How To Win Your PTSD Claim without Diagnosis (Don't Fall for this common Grift!)

Hello and welcome to another Hill & Ponton VA video blog. I'm Matthew Hill here with Gary Baker and Carol Ponton and today we want to talk to you about how to win a PTSD claim when you don't have a PTSD diagnosis and you don't have a stressor that you verified in service. It's a little bit tricky but we have found that one of the traps the VA has put down is, hey you have to have this specific diagnosis or you apply for this specific diagnosis. And also another one is show us exactly what happened in service. And so we've dealt with thousands of VA cases over the years for mental health conditions and we've kind of seen some repetition. And Carol had some ideas on just what those problems are and then how to overcome them. I have a lot of veterans who come to me and they clearly have PTSD but the VA says they don't. And they clearly had a stressor in service but they can't prove it. The VA says it didn't happen. They certainly can't go back and get evidence from the VA to show it happened. But these people have a bad PTSD disorder. But I find that if they framed it differently, if they said I have an acquired psychiatric disorder. In other words, when I went into the service, I had no mental problems. But when I left, I had mental problems. This is what they are and they have lasted since discharge. And then you would have somebody, witnesses, brothers, sisters, parents, cousins who knew them before service and afterwards to do statements, 4138 statements that say, explain what the veteran was like before service and the problems they noticed after and they have continued. The problem is the veterans come and they keep trying to win on the same thing and they're not winning. They're not proving the stressors. The VA still continues to say they don't have PTSD. And so they're losing. If they would just reframe it, they'll win it. But I don't think they understand how to do that. And that would make a lot of people who have been denied the people who were awarded. And Carrie, I think one of the things Carol hits on is the fallacy of proving a stressor. Most people would think I have to prove what happened on that night, in that situation, at that place, at that time. But is it that restrictive? Do they have to show evidence of that or they lose? No, it's not that restrictive. You've got stressors that need to be verified to some degree or another, whether you're talking about combat-related PTSD or military sexual trauma, personal trauma. All of those have their own little nuances. What we see the most, obviously, is combat-related PTSD. And an example of, I think, what you're talking about, Matt, is you've got a, in fact, there was a few good pieces of case law on this subject, where you were a cannoneer in Vietnam firing at the enemy. And so you're obviously in a firefight. You're firing a cannon, so you're not using an M16 100 yards away or 50 yards away. So maybe you're a pretty good distance from the enemy. And I've seen a lot of cases where they would say, well, there's no evidence that the enemy fired back. Or if they did, that the shell was hit close to where you were. And where VA would verify that, yes, this gentleman was a cannoneer. Yes, this unit was in. Yes, they fired on these dates. And so typically, when somebody shoots at you, if you've got a gun, you might want to shoot back. And they will deny the stressor because there's no evidence that you had incoming rounds near you. That's a good example there. It does not take that level of verification for VA to concede a stressor. So I think that's what you were getting at, Matt. Well, in military sexual trauma, you can show a range of things like the change in the behavior, the change in how the veteran acted, trying to get out of service, what they told people at the time. So there are a lot of things you can do for those cases. But I'm talking about cases where we've tried all that, or the veteran has tried all that. And for some reason, the VA is not taking it. The veteran has a mental problem. All you want to do is get that service connected. So if by changing it from PTSD to acquired psychiatric disorder, that gets him what he wants. That's what I'm talking about. I have veterans where there was a fire, a fire in their barracks that killed certain people, but he can't prove it. You know, we're not, we just can't get that stressor proved. This is where we could go to the acquired psychiatric disorder. And that's what I want veterans to understand is if you're beating your head against the wall and you're not getting anywhere on PTSD, you've given them all the evidence you have, then think about reframing what you're calling the disease. It is a psychiatric disorder. You acquired it from the service. And I think you should push it under that with the appropriate background, like I said, of having people testify that you had no problem prior to service, but you've had it since. I'm just saying there are too many times when they walked outside and there was one person they knew there hanging. He killed himself. Somehow we can't prove that. We can't find, you don't remember the name, can't remember the exact date. But this happened and it was traumatic. When you can't prove the stressor, go to acquired psychiatric disorder. Or any psychiatric disorder. Exactly. But it's acquired from service. Okay. Well, you don't have to, just because you come in with a claim for PTSD, you are not competent to diagnose yourself. And the veterans court has mandated the VA look at not just what you say you have, but any other mental health disorder. Because at the end of the day, whatever the label is, doesn't matter. You didn't come to the VA for a label. You came to the VA to get compensation related to your service. And so if they're going to call it acquired psychiatric disorder, if they're going to call it schizophrenia, if they're going to call it bipolar, they're going to call it PTSD. What matters is you actually get the compensation you deserve. Because that disorder, that diagnosis has hindered your ability to live as a normal person. And that is why we have all these laws and regulations to compensate you for what you went through. And what we were talking about earlier, Matt, is I really picked this up more from the judges at the board. I think a lot of them are sympathetic. They cannot give PTSD because they don't have the evidence required. There's no proven stressor, but they can see that there was an acquired psychiatric disorder. So I am seeing the judges there who want to give benefits go that route. And I think if the veterans started earlier, they may win at the regional office on that route. I would recommend if you're filing, the new AMA process is complicated. If you're filing the first time on a 526, or if you're filing a new claim because you've been denied previously, that you file for a mental health condition or a mental health disorder related to service. And that way, the burden is on the VA to find out what kind of disability you have. And it's not you just saying, I have PTSD related to this. Because we want them to explore what do you have? How could that be related? Versus you said PTSD and your doctors don't say PTSD. Taking that to a little silly degree, if I may, part of the problem I think you guys are describing is you will get a case that somebody claims PTSD, and maybe they were in the combat zone, but they don't have a Purple Heart or an individual combat action, some individual stressor. But then they have the acquired psych. And they get examined, and the doctor says you have an anxiety disorder or a major depressive disorder. But it's related to this, this here period of your service for whatever reason. You know, so you still, you've got the diagnosis, and the doctor gives you a nexus to your service. And the VA will come back and go, well, you claim PTSD. So we have to deny your case. Right, exactly. Even though the doctor said, well, this is what you got, and then related it to service. That is an error. You know, but that's. Kerry, I had a case where the veteran filed for a mental condition, depression, and the CMP examiner said you have PTSD. And so they denied his claim because he didn't have depression, he had PTSD. So he filed a claim, this is honest. He filed a claim for PTSD. And the new CMP exam said he doesn't have PTSD. So I think a mental disorder, a mental health condition is really what we should be putting down. Because it's just, like you said. It's three-shell. Yeah, it's three-shell Monty. I mean, they hide it under here, they hide it under there. And that's what you, yeah, don't get denied. Make them make the finding as well. And this just happened within the last month, by the way. I didn't make this up. It's hard to be more imaginative than VA. That's true. All right. Well, again, if you're filing for a claim, PTSD, or any other mental health disorder, remember your ultimate goal is to get service-connected compensation. Don't worry about the name of the diagnosis. So make sure you don't get hung up on the details. Yeah. Call it a mental health condition, but be as broad as possible so that they can't do these dumb little tricks to you and keep you in the system, or make you get frustrated and get out. Right. Well, thank you so much for joining us today on the Hillenponten Video Blog, and we look forward to seeing you on this space sometime soon.