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Understanding the VA's Decision on PTSD Claims

July 11, 2023

Post-traumatic stress disorder (PTSD) is a mental health condition that can significantly impact the lives of those who have experienced traumatic events. Veterans who develop PTSD due to military service may be eligible for disability benefits through the Department of Veterans Affairs (VA). However, filing and receiving a PTSD claim can be complex and challenging. To successfully obtain benefits, veterans must provide medical evidence that establishes a service connection between their PTSD and their time in the military. 

This often involves gathering medical records, disability ratings, and other supporting documentation. The VA's claims process includes several stages, like initial decisions, appeals, and possibly filing a notice of disagreement. Many veterans seek the assistance of experienced attorneys or veterans service organizations to navigate the complicated claims process and ensure they have sufficient evidence to support their disability claims.

The Denial Process of a VA-Denied PTSD Claim

If the VA has denied your PTSD claim, it's important to understand the denial process and the steps you can take to appeal the decision. The first step is to carefully review the rating decision and identify the reasons for the denial. This will help you understand the areas that must be addressed in your appeal.

Once you have identified the reasons for denial, it is crucial to develop additional evidence to support your claim. This could include obtaining medical records or seeking opinions from medical professionals familiar with PTSD. Providing credible evidence is essential in strengthening your case and proving the service connection.

To begin the appeal process, file a Notice of Disagreement (NOD) with the VA's regional office that denied your claim. It is important to provide a detailed explanation of why you believe the denial was incorrect and include any new evidence.

During the appeal, your claim will be reviewed by a Rating Veterans Service Representative (RVSR), who will reevaluate all the evidence and make a determination. If your claim remains denied, you can further appeal to the Board of Veterans' Appeals (BVA) or seek the assistance of an experienced attorney.

Navigating the denial process can be overwhelming, but it is crucial to persist in pursuing the benefits you deserve. With the right evidence, documentation, and knowledge of the process, you can increase your chances of overturning the denial and obtaining the disability benefits you are entitled to.

Reasons for Denial of a PTSD Claim

When the VA denies a PTSD claim, it is crucial to understand the reasons behind the denial. By understanding the specific areas that need to be addressed, claimants can better prepare for the appeals process. In this article, we will discuss some common reasons for the denial of a PTSD claim and provide insight into the steps that can be taken to address and overcome these challenges.

Inadequate Medical Evidence

In filing a PTSD claim with the Veterans Affairs (VA), one of the critical factors for success is providing sufficient medical evidence to support the claim. Inadequate medical evidence can lead to a denial of benefits, emphasizing the importance of building a strong case with credible supporting documentation.

To strengthen a PTSD claim, various types of medical evidence can be included. Psychiatric evaluations play a vital role in providing a professional assessment of the individual's mental health condition. These evaluations should be conducted by qualified psychiatrists or psychologists specializing in PTSD.

In addition to psychiatric evaluations, medical records are crucial in demonstrating the existence and severity of the condition. These records should show a clear history of the individual's symptoms, diagnosis, and treatment received for PTSD. They serve as concrete proof of the claimant's medical condition and provide a chronological account of their journey.

Statements from medical professionals who have treated the claimant can significantly bolster a PTSD claim. These statements should include details such as the professional's diagnosis, their opinion on the disability rating, and the resulting impact on the claimant's ability to function in daily life.

When compiling medical evidence for a PTSD claim, it is important to include specific documents or information, such as the claimant's military personnel records, which can establish a service connection and demonstrate the connection between military service and the development of PTSD. Including records of any service-related stressor events or injuries is also crucial.

Lack of Service Connection or Proof of Service Connection

When filing a PTSD claim with the VA, establishing a service connection is crucial for veterans seeking disability benefits. Proof of service connection helps to demonstrate that the PTSD condition was caused or aggravated by military service.

For veterans with PTSD, proving service connection can be challenging, particularly in cases of military sexual trauma (MST). Unlike physical injuries, MST often lacks direct documentation or witnesses, making it harder to establish a clear link between the condition and military service.

In such cases, veterans may face denials due to insufficient evidence. However, veterans can appeal the denial based on the lack of documentation. This is where an experienced VA disability appeals attorney can be invaluable.

An experienced attorney understands the appeals process and can help veterans in finding indirect pattern evidence that supports the claim. This may include gathering testimonies from fellow service members or seeking records of any professional counseling sought after the MST incident.

While proving service connection in PTSD claims can be challenging, it is not impossible. With the help of an experienced attorney and the inclusion of any available supporting evidence, veterans can increase their chances of success in obtaining the disability benefits they deserve.

Not Meeting the Criteria for Disability Rating Level

To receive disability benefits for PTSD claims, veterans must meet specific criteria for disability rating levels. These rating levels are determined based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria and the VA's rating schedule.

The DSM-5 outlines the criteria for diagnosing PTSD and categorizes the disorder into different levels of severity. The VA's rating schedule then assigns disability rating levels to reflect the condition's impact on a veteran's daily functioning. These rating levels range from 0% to 100%, with 0% indicating no disability and 100% indicating total disability.

Medical providers play a crucial role in evaluating the level of disability a veteran has. They must carefully assess the veteran's symptoms, functional impairment, and response to treatment to determine the appropriate disability rating level. It is essential for medical providers to accurately document these findings to support the veteran's claim.

When applying for disability benefits, it is important for veterans to provide relevant evidence to support their claimed disability rating level. This may include medical documentation, bills for medical services related to PTSD treatment, and records from any treatment received during active duty. Such evidence helps the VA evaluate the severity of the condition and make a fair determination regarding disability benefits.

Filing an Appeal After a VA Denied PTSD Claim

Facing a denial of a PTSD claim can be disheartening and frustrating for veterans who believe they deserve disability benefits. However, it is important to remember that the claims process does not end with a denial. Veterans can appeal the decision and provide additional evidence to support their case. Filing an appeal after a VA denied PTSD claim allows veterans to present their case to a higher level of review, increasing their chances of receiving the benefits they deserve. 

This appeals process can be complex and time-consuming, so it is crucial for veterans to be prepared and seek assistance from experienced professionals, such as disability attorneys or veterans service organizations. By providing credible evidence and building a strong case, veterans can give themselves the best possible chance of a successful appeal and obtaining the disability compensation they are entitled to.

Filing a Notice of Disagreement (NOD)

Filing a Notice of Disagreement (NOD) after a VA denied PTSD claim is an important step in the appeal process for veterans seeking disability benefits. If your claim has been denied, it is crucial to understand the process and timeframes involved in filing an NOD.

The NOD should be submitted within one year of receiving the denial letter from the VA. This is an essential deadline to meet to preserve your appeal rights. It is important to provide limited information in the NOD to avoid leaving out crucial details that may help support your case.

Seeking assistance from an experienced attorney can greatly benefit veterans during the filing process. An attorney can help ensure that all necessary information is included in the NOD, increasing the chances of a successful appeal. They can also provide guidance on the appropriate medical evidence and documentation needed to strengthen your claim. Additionally, an attorney can navigate the complex appeal process on your behalf, taking the stress off your shoulders.

Preparing Your Case with Additional Evidence

Regarding a denied PTSD claim, gathering and submitting additional evidence can greatly strengthen your case and increase the chances of a successful appeal. One crucial step in this process is obtaining personnel statements. These statements provide insights into the specific incidents or events that contributed to your condition and can be obtained from fellow service members who witnessed these incidents firsthand.

In addition to personnel statements, buddy statements are another powerful form of evidence. These statements are provided by friends or colleagues who can attest to the changes they have observed in your behavior or mental state since the traumatic event. Family and friends' statements can also be valuable, as they can shed light on the impact your PTSD has had on your day-to-day life.

Collecting and submitting relevant medical records is another critical aspect of strengthening your case. These records, such as diagnosis reports and treatment notes, should clearly demonstrate the severity of your condition and its impact on your ability to function. Be sure to include any records highlighting the ongoing nature of your symptoms and the treatment you have received.

When gathering additional evidence, it is important to organize and present it in a clear and concise manner. Consider seeking guidance from a medical professional or an experienced attorney who can help you compile the necessary documents and present them effectively.

By gathering and submitting additional evidence, such as personal statements, buddy statements, family and friends statements, and comprehensive medical records, you can bolster the strength of your PTSD claim. Remember, the more credible and detailed evidence you provide, the better your chances of receiving the disability benefits you deserve.

Submitting an Appeal to the Board of Veterans' Appeals (BVA)

When facing a denied PTSD claim, submitting an appeal to the Board of Veterans' Appeals (BVA) can provide the opportunity to present additional evidence and strengthen your case. The appeal process involves several necessary steps and procedures.

First, you must file a Notice of Disagreement (NOD) with the regional office that made the initial decision on your claim. This informs them of your intent to appeal. The regional office will then review your claim and issue a Statement of the Case (SOC), explaining their reasons for the denial.

Once you receive the SOC, you have 60 days to file a VA Form 9, formally requesting a BVA hearing. You can have a hearing before a Veterans Law Judge, where you can present your case and any additional evidence. It is crucial to gather as much relevant evidence as possible to support your appeal.

Additional evidence can include medical records, personnel and buddy statements, and any other documented proof of your PTSD and its impact on your daily life. This evidence not only strengthens your appeal but also helps establish a clear connection between your service and your current disability.

Seeking legal representation can greatly increase your chances of a successful appeal. Experienced attorneys who specialize in veterans' disability claims understand the complex appeals process and can guide you in gathering the necessary evidence and presenting your case effectively to the BVA.

Seek Assistance With Your Appeal Process

If you have received a denial for your VA PTSD claim, it is vital to seek assistance with the appeal process. Hiring an experienced PTSD appeal attorney can greatly increase your chances of success.

An attorney specializing in VA disability claims knows the intricacies of the appeals process and can guide you through each step. They will ensure you properly submit your claim and meet all necessary deadlines.

One of the attorney's key roles is to gather compelling evidence to support your claim. They will work closely with you to obtain the medical records, personnel statements, and other relevant documentation needed to strengthen your case.

By presenting this compelling evidence, your attorney will establish a clear connection between your service and your current disability. This connection is crucial in winning your appeal and securing the service-connected benefits you deserve.

Remember, the appeal process for a denied PTSD claim can be complex and daunting. Seeking professional assistance from a PTSD appeal attorney will provide you with the expertise and support you need to navigate this challenging process successfully.

Disability Ratings and Benefits Available to Disabled Veterans

The Department of Veterans Affairs (VA) uses a disability ratings system to determine the severity of service-connected disabilities and provide benefits to eligible veterans. This system aims to compensate disabled veterans for the impact that their disabilities have on their daily lives.

The disability rating is determined based on how much the service-connected disability impairs the veteran's ability to work and perform other activities. Ratings range from 0% to 100%, with higher ratings indicating more severe disabilities. For example, a 30% rating indicates a moderate disability, while a 70% rating indicates a more severe disability.

Eligible disabled veterans receive a range of benefits based on their disability rating. These benefits include disability compensation, which provides financial assistance for the disabled, and access to healthcare through the VA healthcare system. Disabled veterans may also be eligible for vocational rehabilitation services to help them re-enter the workforce and housing assistance programs to ensure stable housing.

Understanding the disability ratings system and the benefits available to disabled veterans is crucial for navigating the VA claims process. By seeking assistance from experienced professionals and understanding the intricacies of the system; disabled veterans can secure the benefits to which they are entitled and receive the support they need to live fulfilling lives.

Gathering Medical Evidence in Support of Your Claim

When filing a disability claim for post-traumatic stress disorder (PTSD) with the Department of Veterans Affairs (VA), gathering strong medical evidence is crucial to support your claim and increase the chances of a favorable outcome. Proper documentation is vital in showing the severity of your condition and how it is connected to your military service. By providing comprehensive and persuasive medical evidence, you can demonstrate the impact of PTSD on your daily life, workability, and overall well-being. This article will guide you through gathering medical evidence, ensuring you have a strong case when submitting your PTSD claim to the VA.

Obtaining Records from Medical Professionals 

When filing a VA claim for mental health conditions like PTSD, obtaining records from medical professionals is crucial. Here are the steps to help you navigate this process:

1. Seek professional help: The first step is to consult medical professionals specializing in treating mental health conditions. These can include psychiatrists, psychologists, and therapists.

2. Document symptoms: Make sure to fully document your symptoms and experiences related to PTSD. This includes any specific incidents or triggers during your military service.

3. Obtain a proper diagnosis: It is important to receive a proper diagnosis of PTSD from a qualified medical professional. This diagnosis will serve as substantial evidence to support your claim.

4. Contact treating doctors: Reach out to the doctors who have treated your specific symptoms related to PTSD. Request copies of their medical records and treatment notes. This documentation will bolster your VA claim by providing solid evidence of your mental health condition.

5. Include all relevant records: Submit all medical records and supporting documents from the treating doctors, including test results, therapy notes, and evaluations. The more comprehensive your documentation, the stronger your case will be.

By following these steps and obtaining records from medical professionals, you can strengthen your VA claim for mental health conditions like PTSD. Remember, the more evidence you have to support your claim, the better your chances of receiving the disability benefits you deserve.

Addressing Any Sexual Trauma Related to Military Service

When filing a VA claim for PTSD stemming from military sexual trauma (MST), it's imperative to address this sensitive issue with the utmost care and attention. Here are the steps to ensure your claim is supported with the appropriate documentation and evidence.

Thoroughly Document the Incident: Start by documenting the details of the MST incident, including the date, location, individuals involved, and any available evidence. This could include written accounts, photographs, or any other tangible proof that supports your claim.

Seek Medical and Mental Health Assistance: Reach out to a qualified medical professional specializing in treating individuals who have experienced MST. It's crucial to obtain a thorough examination, including any necessary forensic evidence collection if applicable. They can also assess and document any resulting psychological effects.

Gather Supporting Evidence: Compile any relevant records, such as service records, medical records, statements from witnesses, and any other supporting documentation that verifies the occurrence of MST and its impact on your mental health. These records will substantiate your claim and strengthen your case.

Obtain Expert Opinion: Seek assistance from a qualified medical professional who can provide an expert opinion on the link between military sexual trauma and your current mental health condition. This expert opinion can bolster your claim by establishing a clear connection between the MST incident and your PTSD diagnosis.

By thoroughly documenting the incident and obtaining the necessary evidence, you can support your PTSD claim based on military sexual trauma. Remember, seeking the guidance of a qualified medical professional is crucial in ensuring that your claim is effectively supported.


Understanding the VA's decision on PTSD claims is crucial for veterans seeking support and recognition. It is a complex process that requires thorough knowledge of the requirements, documentation, and procedures involved. By familiarizing themselves with the system's intricacies, veterans can navigate the process more effectively and increase their chances of a successful claim.

If you or a loved one is navigating the VA's decision on PTSD claims, it's important to seek assistance from qualified professionals who can provide guidance and support. Reach out to veterans service organizations, legal aid clinics, or accredited representatives to help you understand the requirements, gather necessary evidence, and navigate the claims process. Remember, you are not alone in this journey, and there are resources available to help you obtain the recognition and benefits you deserve.

Learn more about the VA PTSD claim process and how to navigate it effectively with American Veteran. Read our comprehensive guide on filing a PTSD claim with the VA to access the benefits you deserve.

Michael Blair contributes his expertise to help veterans access government benefits and resources. Through his informative articles and guides, he plays a vital role in empowering veterans and improving their quality of life.
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