1. PTSD Claims

2. Requirements for a PTSD Claim
References:
M21-1MR, Part IV, Subpart ii, 1.D
38 CFR 3.304(f), and
38 U.S.C.1154(b)

3. Requirements for PTSD Claim
Credible supporting evidence that the claimed in-service stressor actually occurred
Medical evidence diagnosing the condition in accordance with 38 CFR 4.125(a), and
A link, established by medical evidence, between current symptomatology and the claimed in-service stressor.

4. Requirements for PTSD Claim
Veteran’s lay testimony alone may establish the occurrence of the claimed in-service stressor for purposes of establishing service connection for PTSD if
PTSD is diagnosed in service, and the stressor is related to that service, or
the stressor is related to the Veteran’s
engagement in combat with the enemy
experience as a POW as defined by 38 CFR 3.1(y) or
fear of hostile military or terrorist activity, if a VA psychiatrist or Psychologist, or contract equivalent, conforms
the claimed stressor is adequate to support a diagnosis of PTSD, and
the Veteran’s symptoms are related to the claimed stressor.

5. Conceded stressors
When a Veteran has received any combat decorations (see following slides), VA will presume that the Veteran engaged in combat with the enemy, unless there is clear and convincing evidence to the contrary:

6. Air Force Achievement Medal with “V” Device
Air Force Combat Action Medal
Air Force Commendation Medal with “V” Device
Air Force Cross
Air Medal with “V” Device
Army Commendation Medal with “V” Device
Bronze Star Medal with “V” Device
Combat Action Badge
Combat Action Ribbon (Note: Prior to February 1969, the Navy Achievement Medal with “V” Device was awarded.)

7. Combat Aircrew Insignia
Combat Infantry Badge
Combat Medical Badge
Distinguished Flying Cross
Distinguished Service Cross
Joint Service Commendation Medal with “V” Device
Medal of Honor

8. Navy Commendation Medal with “V” Device
Navy Cross
Purple Heart, and/or
Silver Star.

9. PTSD Claim Forms: SDDVA policy statement VA Form 21-22
VA Form EZ
VA Form or VA Form a

10. VA Form

11. A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication………………………. 0%

12. Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication……………………………………….. 10%

13. Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events) …………………………… 30%

14. Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships ……………………………………………… 50%

15. Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work like setting); inability to establish and maintain effective relationships ………….70%

16. Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name …………………………………………..100%