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Best Practice Manual For Ptsd C & P Exam


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Oh, this is just dandy for those who were in combat and or got sexually assaulted... doesnt say squat about those who were physically assaulted!!!


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Oh, this is just dandy for those who were in combat and or got sexually assaulted... doesnt say squat about those who were physically assaulted!!!



Sure it does - vets that were physically assaulted are included in this - apparently you missed it.

"III. Recommended Guidelines for Assessing Trauma Exposure and PTSD

A. Trauma Exposure Assessment

A.1. Objective. Compensation and pension examinations routinely address PTSD resulting from combat exposure.

However, many other forms of military- related stress are sufficient to induce PTSD and should be reviewed among veterans applying for service-connected disability benefits.

Non-combat forms of military-related trauma that are not uncommon include sexual assault or severe harassment;

non-sexual physical assault; duties involved in graves registration or morgue assignment; accidents involving injury, death, or near death experi- ences; and actions associated with peace-keeping deployments that meet the DSM-IV stressor criterion.

The objective of trauma assessment is to document whether the veteran was exposed to a traumatic event, during military service, of sufficient magnitude to meet the DSM-IV stressor criterion, described below."


(2) Evidence of Personal Assault.

Personal assault is an event of human design that threatens or inflicts harm. Examples of this are rape, physical assault, domestic battering, robbery, mugging, and stalking. If the military record contains no documentation that a per-sonal assault occurred, alternative evidence might still establish an in-service stressful incident.

Behavior changes that occurred at the time of the incident may indicate the occurrence of an in-service stressor.

Examples of behavior changes that might indicate a stressor include (but are not limited to):

Visits to a medical or counseling clinic or dispensary without a specific diagnosis or specific ailment;

Sudden requests that the veteran’s military occupational series or duty assignment be changed without other justification;

Appendix C: Excerpts From VBA’s Adjudication Procedures Manual Concerning The Adjudication Of Claims For PTSDCompensation and Pension Examinations


Lay statements indicating increased use or abuse of leave without an apparent reason such as family obligations or family illness;

Changes in performance and performance evaluations;

Lay statements describing episodes of depression, panic attacks, or anxi- ety but no identifiable reasons for the episodes;

Increased or decreased use of prescription medications; • Increased use of over-the-counter medications; • Evidence of substance abuse such as alcohol or drugs; • Increased disregard for military or civilian authority;

Obsessive behavior such as overeating or undereating;

Pregnancy tests around the time of the incident;

Increased interest in tests for HIV or sexually transmitted diseases;

Unexplained economic or social behavior changes;

Treatment for physical injuries around the time of the claimed trauma but not reported as a result of the trauma; and

Breakup of a primary relationship.

In personal assault claims, secondary evidence may need interpretation by a clinician, especially if it involves behavior changes. Evidence that documents such behavior changes may require interpretation in relationship to the medical diagnosis by a VA neuropsychiatric physician.

(3) Credible Supporting Evidence.

A combat veteran’s lay testimony alone may establish an in-service stressor for purposes of service connecting PTSD (Cohen v. Brown, 94-661 (U.S. Ct. Vet. App. March 7, 1997)). However, a noncombat veteran’s testimony alone does not qualify as “credible supporting evidence” of the occurrence of an inservice stressor as required by 38 CFR 3.304(f). After-the-fact psychiatric analyses which infer a traumatic event are likewise insufficient in this regard (Moreau v. Brown, 9 Vet. App. 389 (1996)).

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Thnx carlie!!


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