disability was diagnosed.
If PTSD was diagnosed during service and the claimed stressor is related to service, then the veteran’s lay testimony regarding the in-service stressor establishes the stressor unless there is clear and convincing evidence to the contrary.
If the evidence establishes the veteran engaged in combat with the enemy, claims a stressor related to that combat, and the stressor is consistent with the circumstances of service, then the veteran’s testimony regarding the stressor is sufficient in the absence of clear and convincing evidence to the contrary. Typically, if a veteran has been awarded a combat medal – such as a combat action/infantryman/medic badge, combat action ribbon, or a valor award – the VA will concede the stressor.
If the veteran was a POW and the stressor relates to that experience, the veteran’s lay testimony will be sufficient to prove the stressor event.
If the stressor is related to a veteran’s fear of hostile military or terrorist activity, and a VA contracted or employed psychiatrist or psychologist confirms the claimed stressor is adequate to support a PTSD diagnosis, and the stressor is consistent with the time and place of the veteran’s service, the veteran’s lay testimony may establish the occurrence of the stressor. A fear of hostile military or terrorist activity includes incoming artillery, rocket fire, mortar fire, small arms fire, IEDs, sniper fire, or the like and the veteran’s response involved psychological states of fear, helplessness or horror.
Lastly, if the veteran’s stressor is related to an in-service personal assault or sexual assault, the VA will consider additional evidence outside of official service records, to corroborate the occurrence of the stressor. Commonly, these are called “markers”, and include evidence of behavior changes, deterioration of work performance, substance abuse, or the like.
The VA rates PTSD under the same schedule for rating mental disorders that it uses for every mental health condition, found in 38 C.F.R. § 4.130. Ratings can range from 0% to 100%.
In many mental health conditions, individuals will experience symptoms that are contemplated in multiple disability ratings. For example, a veteran may experience suicidal ideations (a 70% symptom), mild memory loss (a 30% symptom) and a flattened affect (a 50% symptom).
However, there is no way to split the ratings. Mental health can only be rated at 0, 10, 30, 50, 70, or 100%. In these cases, the VA should sympathetically look at the entire disability picture and choose the highest rating that most closely approximates the disability rating.
Unfortunately, many veterans are under an incorrect impression that PTSD results in an automatic 50% rating. However, this is simply not true. A veteran is only entitled to an automatic 50% rating if the requirements of 38 C.F.R. § 4.129 are met, i.e.,
If those conditions are met, the VA will assign a 50% disability rating and schedule an automatic re-evaluation in 6 months.
While many mental health conditions are considered co-morbid with PTSD – such as anxiety, depression, or insomnia – all mental health conditions are rated on the same schedule of rating mental health disorders. Thus, if you are diagnosed with insomnia and PTSD but both conditions cause chronic sleep impairment, you would only receive one rating for that symptom.
Because mental health symptomology frequently overlaps, veterans generally cannot receive additional compensation for mental health symptoms without running afoul of the Rule Against Pyramiding. That is, that the VA cannot compensate a veteran multiple times for the same manifestation of a disability. Thus, if a veteran is diagnosed with insomnia and PTSD, they may only receive one rating for their mental health condition.
Veterans who are unable to obtain or maintain substantially gainful employment outside of a protected environment, as a result of their service-connected [generic condition description], may be eligible for total disability based on individual unemployability (TDIU). Veterans who obtain TDIU are compensated at the 100% rate, with the potential for Special Monthly Compensation if appropriate.
There are two ways to get TDIU:
To obtain TDIU through the requirements of the VA Schedule for Rating Disabilities, a veteran must have:
The VA understands that the schedule of rating disabilities does not accurately or completely account for how a disability may effect an individual’s ability to work. In these circumstances, a veteran may be eligible for TDIU even if they do not meet the schedular criteria above, on an extraschedular.
We know that VA claims can be frustrating, confusing, and at times, scary. However, the expert VA disability attorneys at Stone Rose Law are ready and willing to assist you in obtaining the benefits you deserve. Have questions? Don’t hesitate to give us a call for a free consultation.