Being told your PTSD is not connected to your service, by someone who has never met you, is a particular kind of insult.
Marc Whitehead & Associates represents veterans in PTSD claims and PTSD denials nationwide. Our role is to read the decision, find the element VA said was missing, and build the evidence that answers it.
A PTSD denial usually turns on one element, and it is not the diagnosis. It is the evidence that the event happened. That element carries its own evidence rules, and they are set out in the regulation rather than in the letter you received.
Send us your decision letter for a free review.
What Does VA Require to Grant VA Disability for PTSD?
Three things, set out at 38 C.F.R. § 3.304(f):
“Service connection for posttraumatic stress disorder requires medical evidence diagnosing the condition in accordance with § 4.125(a) of this chapter; a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred.”
A diagnosis. A medical link between your symptoms and the stressor. And credible supporting evidence that the stressor happened.
Most veterans arrive with the first and assume the claim is about proving how bad it is. In a denied claim, the problem is almost always the third element.
For a free legal consultationwith a ptsd veterans disability lawyer serving Nationwide, call (800) 562-9830
How Do You Prove an In-Service Stressor?
It depends on what kind of stressor it was, and this is where the regulation does veterans far more good than they realise.
If the stressor was combat-related
Your own testimony can establish it.
Where the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, lay testimony alone may establish the stressor, provided it is consistent with the circumstances of service and there is no clear and convincing evidence to the contrary.
No unit record. No witness. Your account, if it fits the service.
If the stressor was fear of hostile military or terrorist activity
A related provision applies, with the additional requirement that a VA or VA-contracted psychiatrist or psychologist confirms the stressor is adequate to support a diagnosis and that the symptoms relate to it.
If you were a former prisoner of war
A parallel relaxation applies.
If the stressor was a personal assault, including military sexual trauma
The regulation treats these claims differently, because it recognises that these assaults are frequently never reported. It provides that “evidence from sources other than the veteran’s service records may corroborate the veteran’s account of the stressor incident.”
The regulation itself lists what can count. Records from law enforcement, rape crisis centres, counselling services, hospitals or physicians. Statements from family, roommates, fellow service members or clergy. Tests taken at the time.
It also puts an obligation on VA. Before deciding a personal assault claim on the ground that the stressor is uncorroborated, VA is required to tell the claimant that this alternative evidence may be submitted, and to give them the chance to send it in. A denial issued without that step is worth examining on its own terms.
And, critically, evidence of behaviour change. A sudden request for transfer. A deterioration in work performance. Substance use that began then. Episodes of depression or anxiety with no identified cause. These can constitute credible supporting evidence that the stressor occurred.
There is also a procedural protection worth knowing: VA must notify a claimant that this alternative evidence may be submitted before denying such a claim. A denial issued without that notice is a denial worth examining.
Note also that the provision covers personal assault generally, not only sexual trauma.
Denied because your stressor was not corroborated? Ask for a free review.
Nationwide PTSD Veterans Disability Lawyer Near Me (800) 562-9830
Why Do VA PTSD Claims Get Denied?
Four reasons, in rough order of frequency.
The stressor was not verified. And frequently the relaxed standards above were never invoked, because nobody framed the claim to bring them into play.
The nexus is missing or inadequate. A diagnosis establishes the condition. It does not establish that service caused it. That requires a medical opinion connecting the two with reasoning, and our guide to nexus letters covers what makes one carry weight.
The examiner disagreed. A VA examiner concluded the criteria were not met, or attributed symptoms to something else. That conclusion is contestable, particularly where the examination was brief or did not address what the regulation requires.
Severity was understated. Frequently because the veteran understated it. Mental health symptoms are the ones people minimise most, in a clinical setting and in an examination, out of habit and out of pride.
Our page on a denied VA disability claim covers the wider denial picture, and if you have already been denied, our overview of VA disability appeals sets out the three decision review options.
What Conditions Can Be Claimed Alongside PTSD?
More than most veterans claim, and this is where a great deal of value goes unfiled.
38 C.F.R. § 3.310 reaches two situations: a condition proximately due to a service-connected disability, and a condition that a service-connected disability has made worse.
Conditions that commonly arise secondary to PTSD include depression and anxiety, insomnia and other sleep disturbance, and sleep apnea. Our page on VA sleep apnea disability claims covers the secondary argument in detail, and our posts on PTSD and insomnia and on major depressive disorder and PTSD go into the individual conditions.
The point to take from this is structural rather than medical. A veteran claiming only PTSD, with a file full of treatment for conditions that flow from it, is frequently leaving an entire second claim unmade.
How Are PTSD Claims Rated?
Under criteria that measure occupational and social impairment rather than the diagnosis itself, which is why two veterans with the same diagnosis can receive very different evaluations.
We do not publish rating criteria or percentages on this page. They are detailed, they are applied to specific findings, and a summary is more likely to mislead you than to help. Our post on how PTSD ratings work covers the subject properly.
What is worth saying here is what the criteria are actually measuring: how the condition affects your ability to work and to function socially. Which means the evidence that moves a rating is evidence about function, and function is exactly what clinical notes describe least.
What Happens at a PTSD C&P Exam?
A VA or VA-contracted examiner assesses whether the diagnostic criteria are met and how the condition affects you.
Three things to know beforehand.
It is usually short, and the examiner has not treated you. They will not see you again. The report still carries substantial weight.
Understatement is the standard failure. Veterans present well in a short appointment. They minimise, they answer “fine” reflexively, and they describe a good week because a bad one is harder to talk about. The examination is the single worst place for that instinct.
Attending matters more than anything else about it. Under 38 C.F.R. § 3.655, failing to report without good cause has consequences that differ by claim type, and on a claim for increase or a supplemental claim the claim shall be denied rather than decided on the record.
What Evidence Builds a PTSD Claim?
Four kinds, and the ones that matter most are usually the ones nobody gathered.
A stressor statement with specifics. Dates where you have them, locations, units, names. Not because the detail proves anything on its own, but because it tells an adjudicator where to look. A vague account gives them nothing to corroborate.
Service records that corroborate the circumstances. Unit histories, deployment records, incident reports, personnel actions. Also, for a personal assault claim, the personnel file itself, because a transfer request or a change in performance ratings can be the corroboration the regulation contemplates.
Lay statements. From people who served with you, or who saw what changed when you came home. In a personal assault claim, statements from family, roommates, fellow service members or clergy are expressly contemplated by the regulation.
A reasoned medical opinion. Connecting your current symptoms to the stressor, explaining why, and based on a review of the records rather than a single appointment.
What is the standard of proof?
More favourable than most veterans assume, and worth knowing before deciding whether the claim is worth continuing.
38 C.F.R. § 3.102 resolves reasonable doubt in the claimant’s favour wherever the evidence for and against sits in approximate balance. Proving the case outright is not required. Getting it level is.
What If Your PTSD Claim Was Already Denied?
You have three decision review options and the choice determines what evidence you can use.
Higher-Level Review puts the same file in front of a senior reviewer who gives no deference to the earlier decision. It is the right route when the stressor evidence was already there and was not properly weighed.
Supplemental Claim is the route for new evidence, and it is the usual answer when the corroboration the regulation permits was never gathered. That is the most common posture in a denied PTSD claim.
Board Appeal puts it to a Veterans Law Judge, and the hearing docket is the one route where you can describe the effect of the condition in person.
Our overview of VA disability appeals sets out all three, with the filing windows they each carry.
VA PTSD Claim Questions
Do I need a combat record to claim PTSD?
No. Combat service brings a relaxed evidentiary standard into play, but PTSD claims arise from non-combat stressors constantly, including accidents, training incidents and personal assault. What each situation needs is different supporting evidence, not a different diagnosis.
What is a stressor statement?
Your written account of the in-service event underlying the claim. It matters more than most veterans realise, because it frames what VA is looking to corroborate. A vague statement gives an adjudicator nothing to verify; a specific one, with dates, locations and units where you have them, gives them somewhere to look.
Can I claim depression along with PTSD?
Frequently yes, either as part of the same psychiatric picture or as a condition secondary to PTSD. Which framing is right depends on the medical evidence, and it is worth getting right, because the two routes require different things.
What if my assault was never reported?
That is the situation the regulation was written for. It expressly allows corroboration from sources other than service records, including behaviour changes such as a transfer request, a decline in performance, or unexplained depression or anxiety beginning at that time. VA is also required to notify you that this alternative evidence may be submitted before denying the claim.
Can my PTSD rating be increased?
It can, and it is worth understanding the mechanism first. Asking VA to look again generally prompts a reexamination, and reexaminations are governed by rules that can cut both ways. Our post on requesting a rating increase covers it honestly.
The examiner said my symptoms were from something else. Is that the end?
No. An examiner’s conclusion is evidence, not a verdict. VA weighs it against the rest of the record, which means a reasoned opinion from a provider who has actually treated you can be set against it. Where the examiner reached that conclusion without the treatment history in front of them, that is a point worth making rather than accepting.
The Part Nobody Explains
Marc Whitehead, Disability Attorney
Most veterans denied on a PTSD claim believe VA did not accept that they are unwell.
Usually VA accepted exactly that. What it did not accept was that the event happened, because nothing in the file corroborated it and nobody invoked the rules that exist precisely for events which leave no paperwork.
Those rules are in the regulation. Your own testimony for a combat stressor. Behaviour change for a personal assault. A requirement that VA tell you about the second one before it says no.
None of that helps if the claim was never framed to use it.
Send us the decision letter and tell us what happened. We will tell you which rule your claim should have been built on.
Marc Whitehead & Associates. Free review of your VA disability for PTSD decision.
Our Main Houston Office
403 Heights Blvd
Houston, TX 77007
(713) 929-2856
Call or text (800) 562-9830 or complete a Free Case Evaluation form
