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This section will describe the mechanics of filing a claim for disability compensation and related benefits for PTSD. However, please note that the VA recommends that veterans ask for help in filing their claim. The next section of this article explains how veterans can obtain free assistance from state veterans affairs agencies or nonprofit veterans service organizations.
This section will describe the mechanics of filing a claim for disability compensation and related benefits for PTSD. However, please note that the VA recommends that veterans ask for help in filing their claim. The next section of this article explains how veterans can obtain free assistance from state veterans affairs agencies or nonprofit veterans service organizations.


To begin the disability claim process, a veteran must submit an application to the [[Veterans Benefits Administration]] (VBA), an organizational element of the VA. The VBA, based on their review of medical and psychological evidence, must conclude that the veteran indeed suffers from [[Veterans benefits for post-traumatic stress disorder in the United States #Service-Connection|service-connected]] PTSD. Reaching such a determination usually requires that the veteran receive a Compensation and Pension examination (C&P exam),<ref>{{cite web|title=The PTSD Compensation and Pension Examination|url=http://www.nap.edu/openbook.php?record_id=11870&page=85|work=Institute of Medicine|publisher=National Academies Press|accessdate=20 October 2012}}</ref> which is a mental health evaluation conducted by a psychologist or psychiatrist at a local VA medical facility, or by a private vendor working under contract with the VA.
To begin the disability claim process, a veteran must submit an application to the [[Veterans Benefits Administration]] (VBA), an organizational element of the VA. The VBA, based on their review of medical and psychological evidence, must conclude that the veteran indeed suffers from [[Veterans benefits for post-traumatic stress disorder in the United States #Service-Connection|service-connected]] PTSD. Reaching such a determination usually requires that the veteran receive a Compensation and Pension examination (C&P exam),<ref>{{cite web|title=The PTSD Compensation and Pension Examination|url=http://www.nap.edu/openbook.php?record_id=11870&page=85|work=Institute of Medicine|publisher=National Academies Press|accessdate=20 October 2012}}</ref> which is a mental health evaluation conducted by a psychologist or psychiatrist at a local VA medical facility, or by a private vendor working under contract with the VA.<ref>{{cite journal|last=Worthen|first=Mark|coauthors=Moering, Robert|title=A practical guide to conducting VA compensation and pension exams for PTSD and other mental disorders|journal=Psychological Injury and Law|year=2011|month=December|volume=4|issue=3-4|pages=187-216|doi=10.1007/s12207-011-9115-2|url=http://www.academia.edu/2446321/A_practical_guide_to_conducting_VA_compensation_and_pension_exams_for_PTSD_and_other_mental_disorders|accessdate=19 May 2013}}</ref>


A veteran can apply for compensation benefits by filling out [http://www.va.gov/VAFORMS/form_detail.asp?FormNo=21-526 VA Form 21-526], ''Veterans Application for Compensation and/or Pension'', although when you review the form and the accompanying instructions, it will probably become clear why assistance from specially trained Veterans Service Officers is recommended.
A veteran can apply for compensation benefits by filling out [http://www.va.gov/VAFORMS/form_detail.asp?FormNo=21-526 VA Form 21-526], ''Veterans Application for Compensation and/or Pension'', although when you review the form and the accompanying instructions, it will probably become clear why assistance from specially trained Veterans Service Officers is recommended.

Revision as of 09:24, 19 May 2013

The United States provides a wide range of benefits for veterans with Posttraumatic stress disorder (PTSD), which was incurred in, or aggravated by, their military service. The United States Department of Veterans Affairs (VA) will provide benefits[1] to almost all veterans that the VA has determined suffer from PTSD, which developed during, or as a result of, their military service, and which interferes at least to some extent in their ability to work. These benefits not only include tax-free cash payments[2] but can also include free or low-cost mental health treatment and other healthcare;[3] vocational rehabilitation services;[4] employment assistance;[5][6] independent living support;[7] and more.[8]

U.S. Army Medic (click on photo for details)

U.S. Veterans Benefits

Brief history

Since the founding of the country, the United States has sought to compensate the men and women who have served in its armed forces.[9] Initially this compensation was given to all veterans as a gratuity payment, i.e., as a 'thank you' for their service. But in 1917, the U.S. Congress initiated a shift in the rationale for compensation away from a gratuity system and toward an indemnity scheme.[10] Since that year, compensation has been provided to veterans suffering from physical or mental disabilities that were incurred during, or aggravated by, military service, and which have adversely impacted the veteran's ability to work. The amount of compensation provided--both cash payments and VA-sponsored services--are based on the veteran's average impairment in earnings capacity.[10]

VA Disability Benefits Claim Process for PTSD

This section describes how to file an intial claim for disability benefits for PTSD; how and why to ask for assistance with filing a claim; sources for such assistance; and definitions of key terms that one will encounter frequently during the process of seeking VA disability compensation for posttraumatic stress disorder.

Benefits application procedures

This section will describe the mechanics of filing a claim for disability compensation and related benefits for PTSD. However, please note that the VA recommends that veterans ask for help in filing their claim. The next section of this article explains how veterans can obtain free assistance from state veterans affairs agencies or nonprofit veterans service organizations.

To begin the disability claim process, a veteran must submit an application to the Veterans Benefits Administration (VBA), an organizational element of the VA. The VBA, based on their review of medical and psychological evidence, must conclude that the veteran indeed suffers from service-connected PTSD. Reaching such a determination usually requires that the veteran receive a Compensation and Pension examination (C&P exam),[11] which is a mental health evaluation conducted by a psychologist or psychiatrist at a local VA medical facility, or by a private vendor working under contract with the VA.[12]

A veteran can apply for compensation benefits by filling out VA Form 21-526, Veterans Application for Compensation and/or Pension, although when you review the form and the accompanying instructions, it will probably become clear why assistance from specially trained Veterans Service Officers is recommended.

You may also file a disability benefits claim online using the Veterans On-Line Application (VONAPP) System.

Obtaining Assistance with Filing a Disability Compensation Claim

Veterans may receive assistance with filing a VA disability compensation claim from Veterans Service Officers, also known as "VSO Representatives" when they are affiliated with a nonprofit Veterans Service Organization - see below.

Note that the VA recommends that veterans ask a Veterans Service Officer to help them file a disability compensation claim:

VA encourages individuals who are applying for disability compensation to work with an accredited representative ... to assist them.... Being accredited means organizations and individuals must have VA permission to represent Veterans before the Department in their claims for VA benefits. The purpose of this requirement is to ensure that Veterans have qualified and competent representation. These individuals receive specialized training in VA benefits law and procedure.[13]

The next two sections briefly describe the two types of Veterans Service Officers.

County Veterans Service Officers

County Veterans Service Officers are public employees of their State's (or Territory's) veterans affairs agency. They are referred to as County Veterans Service Officers,[14] because a majority of the states have set up local veterans affairs offices in each of the state's counties.[15]

Veterans Service Officers Associated with Nonprofit Veterans Service Organizations

Many not-for-profit Veterans Service Organizations recruit, train, and support their own Veterans Service Officers to help veterans file claims and navigate the claims process. In order to represent a veteran before the VA, the Veterans Service Organization must either have been Chartered by the U.S. Congress or have received official approval from the U.S. Department of Veterans Affairs to represent veterans in the disability compensation claims process.[16]

As noted above, these Veterans Service Officers are sometimes referred to as VSO Representatives.

Selecting a Veterans Service Officer

Veterans may select either type of Veterans Service Officer to help them file their disability compensation claim(s). After the veteran selects his or her Veterans Service Officer, he or she completes VA Form 21-22, APPOINTMENT OF VETERANS SERVICE ORGANIZATION AS CLAIMANT'S REPRESENTATIVE, and submits it to the Veterans Benefits Administration. (Note that for the purposes of Form 21-22, a State or Territory veterans affairs agency is considered to be a "Veterans Service Organization").

After VA Form 21-22 has been received and accepted by the Veterans Benefits Administration, the Veterans Service Officer goes to work helping the veteran file the initial disability compensation claim(s). Subsequent to filing the claim, the Service Officer may also engage in a variety of other, related, activities on behalf of the veteran, for example, calling the Veterans Benefits Administration to inquire about the status of a veteran's claim, or appearing with a veteran when meeting with VBA officials, or helping the veteran understand the Compensation and Pension (C&P) examination process.

The veteran does not pay a Veterans Service Officer for their services. The Service Officers are either state employees, employees of a Veterans Service Organization, or are volunteers for a Veterans Service Organization.

Post-Adjudication Representation

A veteran may ask to be represented by an accredited attorney or claims agent:

  • after the veteran has filed his or her disability compensation claim;
  • the claim has been adjudicated (a decision on the claim has been made by the Veterans Benefits Administration); and
  • the veteran has filed a Notice of Disagreement with the VBA Regional Office handling his or her claim.[17]

Unless they agree to work on a pro bono basis, attorneys and claims agents who represent veterans before the Veterans Benefits Administration, Board of Veterans Appeals, and Court of Appeals for Veterans Claims require payment for their services. In most instances, the veteran and attorney (or claims agent) submit a signed payment agreement with the VA Office of General Counsel, which stipulates that the attorney will receive payment directly from the VA after the veteran's claim has been adjudicated, if the adjudicator awards service-connected disability compensation to the veteran. The amount of the attorney's fee is based on a percentage of the lump sum "back pay" compensation issued to the veteran by the VA.

Accredited Attorneys

Attorneys who wish to represent veterans in proceedings before the agency of original jurisdiction (the Veterans Benefits Administration), the Board of Veterans Appeals, or the Court of Appeals for Veterans Claims, must first receive accredition from the VA General Counsel. The attorney begins the process by submitting an Application for Accreditation as a Claims Agent or Attorney (VA Form 21a).

Claims Agents

Accredited Claims Agents must submit an application to the VA General Counsel, which includes submitting the names and contact information of three character references; pass a written examination; and complete three hours of qualifying continuing legal education (CLE) within 12 months of their initial accreditation. (For details, see the text of federal regulation - 38 C.F.R. 14.629(b)).

Important Definitions

Traumatic Stressor

A traumatic stressor is an event that meets the DSM-IV (or, soon to be DSM-5) diagnostic Criterion A for PTSD.[18] Criterion A reads as follows:

The person has been exposed to a traumatic event in which both of the following have been present:


A1. The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.

A2. The person's response involved intense fear,helplessness, or horror.

Note that Criterion A2 will be removed for DSM-5 and Criterion A1 will be modified (the exact language has not yet been determined).

Dr. Matthew J. Friedman of the National Center on PTSD notes that:

PTSD is unique among psychiatric diagnoses because of the great importance placed upon the etiological agent, the traumatic stressor. In fact, one cannot make a PTSD diagnosis unless the patient has actually met the "stressor criterion," which means that he or she has been exposed to an historical event that is considered traumatic.[19]

Service-Connection

The term, service-connected, means that a veteran has a disease or injury that is "connected" to his or her military service, i.e., the disease or injury was incurred in or aggravated by their military service.[20]

The official definition in the Code of Federal Regulations[21] begins:

Service connection connotes many factors but basically it means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein.[22]

The relationship between service connection and access to VA healthcare is emphasized in this definition:

"'Service connected' veterans are those with documented, compensative conditions related to or aggravated by military service, and they receive priority for enrollment into the Veterans Affairs (VA) health care system."[23]

Types of Service-Connection

There are four types of service connection: direct, secondary, aggravated, and presumptive.[24] The present article is primarily concerned with direct service connection, since that is by far the most common type for soldiers, sailors, marines, airmen, or coast guardsmen suffering from PTSD.

Examples of Direct Service-Connection for PTSD

As noted, the vast majority of veterans with PTSD have a direct service-connection, i.e., they developed PTSD as a direct result of a traumatic stressor (or stressors) they endured during their military service. Traumatic stressors can be:

  • Combat-related (the most common kind), e.g., seeing a comrade's vehicle getting blown up by an IED blast, pulling him from the burning wreckage and carrying him to a helicopter, praying he will make it, only to learn a few hours later that he died en route to the field hospital.
  • A personal assault.
    • Such as a physical assault, e.g., as a result of domestic violence or being mugged.
    • Military sexual trauma (MST), which need not be perpetrated by another service member, e.g., if service member is sexually assaulted by a neighbor, who is a civilian, the incident still constitutes MST.
  • An accident while performing military duties, e.g., during training exercises or maneuvers.
  • An accident that occurs while not performing military duties, e.g., a motor vehicle accident that occurs while a service member is travelling to visit family.

These are the most common situations involving traumatic stressors that can lead to direct service connection for PTSD, but it is not an exhaustive list.

Also, note that a service member is still considered to be enrolled in military service even if he or she is not performing specific military duties at the time they are injured (e.g., if they are injured at their home on their day off, that injury, if it results in a permanent disability, would in most instances be considered service-connected).

Types of Military Service

The regulations describe three categories of military service, active duty, active duty for training, and inactive duty training. These categories and their very specific definitions would be particularly relevant to a veteran who, for example, experienced a traumatic stressor that led to PTSD during a period of training for the Reserves or National Guard.[25]

And there are some types of military service which are defined as falling under one of the three categories that might not occur to many people, such as the fact that the definition of active duty military service includes "service at any time as a cadet at the United States Military, Air Force, or Coast Guard Academy, or as a midshipman at the United States Naval Academy." - 38 CFR § 3.6(b)(4).[25] Thus, a midshipman who was sexually assaulted and developed PTSD would, when he or she left the Navy, qualify for VA benefits.

And there are other specifications in this set of regulations (38 CFR § 3.6) that one would never anticipate, such as the fact that the definition of active duty for training includes National Guard soldiers who participated in the reenactment of the Battle of First Manassas in July 1961. - 38 CFR § 3.6(c)(3)[25]

In Line of Duty and Exceptions

"In line of duty means an injury or disease incurred or aggravated during a period of active military, naval, or air service unless such injury or disease was the result of the veteran’s own willful misconduct or ... was a result of his or her abuse of alcohol or drugs." - 38 CFR § 3.1(m)[26] The most important point here is that there are exceptions to the general rule that injuries or diseases incurred in, or aggravated by, military service are eligible for disability compensation benefits. Veterans who have questions about eligibility for VA benefits because of willful misconduct, alcohol or other drug abuse, or discharge status (see the next section), or other factors (see the regulation referenced above), can consult with a Veterans Service Officer in their area[27] and/or contact the VBA Regional Office closest to their home for assistance.

Discharge Status

In order to be eligible for VA benefits, a veteran must have been discharged under other than dishonorable conditions.[28] Stated differently, if a veteran received a Bad Conduct Discharge or a Dishonorable Discharge they will, under most circumstances, not be eligible for VA benefits.[29]

See also

References

  1. ^ "Federal Benefits for Veterans, Dependents and Survivors". Department of Veterans Affairs. Retrieved 30 November 2012. The best single source for learning about the wide range of veterans benefits. Note that the web page has versions of the book in HTML & PDF and for tablets and smartphones.
  2. ^ "VA Compensation Rate Table". Department of Veterans Affairs. Retrieved 20 October 2012.
  3. ^ "Access VA Health Benefits". Department of Veterans Affairs. Retrieved 20 October 2012.
  4. ^ "VA Vocational Rehabilitation". Department of Veterans Affairs. Retrieved 20 October 2012.
  5. ^ "Vet Success". Department of Veterans Affairs + State Government Veterans Agencies. Retrieved 20 October 2012.
  6. ^ "Vet Success Explanation" (PDF). Title 38, Code of Federal Regulations, Chapter 31. County of Kings, California. Retrieved 20 October 2012.
  7. ^ "Independent Living Support for Veterans". Department of Veterans Affairs. Retrieved 20 October 2012.
  8. ^ "Veterans Benefits". Veterans Benefits Administration. Retrieved 30 November 2012.
  9. ^ Ridgway, J. (2011). "The splendid isolation revisited: Lessons from the history of veterans benefits before judicial review". Veterans Law Review. 3: 135–219.
  10. ^ a b Economic Systems Inc (2004). VA disability compensation program: Legislative history. Washington, DC: VA Office of Policy, Planning and, Preparedness.
  11. ^ "The PTSD Compensation and Pension Examination". Institute of Medicine. National Academies Press. Retrieved 20 October 2012.
  12. ^ Worthen, Mark (2011). "A practical guide to conducting VA compensation and pension exams for PTSD and other mental disorders". Psychological Injury and Law. 4 (3–4): 187–216. doi:10.1007/s12207-011-9115-2. Retrieved 19 May 2013. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  13. ^ "Working With an Accredited Representative". U.S. Department of Veterans Affairs. Retrieved 30 April 2013. There are numerous ways to apply for VA disability benefits depending on the type of benefit you are seeking...
  14. ^ "About NACVSO". National Association of County Veterans Service Officers. Retrieved 30 April 2013. The National Association of County Veterans Service Officers is an organization made up of local government employees. Our members are tasked with assisting veterans in developing and processing their claims. Between 75 and 90% of the claims presented to the Veterans Administration each year originate in a county veterans office.
  15. ^ "Find Your County Veterans Service Officer". National Association of County Veterans Service Officers. Retrieved 30 April 2013.
  16. ^ "VETERANS AND MILITARY SERVICE ORGANIZATIONS, 2012/2013 Directory" (PDF). Department of Veterans Affairs. p. 1-1 to 1-38. Retrieved 30 April 2013. Listing of Congressionally chartered and other Veterans Service Organizations recognized by the Secretary for the purpose of preparation, presentation, and prosecution of claims under laws administered by the Department of Veterans Affairs, as provided in Section 5902 (formerly Section 3402) of Title 38, United States Code (U.S.C.) and Sub Section 14.628 (a) and (c) f 38 C.F.R.
  17. ^ "38 C.F.R. 14.636 - Payment of fees for representation by agents and attorneys in proceedings before Agencies of Original Jurisdiction and before the Board of Veterans' Appeals". Code of Federal Regulations. United States Government Printing Office (GPO). Retrieved 30 April 2013.
  18. ^ "DSM-IV Diagnostic Criteria for PTSD". National Center on PTSD. Retrieved 30 November 2012.
  19. ^ Friedman, MD, PhD, Matthew J. "PTSD History and Overview". National Center on PTSD. Retrieved 30 November 2012.{{cite web}}: CS1 maint: multiple names: authors list (link)
  20. ^ http://www.va.gov/opa/publications/benefits_book/benefits_chap02.asp
  21. ^ 38 CFR §3.303(a)
  22. ^ Full text of 38 CFR §3.303(a)
  23. ^ Murdoch, Maureen (2003). "Racial disparities in VA service connection for posttraumatic stress disorder disability". Medical Care. 41 (4): 536–49. doi:10.1097/01.MLR.0000053232.67079.A5. PMID 12665717. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  24. ^ "Service Connection Explained". Nor-Cal Mobility, Inc. Retrieved 30 November 2012.
  25. ^ a b c "Code of Federal Regulations (CFR), Title 38, Chapter I, Part 3, Subpart A, Subjgrp-General(Part 3), Section 3.6 - Duty periods" (PDF). U.S. Government Printing Office, Code of Federal Regulations (CFR). Retrieved 30 November 2012.
  26. ^ "Code of Federal Regulations, Title 38, Chapter I, Part 3, Subpart A, Subjgrp-General(Part 3), Section 3.1 - Definitions - (m) In line of duty" (PDF). U.S. Government Printing Office, Code of Federal Regulations (CFR). Retrieved 30 November 2012.
  27. ^ "State/Territory Veterans Affairs Offices". Department of Veterans Affairs. Retrieved 30 April 2013. Select a state or territory below to visit the Web site for that location's Department of Veterans Affairs office.
  28. ^ "Disability Compensation: Eligibility". Department of Veterans Affairs. Retrieved 30 November 2012.
  29. ^ Moering, Robert. "Military service records: Searching for the truth". Psychological Injury and Law. 4 (3–4): 217–234. doi:10.1007/s12207-011-9114-3.

External links

U.S. Department of Veterans Affairs Benefits Information

  • Federal Benefits for Veterans, Dependents, & Survivors - The best and most comprehensive description of all veterans benefits. Available as a printable document (PDF) or download it to your tablet or smartphone.
  • Apply for Benefits Online - Not the most user-friendly online application process in the world, but it won't be a problem for younger vets and others with a fair amount of Internet savvy.
  • VA Benefits in Brief - Quick overview of all veterans benefits (PDF document).
  • Compensation and Pension Service - links to all the various C&P programs.
  • VA Healthcare Benefits Overview - A well-written and well-organized PDF booklet. You receive the most comprehensive information if you also download the Veterans Health Benefits Guide (the link immediately below).
  • Veterans Health Benefits Guide - Also an easy-to-read PDF booklet - download it with the VA Healthcare Benefits Overview (the link immediately above) for the most comprehensive info.
  • Online VA Healthcare Eligibility Check - Easy way to begin the process of finding out what healthcare benefits you are eligible to receive, although you will probably need to wait a day or two to receive a definitive answer from the VA.

Other Veterans Benefits Resources

PTSD Treatment Resources for Veterans

Further reading

  • Durboraw, Al (2010). Combat veterans rights : to the Department of Veterans Affairs, benefits, medical services, compensation, appeals, etc. Pittsburgh, PA: Dorrance Publishing Co. ISBN 978-1-4349-0409-6. Written by a WWII Marine wounded in the Battle of Tarawa, this book contains tables describing provisions for veterans in U.S. Law.
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