Thursday, August 15, 2013

The PTSD Series - Part 1

Diagnostic Criteria for PTSD

A November 13, 2007, CBS report found that at a significant number of our soldiers returning from Iraq and Afghanistan are committing suicide.

According to the report, since 2005, a total of 6,256 Iraq veterans have killed themselves after returning home. To put that figure into perspective, the total number of US Soldiers killed in Iraq currently totals around 4400. New reports are being developed and the suicide numbers continue to rise despite the efforts of all agencies involved in identifying and treating potentially suicidal military members.

One cause of these suicides may be untreated Post Traumatic Stress Disorder (PTSD). PTSD is a mental health condition which, according to the American Psychiatric Associations Diagnostics and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV) is:

“[T]he development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury or other threat to one’s physical integrity…[the response to which is] intense fear, helplessness, or horror.”

In other words – seeing people kill or be killed on a regular and recurring basis can damage your mental health. It may start with a general feeling of emotional numbness after a traumatic event.

There may be guilt about surviving when others did not, anxiety, depression, flashbacks and nightmares, insomnia, and worse. Untreated, the condition can lead to drug or alcohol abuse and suicide.

Many veterans returning from service in Iraq and Afghanistan suffer from PTSD – sometimes it won’t surface for weeks, months or years. When service-connected PTSD surfaces, it is a compensable condition and the veteran is entitled to disability benefits.

A veteran may find it difficult to prove to the VA that he or she has PTSD. The next few days of this blog will be dedicated to laying out some basic requirements for proving entitlement to PTSD to the VA.

Generally speaking, to successfully claim disability benefits for PTSD, a veteran (or their attorney or advocate), must show three (3) factors:

1) Medical evidence of a current diagnosis of PTSD. A veteran need only prove, by competent medical evidence (consistent with the criteria of the DSM-IV) that it is at least as likely as not that the veteran has disabling PTSD.

2) Credible evidence of an “in-service stressor”. There are, generally speaking, two categories of “in-service stressors”: a) Combat Stressors when the Veteran served in combat, and b) Stressors when the Veteran did not engage in combat or experienced a non-combat stressor. The standards are quite different, and will be discussed in greater detail in the coming days.

3) A link, or connection, between the current condition and the “in-service stressor”. This is the murkiest element of the three, but generally speaking, if the Veteran can show medical evidence – by a lay expert – that the in-service stressor was at least a contributory factor for the current symptoms, then the veteran should be able to secure benefits for this condition.

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