Yes—if you are a veteran diagnosed with PTSD (or are living with symptoms and suspect you have the condition) you may qualify for Veterans Affairs (VA) disability benefits, Social Security Disability Insurance (SSDI) benefits, or both.
Each program’s eligibility criteria are different and must be met. Basically,
- PTSD can be the basis for a successful VA compensation claim if the PTSD is service-connected and properly diagnosed.
- For SSDI benefits, assuming Social Security FICA requirements are met, the veteran needs to satisfy the criteria under SSA’s new medical listing for PTSD – or (as is often the case) the veteran may be granted disability benefits through SSA’s medical-vocational allowance
Getting Maximum Disability Benefits for PTSD
The inherent nature of military service makes PTSD prevalent among our nation’s veterans. When you serve in the military, you may see warfare and acts of violence. You may have endured life-threatening missions or experienced terrifying, shocking events.
Harsh situations outside of combat bring further stress to a veteran who is already frightened, anxious, on-edge or confused. These include hostile or uninhabitable environments, military sexual trauma, or the emotional loss of a buddy to name a few. All may play a role in life-altering PTSD symptoms and other mental health conditions.
Sometimes veterans do not realize that disability benefits for PTSD may be available to them under both the VA and Social Security Disability programs. Do not miss an opportunity to receive disability payments from more than one source.
Just as important, don’t risk denial of your initial PTSD disability claim, or losing on appeal because you do not have competent, experienced legal representation.
Things can get complicated between the two different agencies. If you are a veteran with a PTSD diagnosis, this article explains what it takes to qualify under either one or both disability programs.
How Can I Get Veterans’ Disability Compensation for PTSD?
Under VA rules, first you need to meet three conditions:
- you are properly diagnosed with PTSD, and
- the stressor happened during your military service (service-connection is established), and
- due to your resulting symptoms, you cannot function in normal life as you formerly could.
Submit a claim that fulfills these demands, and VA will likely find you are qualified to receive disability compensation.
While this may sound straightforward, there are many details that your condition must satisfy before it can be considered service-connected. Your case will go through VA’s screening process and you will undergo a C&P exam.
Possible VA ratings for PTSD are 0, 10, 30, 50, 70, and 100 percent, depending on the severity of your symptoms. The VA will consider all your mental impairments together, under the General Rating Formula for Mental Disorders.
Learn how VA rates PTSD and how the C&P evaluation affects your claim in our article: Understand Your PTSD Rating.
Once your condition fulfills all VA’s requirements for PTSD, it can then technically be considered a disability for the purpose of veterans’ compensation.
Symptoms of PTSD Disability
VA focuses on the behavioral symptoms that accompany PTSD. There are four distinct diagnostic symptom clusters; the number of symptoms that must be identified depends on the cluster. A disturbance should continue for more than a month.
Spontaneous, unwanted memories of the traumatic event, recurring dreams (nightmares) related to it, flashbacks, panic attacks, or other intense or prolonged emotional distress.
Extreme avoidance of distressing memories, people, thoughts, feelings or external reminders that you associate with the traumatic event.
Negative cognitions and mood
Adverse changes to mood encompass all sorts of negative feelings, from constant and distorted assumptions of survivor’s guilt, blame of self or others, to feeling isolated, or a markedly reduced interest in everyday activities, to failure to remember key features of the traumatic event.
These symptoms include aggressive, reckless or self-destructive behavior, violent outbursts, sleep disturbances, trouble concentrating, hypervigilance and jumpiness, and related problems.
Symptoms also account for the “fight” reaction often seen in PTSD patients.
VA Disability Claim Forms Specific to PTSD
VA has separate forms to fill out and submit in a PTSD claim for disability benefits, and are available on VA’s website:
- VA Form 21-0781 – Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder
Or, to claim PTSD disability on the basis of a personal assault, submit the following:
- VA Form 21-0781a – Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder Secondary to Personal Assault
Why Does VA Deny PTSD Disability Claims?
If your claim was denied, you should appeal. If you think your PTSD rating is too low, do not settle for the first rating you get. The dollar amount of the VA disability payment is riding on your rating decision.
The trouble is, the road to winning PTSD disability benefits is often a frustrating, uphill battle for veterans dealing with this condition. Service connection rules, impersonal VA forms, addressing facts related to your experience, incomplete service records and other challenges make the claims process harder than it should be.
Far too often, our attorneys represent veterans whose claims were inadequately presented or lacked the proper forms, missed deadlines, or lacked the medical opinions or supporting statements the VA needs to be able to make an accurate decision or rating. In other claims, the VA simply gets it wrong and we are able to identify those errors and resolve the issues.
Common examples of PTSD claim denial include:
Veteran’s claim was missing DSM-5 criteria:
The criteria VA follows to diagnose PTSD is called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). There are specific PTSD criteria listed in the manual that must be met and stated in your claim. If any one component is missed, ignored, or otherwise not included, your VA rater will likely deny your claim.
PTSD claim denied because the “stressor” is not verified:
Every PTSD claim must be able to prove there is a service-related stressor; the event that caused the PTSD. This may be combat related, or non-combat related.
An example of a hard-to-prove combat-related stressor might be as follows: while serving in Afghanistan you witnessed a deadly IED blast during combat. However, as you were not injured or directly involved, the exact stressor incident was never added to your file.
Proving non-combat stressors can be even more difficult. You must have more corroborating evidence than just your own testimony. Suppose you witnessed a violent and deadly car accident while on leave. This stressor incident may be documented in the deceased’s military records, but perhaps not in yours.
Another instance of non-combat PTSD stressor is military sexual trauma (MST). The VA may have no records of the stressor “event” because the injured veteran chose not to come forward to report it.
Often we can locate other military records, such as medical files or performance assessments that provide clarifying documentation. Circumstantial evidence showing behavioral changes and other irregularities may be the paper trail we need to help you connect the dots and develop your claim. Statements from family, spouse, or buddy statements can often help verify an in-service stressor’s occurrence.
You Suffer from PTSD but were issued an other-than-honorable discharge:
You may be one of thousands of veterans who suffer from service-connected PTSD—but were denied VA benefits across the board because your discharge was designated as “other-than-honorable” (and likely due to minor infractions linked to your untreated mental health issues).
Veterans may apply for review of discharge status based on PTSD. If you need a discharge upgrade in order to qualify for VA benefits, please contact our veterans attorneys for a prompt consultation.
For Qualified Veterans, PTSD Is a Disability under Social Security
In many cases, a veteran may be eligible for SSDI, in conjunction with, or as an alternative to VA disability compensation—if the Social Security Administration (SSA) finds you are unable to work.
Like the VA, the SSA is a federal agency with its own purpose, eligibility requirements, definition of disability, and payment amounts. So it is important to know how these two disability programs differ and interact.
SSA has recently issued major revisions to its Listing of Impairments for Section 12.00 Mental Disorders, including a new listing for posttraumatic stress disorder. Previously classified as an “anxiety” disorder, as of January 2017, PTSD is listed under the new Section 12.15, “Trauma- and stressor-related disorders.”
SSA’s Purpose Is Different from VA
SSA is looking for problems with your capacity to work. It follows a five-step process to decide if you cannot work, and therefore would qualify for disability benefits.
SSA does not require a veteran’s PTSD or other impairment to be linked to military service or discharge status.
There are no rating percentages of disability. Basically, under SSA’s “all-or-nothing” definition of “disability,” you no longer have the capacity to work (make enough money to live on) for at least one year, or until death.
Conversely, the objective of VA compensation is to pay veterans who suffered disabling physical and mental health conditions while serving in the military, on a graduated scale, based on the degree of the veteran’s disability. You can be partially disabled (assigned a percentage rating in 10% increments) and still receive disability under the VA.
SSDI Has Income Requirements:
Social Security has an income threshold that applicants (both veteran and civilian) must meet to be eligible for benefits. Under SSA, your functional impairments must limit your ability to work at a substantially gainful level.
As of 2019, this level of income must be less than $1,220 per month before you qualify for SSDI. This may disqualify some veterans from receiving SSDI benefits.
3 Tips Regarding VA and Social Security PTSD Disability Claims
- VA benefits are not considered “earned income” and therefore do not affect your eligibility for getting SSDI benefits. So if the two benefits (SSDI + VA compensation) added together surpass the SSDI income requirements, you are still eligible for those benefits and your chances for approval are not impacted.
- Just as important, if VA grants disability benefits to you, do not assume that SSA will too. Many veterans who receive VA compensation for PTSD do not qualify for Social Security Disability Insurance for PTSD. Remember, VA disability benefits are based on percentages; SSDI benefits are based on that you are totally disabled from working.
- SSA may also use a veteran’s evidence to expedite processing of claims for Wounded Warriors and veterans with a 100% disability rating.
PTSD Is a Disability under SSA’s Medical Vocational Allowance (MVA)
Our work often enables veterans to obtain a medical-vocational allowance under the SSA benefits program. If you were denied SSDI benefits because you did not meet the criteria under SSA’s medical listing for PTSD, you may still qualify for MVA if you can show a limited Residual Functional Capacity (RFC).
Your RFC is what you can still do within the limitations imposed by PTSD. We help present the strongest claim possible to demonstrate your impairment is grave enough to prevent you from working and earning “substantial and gainful” income, when also assessed from the standpoint of functional limitations, past work experience, age, transferrable skills, and other factors Social Security uses to measure whether you qualify for Medical Vocational Allowance.
One Call to Our Law Firm Does It All
The relationship between the VA and SSA, and the types of disability benefits they provide can become complex. At Marc Whitehead & Associates, we take care of everything for you.
Our experienced disability attorneys will help you fill out forms and paperwork, supplement your claims with additional key records and supporting evidence, coordinate with doctors and more, to successfully present your claim and obtain the maximum appropriate benefits that are rightfully yours.
Come to us when you need help:
- developing and proving your veterans claim for PTSD,
- improving your VA rating,
- applying for possible Social Security Disability Insurance in addition to or as an alternative to your veterans’ disability,
- qualifying for a medical vocational allowance, or
- appealing a VA or SSDI claim denial.
Do not wait any longer. Call us toll free at 800-562-9830 or request a Free Consultation to find out how we can help. PTSD is a serious disability, and we are prepared to assist you wherever you live.
Marc Whitehead & Associates are Accredited Veterans Claim Attorneys as required to practice law before the VA. We represent veterans at all levels within the VA disability system including claims before the VA Regional Office, the Board of Veterans’ Appeals and the U.S. Court of Appeals for Veterans Claims.
Our attorneys are Board Certified in Social Security Disability Law by the National Board of Social Security Disability Advocacy. We handle cases from the initial application stage through administrative hearings and federal court.