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Trucker

Ptsd Criteria?

Question

Looking for criteria on ptsd, I've been through the foum and havn't found this answer, can an event (mulitple attempted suisides) by a family member during my time in service be used in my claim for ptsd. I have military evedence also. This led to a hardship discharge and one inpatient stay while in service. If this can be used I can produce 15 year medical history. And I have dealt with the anxiety through hard manual labor, which makes me feel better than the medicine I'm on, is this a positive or a negitive?

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If you are asking if your sister's (or whomever) attempted suicide attemps, while you were in the service, is enough to get you PTSD, nope, don't thiiiiink so.

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No- I agree with Larry on that- the PTSD criteria (old and new one) is in our PTSD forum below this one.

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Looking for criteria on ptsd, I've been through the foum and havn't found this answer, can an event (mulitple attempted suisides) by a family member during my time in service be used in my claim for ptsd.

trucker,

NO - their attempted suicide in no way put your life in danger.

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http://www.ptsd.va.gov/professional/pages/dsm-iv-tr-ptsd.asp

DSM-IV-TR criteria for PTSD

In 2000, the American Psychiatric Association revised the PTSD diagnostic criteria in the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)(1). The diagnostic criteria (A-F) are specified below.

Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning.

Criterion A: stressor

The person has been exposed to a traumatic event in which both of the following have been present:

  • The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
  • The person's response involved intense fear,helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.
    Criterion B: intrusive recollection
    The traumatic event is persistently re-experienced in at least one of the following ways:

    • Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
    • Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content
    • Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes,including those that occur upon awakening or when intoxicated). Note: in children, trauma-specific reenactment may occur.
    • Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
    • Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
      Criterion C: avoidant/numbing
      Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:

      • Efforts to avoid thoughts, feelings, or conversations associated with the trauma
      • Efforts to avoid activities, places, or people that arouse recollections of the trauma
      • Inability to recall an important aspect of the trauma
      • Markedly diminished interest or participation in significant activities
      • Feeling of detachment or estrangement from others
      • Restricted range of affect (e.g., unable to have loving feelings)
      • Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

      Criterion D: hyper-arousal

      Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:

        [*]Difficulty falling or staying asleep[*]Irritability or outbursts of anger[*]Difficulty concentrating[*]Hyper-vigilance[*]Exaggerated startle response

        Criterion E: duration

        Duration of the disturbance (symptoms in B, C, and D) is more than one month.

        Criterion F: functional significance

        The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

        Specify if:

        Acute: if duration of symptoms is less than three months

        Chronic: if duration of symptoms is three months or more

        Specify if:

        With or Without delay onset: Onset of symptoms at least six months after the stressor

        References

        • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author.

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Looking for criteria on ptsd, I've been through the foum and havn't found this answer, can an event (mulitple attempted suisides) by a family member during my time in service be used in my claim for ptsd. I have military evedence also. This led to a hardship discharge and one inpatient stay while in service. If this can be used I can produce 15 year medical history. And I have dealt with the anxiety through hard manual labor, which makes me feel better than the medicine I'm on, is this a positive or a negitive?

First, the disclaimers: This isn't a legal or medical opinion, just the opinion of some guy on the Internet. Void where prohibited. Cash value less than 1/20 of a cent. Not transferable.

Second: Can a Veteran whose claimed in-service stressor is "multiple attempted suicides by a family member" present a well-grounded VA disability claim?

It depends. I've attached 38 CFR 3.304(f), 38 CFR 4.125, and DSM-IV 309.81 (PTSD) below, but let's focus on the first part.

Posttraumatic stress disorder. Service connection for posttraumatic stress disorder requires medical evidence diagnosing the condition in accordance with §4.125(a) of this chapter; a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred.

It appears that in order to prevail, the Veteran would need:

1. A current diagnosis of PTSD which conforms to the DSM-IV and is supported by the findings on the examination report, and

2. A link, established by medical evidence, between the current symptoms and the claimed in-service stressor, and

3. Credible supporting evidence that the claimed in-service stressor occurred.

With regard to the stressor, let's look at 309.81: "the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others."

Do the Veteran's family member's multiple attempted suicides meet this criterion? If so, then those attempts could be the "in-service stressor" which (in conjunction with a current PTSD diagnosis, medical evidence connecting the diagnosis to the stressor, and credible supporting evidence that the stressor occurred) upon which a well-grounded PTSD claim could be based.

I don't want to discuss hypothetical "qualifying" and "unqualifying" scenarios, because 1) those are ultimately matters of opinion about which reasonable people might disagree, and 2) such posts might be "triggers" for some of our fellow Veterans.

Good luck,

Bill

_________________________________

(f) Posttraumatic stress disorder. Service connection for posttraumatic stress disorder requires medical evidence diagnosing the condition in accordance with §4.125(a) of this chapter; a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. The following provisions apply to claims for service connection of posttraumatic stress disorder diagnosed during service or based on the specified type of claimed stressor:

(1) If the evidence establishes a diagnosis of posttraumatic stress disorder during service and the claimed stressor is related to that service, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor.

(2) If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor.

(3) If a stressor claimed by a veteran is related to the veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of posttraumatic stress disorder and that the veteran's symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. For purposes of this paragraph, “fear of hostile military or terrorist activity” means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veteran's response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror.

(4) If the evidence establishes that the veteran was a prisoner-of-war under the provisions of §3.1(y) of this part and the claimed stressor is related to that prisoner-of-war experience, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor.

(5) If a posttraumatic stress disorder claim is based on in-service personal assault, evidence from sources other than the veteran's service records may corroborate the veteran's account of the stressor incident. Examples of such evidence include, but are not limited to: records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals, or physicians; pregnancy tests or tests for sexually transmitted diseases; and statements from family members, roommates, fellow service members, or clergy. Evidence of behavior changes following the claimed assault is one type of relevant evidence that may be found in these sources. Examples of behavior changes that may constitute credible evidence of the stressor include, but are not limited to: a request for a transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifiable cause; or unexplained economic or social behavior changes. VA will not deny a posttraumatic stress disorder claim that is based on in-service personal assault without first advising the claimant that evidence from sources other than the veteran's service records or evidence of behavior changes may constitute credible supporting evidence of the stressor and allowing him or her the opportunity to furnish this type of evidence or advise VA of potential sources of such evidence. VA may submit any evidence that it receives to an appropriate medical or mental health professional for an opinion as to whether it indicates that a personal assault occurred.

§ 4.125 Diagnosis of mental disorders.

(a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by the findings on the examination report, the rating agency shall return the report to the examiner to substantiate the diagnosis.

(b) If the diagnosis of a mental disorder is changed, the rating agency shall determine whether the new diagnosis represents progression of the prior diagnosis, correction of an error in the prior diagnosis, or development of a new and separate condition. If it is not clear from the available records what the change of diagnosis represents, the rating agency shall return the report to the examiner for a determination.

309.81 DSM-IV Criteria for Posttraumatic Stress Disorder

A. The person has been exposed to a traumatic event in which both of the following have been present:

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.

(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma

(2) efforts to avoid activities, places, or people that arouse recollections of the trauma

(3) inability to recall an important aspect of the trauma

(4) markedly diminished interest or participation in significant activities

(5) feeling of detachment or estrangement from others

(6) restricted range of affect (e.g., unable to have loving feelings)

(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

(1) difficulty falling or staying asleep

(2) irritability or outbursts of anger

(3) difficulty concentrating

(4) hypervigilance

(5) exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:

Acute: if duration of symptoms is less than 3 months

Chronic: if duration of symptoms is 3 months or more

Specify if:

With Delayed Onset: if onset of symptoms is at least 6 months after the stressor

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