Service Connection for PTSD or Other Psychiatric Conditions

Service Connection

Service connection refers to an injury, disease, or other disability related to a veteran’s active duty service. Once service connection is achieved, VA will compensate the veteran based on the degree of their disability. Generally, to establish a claim for service connection, the evidence must establish the following three elements: (1) the veteran must have a current diagnosed disability; (2) there must have been an in-service event, occurrence, or symptoms; and (3) there must be a medical nexus or link/connection between the current disability and service.

However, if the diagnosed condition being claimed is PTSD, VA may be able to concede the in-service event (what VA calls “stressors” in claims for service connection for PTSD). If the current diagnosis is a psychiatric condition other than PTSD, the same rules apply as above, and VA will look for an onset of symptoms during active duty service.

Diagnosis

Diagnoses of a psychiatric condition generally must be provided by a competent provider. For a diagnosis of PTSD, VA requires that the diagnosis at least be confirmed by a psychiatrist or psychologist. If there is a diagnosis of a psychiatric condition other than PTSD, it need only be diagnosed by a suitable provider or clinician.

In-Service Event

The main difference in a claim where PTSD is the underlying condition, versus another psychiatric condition, is the evidence the veteran needs to show in order to confirm his/her in-service event.

If the diagnosis is PTSD and the veteran served in combat, was diagnosed with PTSD while on active duty, was a prisoner of war, or his/her “stressor” is related to fear of hostile military activity, then VA will concede the in-service event so long as it is “consistent with the circumstances, conditions, or hardships of the veteran’s service.”

Note on fear of hostile military activity: According to VA regulations, fear of hostile military activity means: “that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others.” Examples provided by VA’s regulation include, actual or potential IEDs, incoming artillery, rocket, mortar fire, etc., small arms fire or suspected sniper fire, etc. However, the term is broad and could involve other situations, such as drone operations against hostile forces.

If the diagnosis is PTSD and the veteran’s in-service stressor was based on personal assault or trauma, such as military sexual trauma, hazing, bullying, or harassment or violence against your person for any reason, the rules are slightly different. Whereas information confirming a veteran’s participation in combat, for example, would generally be clear from a review of the veteran’s service record, events that result in personal assault are typically not preserved in a service record because reporting of such events in the military is chronically low.

Because VA is aware that reports of personal assault are low and unlikely to appear to in the veteran’s service record, or service treatment record, VA regulations allow for “evidence from sources other than the veteran’s service records” to assist in confirming the trauma did occur. This evidence could be outside medical treatment, such as civilian hospitals or counseling centers, records from civilian law enforcement authorities, or information related to subsequent medical treatment due to an assault. Corroborative evidence could also simply be evidence of behavioral changes after the event, for example, statements from family members or friends describing a change in your person after the event, or a deterioration in your work performance (as shown on annual performance evaluations), or requests for transfers, etc.

If the diagnosis is a psychiatric condition, other than PTSD, for example, Generalized Anxiety Disorder, or Major Depressive Disorder, the same rules apply as in any other claim for service connection. However, this does require at least some evidence that there was an onset of symptoms in service. This may be accomplished by service treatment records documenting treatment in service, but may also be established by a veteran’s own personal statement regarding the events in service and onset of symptoms.

Nexus

The nexus requirement, confirming that the in-service event is related to your current diagnosed condition, is typically accomplished for most veterans by the VA C&P exam process. During the VA examination, the examiner will be confirming the diagnosis, as well as documenting the history of the symptoms, as well as the current severity of the symptoms. Following, the examiner will then be asked by VA whether it is “at least as likely as not” that the current diagnosed condition is related to the veteran’s in-service event(s). The examiner’s answer to this question typically forms the basis for VA’s ultimate decision.

There are some instances where a nexus may be presumed, such as if there was a diagnosis of PTSD while on active duty service and the veteran continues to have a diagnosis of PTSD post-service. It is usually best to file a claim for service connection either through the Benefits Delivery at Discharge program, or within one year following discharge from active duty to preserve not only the earliest effective date, but also because it is generally easier for VA to presume the nexus requirement for chronic conditions if the claim is received closely in time to the veteran’s discharge.

Once VA determines that service connection for a psychiatric condition (PTSD or other) is warranted, it will then rate the condition based on VA’s Schedule for Rating Disability. To learn more about how VA rates psychiatric disabilities, read our next blog post here.

Do you have a claim that you need help with, or have you recently been denied service connection for a psychiatric condition? Reach out us for a free case evaluation.