You just got your VA Ratings Decision on your PTSD service-connection claim, and tear the envelope open expecting to see a 50%, or 70% rating.
After all, your battle buddy from your unit, who witnessed the same traumatic event, got 30% and you are FAR worse off than him.
You read the letter to find that the VA only gave you a 10% rating.
A wave of anger and frustration comes over you. Where do you go? What do you do?
I’m going to walk you through 9 Things that might help you get the PTSD rating you are entitled to. These are not the ONLY 9 things, and every case is different.
Let’s get started.
Understand where your VA PTSD Rating fits in the 4 Pillars.
When we talk about a VA Claim, we talk about simplifying it by building the 4 Pillars.
The 4 Pillars are the 4 things that every Veteran, in every VA claim, needs to prove before they will recover service-connected disability compensation.
Impairment ratings – or the way that the symptoms of your service-connected condition are equated to a percentage and a dollar value – are the 3rd Pillar.
For example, here is the VA PTSD Rating Table that you can download to your computer:
[s3file s3url=”S4_130.doc” newtab=”yes” ]Download VA Mental Health Impairment Rating Tables[/s3file]
Many Veterans with a diagnosis of PTSD find themselves “low-balled” with a rating that is much lower than that of their peers. When it comes time to appeal that low rating though, most Veterans don’t have the tools to adequately challenge the low rating.
Here are 9 pointers to help you evaluate the rating in your VA PTSD claim.
#9: Did you File your VA Claim – the Right Way?
The 2 biggest errors that Veterans make in their VA Claims – and the 2 errors that cause them to get stuck in the VA backlog for longer and longer periods of time, are these:
A) They filed their claim and expected the VA to do the work – or to do the RIGHT work – in developing the claim.
B) They didn’t “connect the dots” for the VA in a simple straightforward way that made the VA Rater WANT to grant the claim.
You can avoid those solutions by Filing Your VA Claim – the Right Way – from the very start.
* Find out WHAT evidence you need to put in your VA Claim.
* Find out HOW to make the arguments in a way that makes them easy for a rater to understand.
It’s a simple fact that if you put the RIGHT evidence into your claim, and explain in a very clean and basic way how that evidence shows your sleep apnea is service connected, your claim will go quicker.
And you will probably get better results.
When you are ready to start learning How to File Your VA Claim the right way, click here & read this post.
#8: The best-kept secret in a VA PTSD Rating is the Mauerhan case.
The Code of Federal Regulations – before listing the PTSD rating criteria in DC 9411 – says that when rating PTS, the VA should consider symptoms “such as” those listed.
That’s key language – as the Courts told us in Mauerhan.
You don’t have to find ALL the factors on the list to qualify for a particular rating. You just have to make a case for your symptoms being similar to the symptoms listed at the rating level you believe you are entitled to.
#7: Occupational Impairment factors are more important for VA PTSD Rating purposes.
I’ve reviewed hundreds, if not thousands of Veterans C-Files.
When the PTSD rating is too low, a common reason I have seen is that the Veteran focused on the social impairment factors, and not the occupational impairment factors.
Take a look at all the factors in the 50% category for PTSD – instead of equating those symptoms to your social life (home, family, friends and social interactions), relate them to your ability or inability to get or keep a job.
#6: The VA PTSD Rating criteria is NOT a complete list of PTS symptoms.
Remember that the list of symptoms on this list are not meant to be every possible symptom – if you have symptoms, or manifestations of symptoms of your PTSD that are not on this list (and there are plenty), see which ones on the list your symptoms are most like.
This list not as a comprehensive listing of PTSD symptomatology, but to have an objective tool to help make sure that Veterans get rated as consistently as possible when PTSD affects them in similar ways.
#5: Did the VA examiner consider the frequency, severity and duration of PTS symptomatology?
This is the one that C&P Examiners overlook the most often.
Rarely do C&P exams for Veterans with a PTSD claim discuss how long the symptoms last or the length of any periods of “remission”. Sometimes, they discount the resilience/remission factors so much so that they change the Veteran’s diagnosis altogether.
For example, we were able to get one Veteran a higher PTSD rating by showing that her “resilience” was not as high as one might thing from frequent periods of remission: because of the nature of her symptoms, she still had significant social and occupational impairment limitations during the “remission” period.
#4: Did the VA consider ALL of the evidence in the record?
Far too often, VA C&P examiners focus on the most recent symptomatology. The doctor has to look at the whole of the evidence of the record.
Organize those documents from your C-File in chronological order, and type up an EASY to read outline of the chronology of your symptoms – keep it to 1 page, double spaced, so it’s easy to read.
Share it with your C&P Doc, and ask them to put the chronology in your C-File when they are done.
Don’t argue your position, just hand it to the doc and say “Here’s the chronology of my condition, if it helps you, use it. If not, just put it in my C-File.”
This is really hard to do if you don’t have your C-File – here’s how to get a copy of your C-File.
#3: What is the GAF scale?
The GAF scale is a test that rates, on a scale of 0 to 100, a Veteran’s overall psychological, social and occupational functioning. The higher the score, the more ability the Veteran has – in theory – to function in a wide range of activities.
I see many, many PTSD ratings given without consideration of GAF scores at all, without consideration of the pattern of GAF scores over time, or relying solely on the GAF score.
Think of the GAF score like the check engine light in your car. It gives you an indicator that something is going on – but is not the only thing a mechanic considers when repairing your vehicle.
In current claims, the GAF score is no longer used – however, many VA Raters still wrongly use the GAF score and in some claims, the appeal is based on the law at the time of the denial, which may have involved use of the GAF Score.
#2: Don’t let the VA rate you based on the ABSENCE of factors for a particular level.
I really think that if the VA would get away from using “negative evidence”, 40% of the backlog would be cleared out.
Seriously – I think I see this error in nearly every case I look at. The VA cannot usually consider the absence of evidence as proof of anything.
If your PTS rating talks about how you DON’T have certain symptoms or problems, you need to get in touch with a lawyer ASAP. The way to fix this is a legal argument, coupled with a long-term appeal strategy.
Find out how to choose the best attorney for your VA appeal in this free eBook.
#1: Did you downplay your symptomatology?
Many Veterans get dressed up in their “Sunday best” for their Comp & Pen exam, believing that they are more persuasive when they “present” well.
Other Veterans refuse to shower, shave, or wear clean clothes, based on the suggestion of some random Veteran in a facebook group.
BOTH approaches are wrong.
Remember, doctors can assess the symptoms in your records – AND the symptoms they observe. When it comes to your appearance at the C&P exam, BE your symptoms.
More importantly, don’t downplay your situation.
Let the doctor see, and hear, how bad your PTSD is affecting you.
Vietnam Veterans out there tend to be serious hard-asses, and refuse to tell people when they are hurting.
I’m not judging at all – I am saying that the time to downplay your symptomatology is NOT during your PTSD C&P exam. (By contrast, you don’t want to exaggerate your symptoms either).
The Veterans I see with PTSD ratings that are too low (or that later face ratings reduction problems because they were over-rated) all have one thing in common – they failed to follow the Golden Rule of PTSD C&P Exams: Just be yourself.
These tips for evaluating your VA PTSD Rating are worthless unless you have your C-File.
Without your C-File, you can’t know your GAF score (for rating purposes), whether there is even a GAF score in your record (the absence of a GAF score could be reversible error) or whether the VA consider all the evidence of the record.
Here’s where I show you my Firm gets C-Files from the VA.