2014 marked the centenary of the beginning of World War I. This year, in many parts of the world, commemorative events will be held, marking the 100th anniversary of the start of what was referred to at the time as the Great War. In the history of psychiatry, the First World War is often identified with the first time in history that military Post-Traumatic Stress Disorder was officially recognized, then known as “shellshock.”  “Shellshock” would undergo a long metamorphosis to emerge in 1980 as “PTSD”.
The VA process for service connection for PTSD has travelled a long and often uncertain road. Let’s take a look at how you should present your case to the VA.
First, when you file your claim with the VA submit all the evidence that you have in an effort to establish service connection at the outset. If you are a Vietnam veteran, your DD-214 will most likely list your tour(s) on its face. If you received a CIB, Combat Action Ribbon, Purple Heart, or decoration for Valor (Bronze Star w/V, Silver Star, etc.), make sure these are reported in the VA claims file.. The same principles apply to veterans of Desert Storm or the Iraqi /Afghanistan War on Terrorism.
In the initial application for PTSD, you will be asked to describe the stressors that caused your PTSD symptoms. Be as specific as you can in describing the stressors. For example, “My good friend, Joe, was running point during a night combat patrol. He stepped on a VC mine and his legs were blown off. He died in my arms.” Include with your claim any medical records from the VA or civilian sources that support a diagnosis of PTSD and the symptoms that you may suffer from the disability.
Let’s assume that you are successful and receive a rating decision that awards service connection for PTSD and assigns a rating of 10 % disabling, but you feel the rating is too low and want to appeal. Your first step is to file a Notice of Disagreement (NOD) using VA Form 21-0958 within one year of the rating decision.
Once the NOD is filed, you will most likely receive a VCAA (Veterans Claims Assistance Act) letter and be asked to provide any additional information that may pertain to your claim. The VCAA response will be your opportunity to disclose to the VA all treating sources and, if no examination was conducted on the original claim, you may request a VA C & P exam to assess the severity of your PTSD.
At some point, you will receive an election for a decision review officer (DRO) hearing or traditional appeal process (TAP) hearing with a Veterans’ Law Judge with the Board of Veterans’ Appeals. In either event, you will need to garner evidence to support your appeal for an increased rating. Let’s assume you think a 30% rating would be fair. The mental disorder ratings are governed by the General Rating Formula for Mental Disorders which prescribe a 30% rating; however, since the listed symptoms are only examples, a higher rating cannot be denied simply due to the lack of one or more listed symptoms. At this point, it is suggested that you consider an independent mental evaluation with a private mental health specialist. Although you will have to pay for the examination, it may prove to be a good investment!
For further information on filing for VA disability or appealing your ruling, give Bluestein Attorneys a call at (803) 779-7599 or click the banner below to schedule your free consultation.
*This article appeared in the April 4, 2014 issue of the Columbia Star weekly newspaper.
 Psychiatric Times, The World War and the Legacy of Shellshock, 2-26-2014