Overview
A claim for compensation for post-traumatic stress disorder (PTSD) has some unique requirements. PTSD is not presumed to be related to service. Therefore, more than a diagnosis is required to obtain benefits. The diagnosis of PTSD must be based upon one or more specific stressful events in service (commonly referred to as a "stressor"), and there must be corroborating evidence that the stressful event occurred. If the stressor were an event that occurred in combat, then the veteran need only prove that he or she participated in combat. If the stressor were not combat related, then more specific proof of the stressful event is required. However, the evidence does not have to be eye-witness proof of the event. For example, evidence of a substantial change in the behavior of the veteran shortly after the stressor occurred can be used to substantiate the claim.
Statutory Law
There is no specific law creating benefits for PTSD. However, one statutory provision that is often relevant to PTSD claims is 38 U.S.C. § 1154 [available here]. That statute provides, in essence, that a veteran who engaged in combat does not need evidence that a specific injury or disease was incurred in combat to support a claim for benefits.
There have been recent legislative proposals to make this provision more generous to claimants. Recent legislative hearings include:
- H. Hrg. 111-13 — Legislative Hearing on H.R. 952, the "Compensation Owed for Mental Health Based on Activities in Theater Post-Traumatic Stress Disorder Act," Apr. 23, 2009 [link to House page for hearing] [download .pdf]
- H. Hrg. 111-9 — The Nexus Between Engaged in Combat with the Enemy and PTSD in an Era of Changing Warfare Tactics, Mar. 24, 2009 [link to House page for hearing] [download .pdf]
- S. Hrg. 110-638 — Review of Veterans' Disability Compensation: Expert Work on PTSD and Other Issues, Feb. 27, 2008 [download .pdf]
Regulations
VA has a number of regulations relevant to PTSD claims:
- 38 C.F.R. § 3.304(f) sets forth the specific requirements for granting benefits for PTSD, including special provisions for stressors related to (1) combat, (2) prisoner of war status, and (3) in service personal assault [available here]
- 38 C.F.R. § 4.125(a) requires a diagnosis that conforms to the requirements of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) [available here]
- 38 C.F.R. § 4.129 is a special provision relating to veterans who were released from service because of a mental disorder that manifested after a highly stressful event in service [available here]
- 38 C.F.R. § 4.130 defines how much compensation will be paid for any mental condition, including PTSD, based upon the symptoms the veteran experiences [available here]
Federal Register Notices
When VA proposes or finalizes a regulation relating to PTSD or when it withdraws such a proposed regulation, it publishes a public notice in the Federal Register (which all government agencies use to announce proposed and final rule changes).
- Recent Rule Change:
- Stressor Determinations for Posttraumatic Stress Disorder, 75 Fed. Reg. 39843 (Jul. 13, 2010) [download .pdf]
Selected Cases
A few cases relating to PTSD claims are:
- Federal Circuit:
- Nat'l Org. of Vet. Advocs. v. Sec'y Veterans Affairs, 330 F.3d 1345 (Fed. Cir. 2003) (upholding the validity of 38 C.F.R. § 3.304(f))
- CAVC:
- Clemons v. Shinseki, 23 Vet. App. 1 (2009) (discussing the relationship between PTSD and other mental disorder claims) [download .pdf]
- Gallegos v. Peake, 22 Vet. App. 329 (2008) (discussing special notice provisions relating to PTSD claims based upon an in-service personal assault) [download .pdf]
- Sizemore v. Principi, 18 Vet. App. 264 (2004) (comprehensively setting forth the elements of a claim for compensation for PTSD) [download .pdf]
- Pentecost v. Principi, 16 Vet. App. 124 (2002) (discussing what constitutes combat) [download .pdf]
- Suazzi v. Brown, 10 Vet. App. 307 (1997) (stating that a stressor need not be corroborated in every detail)
- Cohen v. Brown, 10 Vet. App. 128 (1997) (discussing the differences between the DSM-III and the DSM-IV as they relate to a PTSD claim)
Law Review Articles
- Jennifer C. Schingle, A Disparate Impact on Female Veterans: The Unintended Consequences of Veterans Regulations Governing the Burdens of Proof for Post-Traumatic Stress Disorder Due to Combat and Military Sexual Trauma, 16 Wm. & Mary J. Women & L. 155 (2009)
- Kristi A. Estrada, Note, Welcome Home: Our Nation's Shameful History of Caring for Combat Veterans and How Expanding Presumptions For Service Connection Can Help, 26 T.M. Cooley L. Rev. 113 (2009) [download Word copy here]
- Shera Finn, Thomas Jones, & Barbara C. Morton, VA's Duty to Assist in the Context of PTSD Stressor Verification: What Must VA Do to Fulfill the Veterans Claims Assistance Act of 2000?, 1 Veterans L. Rev. 50 (2009) [available here]
- Scott Simonson, Note, Back from War — A Battle for Benefits: Reforming VA's Disability Rating System for Veterans with Post-Traumatic Stress Disorder, 50 Ariz. L. Rev. 1177 (2008)
Books
- Barry R. Schaller, Veterans on Trial: The Coming Court Battles over PTSD (2012)