ptsd Definition Of A

[Berta]

Definition of a Stressor:

The VA defines a stressor based on the DMS –IV (Diagnostic Statistical Manual of Mental Disorders) thus:

“the person experienced,witnessed,or was confronted with an event or events that involved actual or threathened death or serious injury,or a threat to the physical integrity of self or others, and the person’s response involved intense fear,helplessness, or horror.”

A stressor also involves having persistent traumatic re- occurences of the event- such as flashbacks, external reminders of the stressor, distressing dreams of the stressor etc.

Many avoidance efforts as to avoidance of thoughts, people, places that remind of the stressor , and often a feeling of detachment.

The full gamut of PTSD symptoms is found within the DSM IV Manual and VA uses this manual as a guideline to diagnose PTSD.

When I worked with the PTSD group at a Vet Center, the vets always would say ‘before,during, and after’-to define how tremendously they changed due to the Vietnam War.(as well as the whole country-these vets came back to a much different America then they left.)

The changes in their behavior and reactions, sleep patterns and interactions with family and friends were symptomatic of PTSD.

Also the VA considers some events as part of the nature of warfare and not stressors.I have seen statements like that in BVA decisions.

If a combat vet say ‘I saw dead people during the war ’, this does not raise to stressor level as it is part of the nature of warfare.

If the vet however says ‘my buddy blew up in a land mine explosion’, that is a stressor and the VA can verify , with the Unit reports and deceased veteran’s name, that the veteran has a confirmed stressor.

“We took incoming’ – a usual nature of warfare-not a stressor

“Our unit lost 3 men during incoming at Danang in 1966 and one man was Sgt ---- who I knew ----.and I had to help them put these men into body bags. A stressor which can be confirmed.

‘Hanoi Hannah said we would be overcome by the weekend.’ Not a stressor.She lied all the time.

The enemy overtook our camp by the weekend and I had my first kill. A stressor- which unit reports could prove.

‘There was a horrific accident on the runway and they say 20 men were lost ‘. not a stressor

“I participated in recovery ops after there had been a terrible plane accident at the airport in Danang.20 men had died and no one survived.” A stressor that could be proven by the veteran’s MOS and unit reports.

Sometimes a veteran will not give the VA enough details as to the stressor and how it affected them.

This is just a pretty generic description of stressors but the VA holds to the DSM as to how they describe them.

Although the most difficult thing a PTSD can do is to recall in detail stressful events-whether stateside or in combat- as there are MANY reasons a veteran can have stressors and PTSD that have nothing to do with combat-

it is often the details that VA needs in order to confirm what the veteran described was consistent with the circumstances .

An example of what I mean is Swann V. Brown. The veteran was working at a USAF refueling air base in Vietnam and the air base was attacked by mortars.

He claimed this as a combat stressor.

The CAVC found that this did not constitute " engaging in combat" as the veteran could not rpove he was close to the mortars attacks and there had been no casualties.

Buddy statements have to be detailed too.One buddy statement I read that a vet I know got told the VA the exact detailed circumstances of the stressor, and how the buddy could verify that the claimant veteran was at this same stressor with him and the buddy even gave VA his C file number and told the VA they could check his C file if needed because he received PTSD comp for this same stressor event. The vet I knew had 6 buddys to contact- mainly to tell them they had received awards from the Vietnamese that they didnt know they got (long story -my daughter translated an Official Vietnamese document and they all got awards, one got the DFC) and ironically one buddy was able to confirm this stressor for one of them (actually the Vietnamese document citations would sure have awarded PTSD too to them all.)

Of 6 buddys =one had died and I think maybe they couldnt find one of them- it took this vet many months but he did reach 4 or 5 of them. This can be done.Buddys can be found.Simply googling their name as well as checking reunion rosters and going to unit web sites has made finding a buddy much easier than it used to be prior to the internet.

A Wall tracing too can be used to verify you lost a buddy in Vietnam. You have to search the Wall via buddy's hometown, unit , approx date of death and name.

Even at the moving Wall -with this information-they can find the exact panel where the Buddy's name is and you can provide a tracing of it as evidence for VA claims.

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Also One of our faithful listerners me reminded me to tell you that ALL General Court Martial Records ,if needed to prove PTSD due a personal assault, can be requested and obtained from the Clerk of Court JAG of the specific branch of service in Washington DC.

Also many personal assaults and MST (military Sexual Trauma claims) can be supported by medical records in the SMRs ,of course as well as by eye witness buddy statements as to an “outcry”-a report by the victim to them immediately after this type of event occurred.

Even Personnel records shpwing transfer to a different unit soon after claimed stressor can also support PTSD and personal trauma claims.

To get back to PTSD claims when the veteran was in combat but does not have the PH, CIB or CAR on his/her DD 214.

The vet should apply for a DD 215 as a correction if they feel these awards should be on the DD 214. (DOD Form 149)

Also they can writ to the JSRRC themselves. I advise this even when VA says to thm that JSRRC could not verify their stressor-

Vet recently – this scenario-

All Branches except for Marine Corps-

US Army and Joint Services Records Research Center

7701 Telegraph Rd,Kingman Building Room 2CO8

Alexandria VA. 22315-3802

1-703-428-6801

Marines-

Go to the Marine Corps University Archive Site http://www.mcu.usmc.mil/MCRCweb/Archive/

Or contact to the Commandant of the Marine Corps

Headquarters USMC Quantico toll free 1-800-268-3710

Fax 11-703-784-5792

[johnsoncm]

my question is that I was diagnosed with PTSD, that's both from a civilian neurologist and the VA claim I filed, but the VA said I only have PTSD to qualify for treatment not compensation. My PTSD is non combat related and I feel that I, and other vets with non combat PTSD are getting overlooked. Don't get me wrong, the men and women who were in the fighting and saw combat should definately be taken care of, but I feel like we are the lost vets because we have a real disease with a real diagnosis, but are not given the same credence as a combat vet. So really, my question is, how does the VA determine what kind of non combat trauma is significant enough to call it a PTSD stressor, especially given that stress affects different people in different ways?

[cowgirl]

Thank you Berta for presenting these facts and defining stressor so clearly. Proof of those type of psychosocial 'stressors' support PTSD as well as diagnoses of MST and Dysthymia, Anxiety, etc. but imho it takes the right Physician or Rater to confirm it.

My experience, written correspondence to family and freinds can also help validate stressors to the VA. A letter 'home' 'clinched' the personal effects of serious injury, threat and horror. The person wrote a simple statement confirming the letter and recalled affects on me, the veteran. The award decision referenced three sentences of the letter and 'validated' the stressor 20 years later. Odd, there was no specific reference to official medical or personnel records of injuries, hospitalizations or official actions to the incident(s).

Again, good post - only if I'd known this then....

Cowgirl

[Berta]

I put this into Claims Research too and added a little more there-

PTSD does not necessarily derive from combat:

PTSD due to typhoon

http://www4.va.gov/vetapp07/files3/0725407.txt

on remand(strong claim)

PTSD due to sexual assault granted

http://www4.va.gov/vetapp09/files3/0923254.txt

[cowgirl]

May I welcome you to Hadit if I haven't before? Thanks for posting, could be your post is someone elses question. From what I've learned and keep learning its the medical opinion that 'wins'. The medical opinion is a supported diagnosis, but sometimes I've percieved (or heard) the diagnosis different than what a doc, civilian or the VA wrote.

For instance a auto accident, on the job accident, incident can cause anxiety, depression.even though I think ptsd. So...do you get care from the VA now? what is your current diagnosis? depression with ptsd or what? do you have medical or personnel record confirming the 'ptsd' you feel? Ok, no need to answer here on the board unless you wish.

For many years I got wrapped up in trying to confirm my 'non-combat' ptsd, but was assigned depression diagnosis. The ptsd is in my records now but I learned to accept the VA or any mental health doc can apply a diagnosis for one or a number of things - but not always individually. I have a few mental health 'diagnosis's' if you will, but the VA seems to rate under the most compelling diagnosis (at least most compelling to them).

I agree, noncombat vets shouldnt be overlooked for their service nor 'compete' for VA support versus combat veterans. Imho the servicing agency is responsible to balance the scales for the clients. So, hang in there, keep at it, services are bound to change.

Best to ya,

Cg'up2009!

my question is that I was diagnosed with PTSD, that's both from a civilian neurologist and the VA claim I filed, but the VA said I only have PTSD to qualify for treatment not compensation. My PTSD is non combat related and I feel that I, and other vets with non combat PTSD are getting overlooked. Don't get me wrong, the men and women who were in the fighting and saw combat should definately be taken care of, but I feel like we are the lost vets because we have a real disease with a real diagnosis, but are not given the same credence as a combat vet. So really, my question is, how does the VA determine what kind of non combat trauma is significant enough to call it a PTSD stressor, especially given that stress affects different people in different ways?

[johnsoncm]

For instance a auto accident, on the job accident, incident can cause anxiety, depression.even though I think ptsd. So...do you get care from the VA now? what is your current diagnosis? depression with ptsd or what? do you have medical or personnel record confirming the 'ptsd' you feel? Ok, no need to answer here on the board unless you wish.

Thanks for the welcome. I am getting disability now at 20%. 10% for exercise induced asthma (a major part of the stressor argument, because I passed out from it once, they miss-diagnosed me and made me continue to run for about 6 months or so. Scared the heck out of me everytime, it's like almost drowning or running while breathing through a straw) and 10% for chronic thorasic strain with minimal scoliosis of the mid thoracic spine. The VA came back with PTSD as far as treatment goes, but said I had generalized anxiety disorder when it came to C&P. My medical records can confirm the back injury and asthma diagnosis, and the limited duty board I was put on for the asthma (which they canceled when they discovered I would EAS and not re-up)

[john999]

You can get 100% for GAD easier than a PTSD claim. If your C&P says you have GAD and it is related to your service then you don't need a verifiable stressor. PTSD, GAD, Panic Disorder are all anxiety disorders. The VA is fixated on PTSD and trying to make every vet prove a PTSD claim. You should read all you can about PTSD and decide if you have it. I think of PTSD as a person suffering some horrendous event ro events that are life threantening like combat or a major accident. However, other types of anxiety disorders may arise during service without such stressors. In some ways all these disorders are related and they all share symptoms. PTSD has the strictest criteria. The thing about PTSD is that you can SC it many years after discharge whereas the others it is more difficult unless you have SMR's that show treatment or symptoms.