Posttraumatic Stress Disorder (PTSD) is a mental disorder that is characterized by the exposure to a traumatic event. This condition is rated under the general rating formula for mental health conditions found in 38 C.F.R. Section 4.130, DC 9411. To obtain a VA disability rating for PTSD, a veteran must generally establish the following three elements: (1) a current diagnosis of PTSD; (2) a corroborated in-service stressor; and (3) medical evidence linking the PTSD diagnosis to the stressor. Sizemore v. Principi, 18 Vet. App. 264, 275 (2004). Often, the major hurdle that veterans looking to establish service connection for PTSD face involves the second element—credible supporting evidence of in-service PTSD stressor(s). However, the VA’s duty to assist, along with multiple exceptions that relax the evidentiary requirement, provide multiple avenues to navigate and support a claim for service-connected PTSD. Despite relaxed evidentiary standards in some cases, proper development in any PTSD case should begin with a veteran’s own statement about the in-service PTSD stressor.
Proving a PTSD Stressor When PTSD is Diagnosed During Active Military Service
If a veteran was diagnosed with PTSD during active military service, his or her own lay statement may be sufficient to establish the occurrence of the in-service PTSD stressor(s). Historically, the VA required credible supporting evidence of an in-service stressor for all PTSD claims. This meant that a veteran’s lay statement was never alone sufficient to establish the occurrence of the event. However, in 2009 the VA amended its regulations to allow a veteran’s lay statement to establish the occurrence of a stressor without further evidence provided that the veteran was diagnosed with PTSD during active duty service and the claimed stressor is “consistent with the circ*mstances, conditions, or hardships of the veteran’s service.” If you had an in-service diagnosis of PTSD due to a stressor that occurred during service, satisfying this requirement should be relatively easy.
Proving a PTSD Stressor When PTSD is Diagnosed After Service
As you may have guessed, the evidentiary rules that apply to proving an in-service PTSD stressors when PTSD is first diagnosed after service depend on the facts of a veteran’s case. The first set of rules that will be discussed below apply to in-service stressors that occurred during combat. The second set of rules apply to stressors based on a fear of hostile military or terrorist activity. The third set of rules apply generally apply to non-combat PTSD stressors. The fourth and final set of rules apply to a subset of non-combat PTSD stressors involving assault including military sexual trauma.
No matter theory a veteran intends to rely on in order to prove the occurrence of an in-service PTSD stressor, triggering the VA’s duty to assist with the verification of the alleged in-service stressor is an important first step. The duty to assist is triggered if the veteran’s own statement about the stressor event, without consideration of any other record evidence, is not inherently incredible. In most cases the veteran’s own statement will not be inherently incredible, so a lay statement from the veteran detailing the stressor(s) is an important place to start.
Combat Stressors
In most instances, if a veteran alleges that a PTSD stressor occurred during combat, then he or she will not have to present any evidence that the stressor occurred other than his or her own lay statement to establish the occurrence of the stressor event. There are two general exceptions to this rule. The first exception is if the alleged in-service PTSD stressor is not consistent with the circ*mstances, conditions, or hardships of the veteran’s service. The second exception is if there is clear and convincing evidence that the alleged stressor event did not occur. If one of these exceptions apply, then the veteran will likely be required to present additional corroborating evidence in support of the occurrence of the stressor in addition to his or her own statement.
However, in practice, the VA commonly seeks out additional evidence of both the veteran’s combat service and the occurrence of the stressor event even when a veteran has a PTSD diagnosis due to a stressor that occurred in combat. This is especially true where the veteran’s service records do not clearly show whether he or she engaged in combat. For instance, the absence of combat awards or a MOS that suggests combat experience will often result in a deeper dive from the VA to verify whether a veteran engaged in combat with the enemy. If combat experience is not clear from the service records, assume that the VA will take additional steps to attempt to verify a veteran’s PTSD stressor(s).
Stressors Related to Fear of Hostile Military or Terrorist Activity
An additional category of PTSD cases that do not require corroborating evidence of an in-service stressor is where a veteran has a PTSD diagnosis from a psychiatrist or psychologist based on “the veteran’s fear of hostile military or terrorist activity.” VA regulation states that this “means that a veteran experienced, witnessed, or was confronted with an event or circ*mstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran of others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veteran’s response to the event or circ*mstance involved a psychological or psycho-physiological state of fear, helplessness, or horror.” In such instances, no corroborating evidence is required to establish the occurrence of the stressor, provided that the stressor is consistent with the veteran’s service and there is no clear and convincing evidence to the contrary.
The General Rule for VERIFYING PTSD Stressors
If PTSD is not diagnosed in service, is not due to a fear of hostile military or terrorist activity as reported by a psychiatrist or psychologist, is not due to a stressor that occurred while the veteran was engaged in combat, and/or combat service is disputed by the VA, then the VA will look for additional evidence to verify the reported in-service stressor(s). In such cases, corroborating evidence other than the veteran’s own lay statement is necessary to establish that the in-service PTSD stressor occurred. There is a wide range of traumatic events, or groups of events, that may qualify as stressors for a PTSD claim. However, there is no requirement that the corroborating evidence supporting the occurrence of the stressor(s) be found in military service records. Credible supporting evidence from any source may fulfill this requirement.
For instance, the VA is required to consider buddy statements or any other evidence that supports the occurrence of an in-service stressor, and in some circ*mstances such lay evidence from other individuals may alone suffice. Likewise, old newspaper articles or documents from a veteran’s unit may also be helpful evidence in establishing the occurrence of a PTSD stressor.
Additionally, the VA must attempt to verify an in-service PTSD stressor by referring the matter the Joint Services Records Research Center (JSRRC) where the minimum requirements are met. In fact, it is improper for the VA to deny a veteran’s claim because of an unverified PTSD stressor without sending a verification request to the JSRRC (or the Marine Corps because those records are held separately from the JSRRC) to attempt to confirm the in-service PTSD stressor if the veteran has a diagnosis of PTSD and has provided the VA with sufficient information for the JSRRC to conduct a search. The information necessary to compel the VA to request a JSRRC search is a relatively easy standard to meet. By way of example, in Gagne v. McDonald, 27 Vet.App. 397, 398 (2015), a veteran with a diagnosis of non-combat PTSD sought to verify his reported stressor of witnessing a casualty during a truck accident. The specific information provided by the veteran included the name of his unit, city where the accident occurred, a date range exceeding one year, and he identified the casualty only as “[h]is sergeant.” Id. at 398–99. The VA did not submit a request for verification of the veteran’s stressor because it stated that he did not provide the minimum requested information to facilitate the search, namely that he did not provide a time period in which the event occurred to within a period of 60 days or less. Id. at 399–400. The Court of Appeals for Veterans’ Claims held that the Board clearly erred in finding that the duty to assist was satisfied, vacated the Board’s decision and “remand[ed] the matter for the RO to submit to the JSRRC multiple requests for records of a stressor event, each request encompassing a different 60-day period, to cover the appellant’s relevant service period from July 1967 to September 1968 as a truck driver with the 91st Engineer Company.” Id. at 403–404. In some situations, the JSRRC may request more detailed information, which the VA must pass along to the veteran, and if the veteran does not respond to the request for additional information, that may be grounds to deny the claim due to an unverified PTSD stressor.
PTSD Stressors Based on Assault Including Military Sexual Trauma (MST)
For in-service assault or trauma stressors, including military sexual assault, the VA may not use the absence of service records documenting the event or the veteran’s failure to report the event to conclude that the event did not occur. VA adopted regulations providing this rule in response to acknowledgement that many incidents of personal or sexual assault go unreported.
For this reason, VA regulation allows veteran’s claiming PTSD based on an in-service assault including military sexual trauma to establish its occurrence by evidence from sources other than the veteran’s service record including records from law enforcement authorities, rape crisis centers, mental health counseling centers, and evidence of behavioral changes following the claimed assault. Often, lay statements attesting to behavioral changes following an unreported incident during service is key to prevailing.
