PTSD requires several criteria for a diagnosis. According to DSM-5 Criteria for PTSD, and as cited by the VA, the following are required:
- Direct exposure
- Witnessing the trauma
- Learning that a relative or close friend was exposed to a trauma
- Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)
- Intrusive thoughts
- Emotional distress after exposure to traumatic reminders
- Physical reactivity after exposure to traumatic reminders
- Trauma-related thoughts or feelings
- Trauma-related reminders
- Inability to recall key features of the trauma
- Overly negative thoughts and assumptions about oneself or the world
- Exaggerated blame of self or others for causing the trauma
- Negative affect
- Decreased interest in activities
- Feeling isolated
- Difficulty experiencing positive affect
- Irritability or aggression
- Risky or destructive behavior
- Heightened startle reaction
- Difficulty concentrating
- Difficulty sleeping
Even after a diagnosis of PTSD, the VA often does not assess the disability to its full effect. In order to determine the rating schedule for PTSD, after it is diagnosed, the following is assessed:
- 100% rating:
- Completely unable to function socially or at work with symptoms such as severely inappropriate behavior, ongoing hallucinations or delusions, consistent threat of harming self or others, unable to remember basic information such as names of close relatives, severe confusion and disorientation, and/or inability to care for self.
- 70% rating:
- Unable to function in most social and work areas with symptoms such as obsessive behaviors, illogical speech, depression and panic so persistent that it interferes with ability to function, suicidal thinking, inability to control impulses (including becoming violent without provocation), neglecting self-care such as hygiene, inability to handle stress, and/or inability to maintain relationships.
- 50% rating:
- Some impairment in ability to function socially and at work with lack of reliability and productivity, due to symptoms such as trouble understanding, memory loss (forgetting to do things), poor judgment, mood disturbances, trouble with work and social relationships, and/or having one or more panic attacks weekly.
- 30% rating:
- Some trouble functioning socially and at work, occasionally inefficient with work or unable to perform work tasks, but generally able to care of self and speak normally. Symptoms can include depression, anxiety, chronic difficulty sleeping, mild memory loss, suspiciousness, and panic attacks (can be less than once a week).
- 10% rating:
- Mild symptoms creating work and social impairment when under significant stress, or mild symptoms managed successfully with continuous medication.
- 0% rating:
- Diagnosis of mental illness but symptoms are so mild that they don’t require continuous medication, or, don’t interfere with social and work functioning.
Far too often, I represent veterans who need a medical opinion or supporting statements that are not in the file. Other times, a failure on behalf of the VA needs to be pointed out and addressed. Do not risk losing your case due to substandard representation.
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