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How Does the VA Determine My PTSD Disability Rating?

Rep for Vets > PTSD  > How Does the VA Determine My PTSD Disability Rating?

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How Does the VA Determine My PTSD Disability Rating?

Veteran discusses disability claim with claims expert

As every solider knows, you can’t go into battle alone. You need a reliable and dependable support team behind you. The same is true of veterans battling with PTSD. Having a compassionate, understanding PTSD recovery team can help the healing process along. But the road to recovery is not always easy. We know of veterans who’ve done all the “right” things. They’ve reached out to their people for help. Received a PTSD diagnosis from a doctor. Applied for disability benefits, had a VA medical evaluation–only to have the VA deny them benefits, or give them a rating lower than their condition warrants.

James, a veteran of the first Gulf War, had been receiving a 30% rating for over 20 years despite not being able to work at all. James downplayed his PTSD symptoms at his initial C&P exam. And so did the VA. As a result, James was receiving far less compensation than he deserved. The medical records and buddy statements told a different story, and we were able to increase James’ PTSD rating to 70%, a difference of about $1,000 a month.

If your situation is anything like James’ was, know that you have options. You can appeal an unfavorable VA decision. If your PTSD has gotten worse over time, you can file for a higher rating. To proceed with a claim appeal, you need to understand how the VA rates PTSD and mental health conditions in general. From there, you may want to contact a VA-accredited claims agent about increasing your rating, thereby increasing your monthly compensation.


Understanding Your VA Disability Rating for PTSD

VA disability ratings range from 0% to 100%, but for PTSD claims, the standard ratings are 0%, 30%, 50%, 70%, and 100%. These ratings are meant to capture the severity of your condition, and how much it affects your ability to work and take care of everyday life stuff.

  • A 0% rating indicates that your PTSD doesn’t interfere with your work or school or family life. This is not a common rating, because it doesn’t make much sense for someone with a PTSD diagnosis to not experience its disabling impacts.
  • A 30% rating means you have mild symptoms that may come and go, depending on your stress level. At the 30% rating medication and therapy can be effective at mitigating symptoms.
  • A 50% rating applies when your PTSD causes more pronounced problems at work and in your daily life.
  • A 70% rating means PTSD causes significant and frequent difficulties in your daily life, such as near continuous panic attacks. At this rating you also have trouble working and maintaining healthy relationships.
  • A 100% rating is rare, and applies to people who are not able to function in the workplace, and have become socially isolated. The technical term is complete occupational and social impairment.

We often consult with veterans who received a very low rating from the VA, and we’ve had to fight to get more. The VA, unfortunately, in evaluating PTSD claims, can be dismissive. A too-low rating could also mean that the veteran downplayed their symptoms. If you’ve been through trauma or other challenges in life, it may be hard to talk about your experiences. It’s important to be forthright when discussing your mental health at your VA exam and with other medical providers. For tips on preparing for a PTSD or other psychiatric evaluation, check out this helpful article on PTSD at Real Warrior.

The VA is especially interested in whether you are able to work and support yourself. If you have panic attacks more than once a week, making it difficult to hold down a job, you could be eligible for a 50% rating. If you have near continuous panic attacks and thoughts of self-harm, a 70% rating would be more appropriate.

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The good news is that a denied PTSD claim or a too-low rating is not the end of the story. You can appeal the decision and submit more evidence to support your claim.

How the VA Appeals Process for PTSD Works

The denial or award letter you received comes with a statement from the VA on how they reached their decision, so make sure you hang on to it. You can use this information to determine what new evidence you should submit with your appeal. Once you get a rating decision from the VA, you have a year to appeal. The general plan for appealing a claim is as follows.

  • Have a VA-accredited claims agent or attorney review your claims file.
  • Request any pertinent records that are missing from your claims file.
  • If necessary, get “buddy statements” from friends and family, and additional statements from doctors.
  • File the appeal with the new evidence and send a “brief” to your VA Regional Office or the Board of Veterans’ Appeals.

Not every appeal follows this pattern to a T, so it’s best to consult with an experienced claims agent to get a better sense of how things will go.

Now let’s take a closer look at types of evidence that can help you show that your PTSD rating is in need of revision.

Types of Evidence That Can Help Your Appeal

Buddy Statements

The VA considers medical records, but it is also required to look at other evidence the veteran can provide, such as buddy statements. Buddy statements can come from family members, friends, or former military colleagues who can attest to your battles with PTSD. A spouse or a friend, for example, can attest to the frequency and severity of symptoms like panic attacks, insomnia, and angry outbursts. Outside observers may be able to describe how your PTSD symptoms manifest better than you can. For this reason buddy statements are an effective way to strengthen your appeal.

Occupational Factors

Too little evidence about how PTSD impacts your work can result in a low rating. In your appeal it’s important to submit additional evidence about how your PTSD impacts your job. A statement from an employer or a coworker who knows you well and can speak to the challenges you face at work can be helpful in supporting your appeal.

Long-Term Medical Records

If not treated, or if the traumatized person is under a lot of stress, the frequency and severity of PTSD-related symptoms can get worse over time. That’s why it’s important to look at your full medical history, so that a doctor can see trends and patterns that have developed over the years. If your symptoms have gotten worse, your PTSD rating should increase to reflect your current condition.

Related:  How Can I Get a 100% VA Disability Rating for PTSD?

Fighting on Behalf of Veterans with PTSD for Full Compensation

Need a little more help understanding your PTSD disability rating? The VA-accredited claims agents at the Rep for Vets have helped countless veterans across the United States navigate the claims process and get the benefits they deserve. To schedule a free consultation, give us a call at 1-888-573-7838, or fill out this quick form to get started. We look forward to learning about your unique situation and helping out in any way we can.

Do you need help or advice? Contact us now.

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