Is PTSD a disability under VA compensation and Social Security? (2023)

Yes, if you are a veteran diagnosed with PTSD (or living with symptoms and suspected of having the condition), you may qualify for Veterans Affairs (VA) disability benefits, Social Security Disability Insurance (SSDI) benefits, or both.

The eligibility criteria for each program are different and must be met. Basically,

• PTSD can be the basis for a successful VA compensation claim if the PTSD isconnected to the serviceand properly diagnosed.
• For SSDI benefits, assuming Social Security's FICA requirements are met, the veteran must meet the SSA criterianew medical checklist for PTSD– or (as is often the case) the veteran can receive disability benefits through the SSAmedical-professional subsidy

Getting Maximum PTSD Disability Benefits

The inherent nature of military service makes PTSD prevalent among our country's veterans. When you serve in the military, you may witness war and acts of violence. You may have faced life-threatening missions or experienced shocking and terrifying events.

Difficult situations outside of combat bring more stress to a veteran who is already scared, anxious, nervous, or confused. This includes hostile or uninhabitable environments, military sexual trauma, or the emotional loss of a friend, to name a few. All can play a role in the life-altering symptoms of PTSD and other mental health conditions.

Veterans sometimes don't realize that PTSD disability benefits may be available to them through the VA and Social Security disability programs. Don't miss out on receiving disability payments from more than one source.

Just as important, don't risk having your initial PTSD disability claim denied, or losing on appeal because you don't have competent and experienced legal representation.

Things can get complicated between the two different agencies. If you are a veteran diagnosed with PTSD, this article explains what it takes to qualify for one or both of these disability programs.

How can I get veterans disability compensation for PTSD?

According to VA rules, you must first meet three conditions:

• you are correctly diagnosed with PTSD, and
• the stressor occurred during military service (service connection established) and
• due to the resulting symptoms, one cannot live normally as before.

Submit a claim that meets these demands, and the VA will likely determine that you are eligible for disability compensation.

While this may sound simple, there are many details that your conditionmust satisfybefore it can be considered connected to the service. Your case will go through the VA screening process and pass a C&P exam.

Possible VA scores for PTSD are 0, 10, 30, 50, 70, and 100 percent, depending on the severity of your symptoms. The VA will consider all of your mental disabilities together under the General Classification Formula for Mental Disorders.

Learn how VA evaluates PTSD and how the C&P evaluation affects your claim in our article:Understand your PTSD score.

Once your condition meets all of the VA requirements for PTSD, it can technically be considered a disability for veteran's compensation purposes.

PTSD Disability Symptoms

VA focuses on the behavioral symptoms that accompany PTSD. There are four distinct groups of diagnostic symptoms; EITHERnumber of symptomswhich one should be identified depends on the cluster. A disturbance must continue for more than one month.

re-experiencing

Spontaneous and unwanted memories of the traumatic event, recurring dreams (nightmares) related to the traumatic event, flashbacks, panic attacks, or other intense or prolonged emotional distress.

avoidance

Extreme avoidance of distressing memories, people, thoughts, feelings, or external reminders that you associate with the traumatic event.

Negative cognitions and mood

Adverse mood swings encompass all kinds of negative feelings, from constant and distorted assumptions of survivor's guilt, self-blame, or others', to feeling withdrawn or markedly reduced interest in daily activities, to not remembering the main features of the event. traumatic.

Excitement

These symptoms include aggressive, reckless, or self-destructive behavior, violent outbursts, sleep disturbances, difficulty concentrating, hypervigilance, and nervousness and related problems.

The symptoms are also responsible for the "fight" reaction often seen in PTSD patients.

PTSD Specific VA Disability Claim Forms

VA has separate forms to complete and submit on a PTSD claim for disability benefits and are available atVA site:

• VA Form 21-0781–Statement in Support of PTSD Service Connection Claim

Or, to claim a PTSD disability based on a personal assault, submit the following:

• VA Form 21-0781a–Statement in Support of Service Connection Claim for PTSD Secondary to Personal Assault

Why does the VA deny PTSD disability claims?

If your application was denied, you must appeal. If you think your PTSD score is too low, don't settle for the first score you get. The dollar amount of the VA disability payment depends on your qualifying decision.

The problem is that the path to obtaining PTSD disability benefits is often an uphill and frustrating battle for veterans dealing with this condition. Service connection rules, impersonal VA forms, treatment of facts related to your experience, incomplete service records, and other challenges make the claims process more difficult than it should be.

Too often, our attorneys represent veterans whose claims were filed incorrectly or lacked the proper forms, missed deadlines, or lack the medical opinions or supporting statements the VA needs in order to make an accurate classification or decision. On other claims, the VA simply gets it wrong and we can identify those mistakes and resolve the issues.

Common examples of PTSD claim denials include:

The veteran's statement did not contain the DSM-5 criteria:

The VA criteria used to diagnose PTSD are called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). There are specific PTSD criteria listed in the handbook that must be met and declared on your application. If any component is missing, ignored, or missing, your VA adjuster will likely deny your claim.

PTSD claim denied because "stressor" was not verified:

Each PTSD claim must be able to prove that a service-related stressor exists; the event that caused the PTSD. This can be combat related or non-combat related.

A difficult example to provecombat-related stressorIt could be this: While serving in Afghanistan, he witnessed a deadly IED explosion during combat. However, because you were not directly involved or injured, the exact stressor incident was never added to your file.

difficultnon-combat stressorsit can be even more difficult. You must have more corroborating evidence than just your own testimony. Suppose he witnessed a violent and deadly car accident while he was on leave. This stressful incident may be documented in the deceased's military records, but it may not be in yours.

Another example of a non-combat PTSD stressor ismilitary sexual trauma(MST). The VA may not have records of the stressful "event" because the injured veteran chose not to show up to report it.

We can often locate other military records, such as medical files or performance reviews, that provide insightful documentation. Circumstantial evidence showing behavioral changes and other wrongdoing may be the paper trail we need to help you connect the dots and develop your claim. Statements from family members, spouses, or friends can often help verify the occurrence of a stressor at work.

Suffer from PTSD but have received an unhonorable discharge:

You may be one of the thousands of veterans who suffer from service-connected PTSD, but have been denied VA benefits across the board because their discharge was designated "non-honorable" (and likely due to minor infractions related to their untreated mental health problems) .

Veterans can request a discharge status review based on PTSD. If you need a discharge update to qualify for VA benefits, contact our veteran attorneys for an immediate consultation.

For qualified veterans, PTSD is a Social Security disability.

In many cases, a veteran may be eligible for SSDI, along with or as an alternative to VA disability compensation, if the Social Security Administration (SSA) believes they are unable to work.

Like the VA, the SSA is a federal agency with its own purpose, eligibility requirements, definition of disability, and payment amounts. Therefore, it is important to know how these two disability programs differ and interact.

The SSA has recently published important revisions to itsOdds ListforSection 12.00 Mental disorders,including a new checklist for post-traumatic stress disorder. Previously classified as an "anxiety" disorder, in January 2017, PTSD was included in the new Section 12.15, "Trauma and Stressor-Related Disorders."

The purpose of SSA is different from that of VA

SSA is looking for problems with your ability to work. You follow a five-step process to decide if you are unable to work and therefore qualify for disability benefits.

The SSA does not require that a veteran's PTSD or other disability be tied to military service or discharge status.

There are no disability rating percentages. Basically, according to the SSA's definition of "all or nothing disability", you no longer have the ability to work (earn enough money to live) for at least one year or until death.

Rather, the purpose of VA compensation is to pay veterans who suffered disabling physical and mental health conditions while in the military, on a graduated scale based on the veteran's degree of disability. You can be partially disabled (assigned a percentage range in 10% increments) and still receive disability under VA.

SSDI has income requirements:

Social Security has an income threshold that claimants (both veterans and civilians) must meet to be eligible for benefits. According to the SSA, your functional impairments must limit your ability to work at a substantially profitable level.

Starting in 2019, this income level must be less than$1,220 per monthbefore qualifying for SSDI. This can disqualify some veterans from receiving SSDI benefits.

3 Tips on VA and Social Security PTSD Disability Claims

• VA benefits are not considered "earned income"and therefore do not affect your eligibility for SSDI benefits. Therefore, if the two benefits (SSDI + VA compensation) together exceed the SSDI income requirements, you will still be eligible for these benefits and your chances of passing will not be affected.
• As important as,If the VA gives you disability benefits, don't assume the SSA will too. Many veterans who receive VA compensation for PTSD do not qualify for Social Security Disability Insurance for PTSD. Remember, VA disability benefits are based on percentages; SSDI benefits are based on your being unable to work at all.
• The SSA can also use a veteran's evidence tospeed up processingof claims towounded warriorsmiveterans with a disability rating of 100%.

PTSD is a disability under the SSA Medical Vocational Allowance (MVA)

Our work often allows veterans to obtain amedical-professional subsidyin the SSA benefits program. If you were denied SSDI benefits because you did not meet the medical criteria listed by SSA for PTSD, you may still qualify for MVA if you can show aLimited residual functional capacity(RFC).

Your RFC is what you can still do within the limitations imposed by the PTSD. We help you present the strongest claim possible to show that your disability is severe enough to prevent you from working and earning a "substantial gainful" income, when also assessed from the standpoint of functional limitations, previous work experience, age , transferable skills, and other factors Social Security uses to assess whether you qualify for Professional Medical Assistance.

One call to our law firm does it all

The relationship between the VA and SSA and the types of disability benefits they provide can become complex. At Marc Whitehead & Associates, wetake care of everythingfor you.

Our experienced disability attorneys will help you complete forms and documents, supplement your claims with important additional records and supporting evidence, coordinate with physicians, and much more to successfully file your claim and obtain the most appropriate benefits to which you are entitled.

Come to us when you need help:

• develop and prove your veterans claim for PTSD,
• improve your VA score,
• apply for possible Social Security Disability Insurance, in addition to or as an alternative to your veterans' disability,
• qualify for a medical vocational scholarship, or
• appeal a VA or SSDI claim denial.

Do not wait more.call us free at800-562-9830or request a free consultation to find out how we can help you. PTSD is a serious disability and we are ready to help you wherever you live.

Marc Whitehead and associates areBoard Certified Veterans Claims Attorneysas required to practice law before the VA. We represent veterans at all levels within the VA disability system, including claims before the VA Regional Office, the Board of Veterans Appeals, and the US Court of Appeals for Veterans Claims.

Our attorneys are board certified inSocial Security Disability Lawby the National Social Security Disability Advocacy Board. We act from the initial phase of the application to administrative hearings and federal courts.