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Stressed Over Stressor Letter; Near Done; Advice?

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cowgirl

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  • HadIt.com Elder

After too many years a 4 page stressor letter near done; any last minute advice?

Letter organized with miitary history, major stressors; attachments lettters,reports, diagnosis,Cfile.SMR etc.

Thanks and pray for me..cg

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  • HadIt.com Elder

Is this a Military Sexual Trauma (MST) claim or combat stressors claim? There are some differences ... Sounds like you had your claim denied as NWG some time back. Are you re-opening with "new and material evidence"? ~Wings

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  • HadIt.com Elder
my first claim listed lots of stuff, but this claim is specific to current VA diagnosis and is more direct. MST, how descriptive, factual or factual plus descriptions? Only want to do minimal description, very stressful otherwise. thanks. cg

MST is a term that has evolved since I filed my claim (1999). It helps to know this information when you need to research current laws, treatment, etc. I'm not gonna ask you to share details. I think it's a mistake to share trauma details over the net: that's what counselors are for! Sounds like you are feeling more confident about this claim than last. If you have a current diagnoses, and the first claim lacked this evidence, you are in a better position. You already know that you are going to need evidence of trauma(s); however, MST claims do allow for "alternative evidence" (see below). I don't know if this is a claim for PTSD or other mental health problems, but I would definately list all my psychiatric diagnoses ie depression, anxiety, panic, etc. Sometimes the VA will service connect (for example) major depression or eating disorder before PTSD, but they are all related to the original wound! Let me know if there's anything more I can do. ~Wings, woman vet

Alternative Evidence. If the military record contains no documentation that a personal assault occurred, alternative evidence might still establish an in-service stressful incident. Examples of such evidence include, (but are not limited to):

Records from law enforcement authorities

Records from rape crisis centers, hospitals, or physicians

Pregnancy tests or tests for sexually transmitted diseases, and

Statements from family members, roommates, fellow service members or clergy.

Behavior Changes. Behavior changes that occurred at the time of the incident may indicate the occurrence of an in-service stressor. Examples of such changes include (but are not limited to):

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

Sudden requests for a change in occupational series or duty assignment without other justification

Increased use or abuse of leave without an apparent reason, such as family obligations or family illness

Changes in performance and performance evaluations

Episodes of depression, panic attacks, or anxiety but no identifiable reasons for the episodes

Increased or decreased use of prescription medications

Increased use of over-the-counter medications

Substance abuse such as alcohol or drugs

Increased disregard for military or civilian authority

Obsessive behavior such as overeating or undereating

Unexplained economic or social behavior changes, and

Breakup of a primary relationship.

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WOW -I am impressed with the way you have done this with the help of Wings-

CUDDOS to you both- if civs are allowed to salute I salute you both-

I wish with all my heart that this type of claim never had to be filed.

And hope that you are properly compensated for this---

I had a claim like this from a vet some years ago-it was difficult to get the whole story-he kept breaking down-yes ---he--- this crime can happen regardless of one's sex and regardless of anything at all-

I got a remedy for these criminals but -----

you have both done such an excellent job here-

I also hope that all this might reach others out there who went through anything like this and it will inspire them to know -this is NOT their fault in any way, it should not have happened ,and they can be compensated for it.

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  • HadIt.com Elder

Thanks Wings, minimum of 8 confirmed items. Question? Once submitted, does the claim&stressor letter become part of my Cfile? Thanks, "On eagles wings ~" cg

Dear Sister CG, When you write your "letter", be sure to reference your attachments. You have to write for your audience: think kindergarden - 3rd grade LOL! Seriously, you write the story, give the details/facts and then say (see attachment #1). Lay out your evidence in linear time. Yes, the stressor letter is kept with your C-File, never destroyed. In retrospect, it's your personal history - you need not be ashamed, ever. Keep fighting. HUGS! ~Wings

M21-1MR http://www.warms.vba.va.gov/M21_1MR.html

Subpt IV - General Rating Process, Chapter 4 - Rating Specific Disabilities, Section H - Mental Disorders

Deciding a Claim for Service Connection for PTSD

Introduction

This topic contains information about deciding a claim for service connection for PTSD, including

· considering stressors when making the decision

· determining combat service

· considering

- secondary evidence, and

- participation in operations or campaigns

· the requirement for credible supporting evidence

· identifying credible supporting evidence of a non-combat stressor

· reviewing evidence for corroboration of a stressor

· examples of credible supporting evidence to corroborate a claimed in-service stressor

· determining link between in-service stressor and diagnosis

· making a decision, and

· requesting evidence from JSRRC, NARA, or the Marine Corps.

a. Considering Stressors When Making the Decision

When determining the occurrence of stressors to establish service connection for PTSD, consider the following:

· PTSD does not need to have its onset as a result of combat (for example, vehicular or airplane crashes, large fires, floods, earthquakes, and other disasters evoke significant distress in most involved persons)

· the trauma may be experienced alone, such as in cases of rape or assault, or in the company of groups of people, such as in military combat

· do not limit a stressor to just one single episode; a group of experiences also may affect an individual, leading to the development of PTSD

· PTSD can be caused by events that occur before, during, or after service, and

· PTSD can develop hours, months, or years after a stressor.

Notes:

· The relationship between stressors during military service and current problems/symptoms will govern the question of service connection.

· Despite the possibly long latent period, PTSD may be recognizable by a relevant association between the stressor and the current presentation of symptoms.

Important: Symptoms must have a clear relationship to the military stressor as described in the medical reports.

b. Determining Combat Service

Every decision involving the issue of service connection for PTSD that allegedly developed as a result of combat must include a factual determination as to whether or not the veteran was engaged in combat, including the reasons or bases for that finding.

Important: In order to conclude that a veteran “engaged in combat with the enemy,” the evidence must establish that the veteran was present during an encounter with a military foe either as a combatant or as a service member performing duty in support of combatants.

Notes:

· There are no limitations as to the type of evidence may be accepted to confirm engagement in combat. Any evidence that is probative of (serves to establish the fact at issue) combat participation may be used to support a determination that a veteran engaged in combat.

· Determining whether evidence proves a veteran developed PTSD as a result of combat-related stressors requires an evaluation of all evidence in the case, including

- an assessment of the credibility of the evidence, and

- whether the evidence can establish that the stressful event occurred.

· Apply the benefit-of-the-doubt standard if the evidence is in equipoise.

References: For more information on

· the need to determine combat involvement in PTSD claims, see Gaines v. West, 11 Vet. App. 113 (1998), and

· what evidence may be used to support a determination that a veteran engaged in combat, see VAOPGCPREC 12-99.

c. Considering Secondary Evidence

Although secondary evidence may be used to confirm engagement in combat, it must be critically and carefully reviewed for sufficiency.

Note: In many instances, secondary evidence does not constitute competent evidence to support such a determination.

Reference: For more information on secondary sources of evidence, see M21-1MR, Part III, Subpart iv, 4.H.29.h.

d. Considering Participation in Operations or Campaigns

Generally, reference to a veteran’s participation in a particular “operation” or “campaign” will not, by itself, confirm engagement in combat. However, there may be circumstances in which the language and context of the reference does reflect combat participation.

e. Requirement for Credible Supporting Evidence

The requirement for credible supporting evidence means that there must be some believable evidence that tends to support the veteran’s assertion. In determining whether evidence is credible, consider its

· plausibility

· consistency with other evidence in the case, and

· source.

Note: Credibility is only a minimum requirement. (Evidence that is not believable is not entitled to any weight.) In addition to being credible, evidence must also

· be material or probative to the issue, and

· have enough weight to persuade the decision-maker that the stressor is sufficiently verified with some degree of specificity.

f. Identifying Credible Supporting Evidence of a Non-Combat Stressor

If the claimed stressor is not combat-related, a claimant’s lay testimony regarding in-service stressors

· is not sufficient, by itself, to establish the occurrence of the stressor, and

· must be corroborated by credible supporting evidence.

Credible supporting evidence of a non-combat stressor may include

· service medical or personnel records

· private medical records

· lay statements, or

· newspaper accounts of the traumatic event.

Example: SMRs may contain record of the veteran’s medical treatment after an accident.

g. Reviewing Evidence for Corroboration of a Stressor

There is no requirement in VA statutes or regulations that corroboration must, and may only, be found in official documentary records. In most cases, however, this type of evidence will serve as the most reliable source of stressor verification.

When reviewing evidence for corroboration of a claimed stressor(s),

· carefully analyze the most reliable sources of evidence first, and

· if these sources do not contain the necessary information, review secondary sources of evidence carefully and critically for their adequacy and reliability.

Note: Generally, documents written or recorded by the lowest possible unit in the chain of the command are the most probative source of information to verify a claimed stressor, because they tend to include details of events with greater precision. Examples:

· A company commander’s narrative is likely of greater relevance and specificity than a battalion commander’s, and

· a Navy ship’s deck log would likely yield more probative information than a fleet log.

h. Examples of Credible Supporting Evidence to Corroborate a Claimed In-Service Stressor

The following court cases include examples of evidence found to be sufficient to meet the requirement of credible supporting evidence to corroborate a claimed in-service stressor:

· In Pentecost v. Principi, 16 Vet. App. 124 (2002), the veteran claimed as stressors the occurrence of rocket attacks while he was stationed in Da Nang in 1967 and 1968. Unit records obtained in support of the claim contained descriptions of rocket attacks occurring while the veteran was stationed at Da Nang in January 1968.

· In Suozzi v. Brown, 10 Vet. App. 307 (1997), the veteran claimed as his stressor the events of May 2, 1967, when his company came under attack, taking heavy casualties. He and a lieutenant had to identify the bodies of those killed. The veteran recalled being sick for days after this, and SMRs confirmed he received medical attention for several days thereafter. The veteran later submitted a morning report and a radio log corroborating the events of that day. The lieutenant who assisted in identifying the bodies signed the morning report, and the radio log confirmed that the veteran’s company had come under big attack and had taken a lot of casualties. The logs did not specifically name the veteran but included the names of his superiors, who later nominated the veteran for a Bronze Star.

i. Determining Link Between In-Service Stressor and Diagnosis

Establish service connection for PTSD only where the examination and supporting material indicate a link between current symptoms and a verified in-service stressful event(s).

j. Making a Decision Use the table below when making a decision regarding service connection for PTSD.

If … Then …

the claimant has failed to provide a minimal description of the stressor, such as an indication of the time or place of a stressful event deny the claim on that basis.

Note: The rating decision should note the previous request for information.

· the veteran has provided at least a minimum description of the stressor, such as approximate time, place, and unit, and

· the records contain prima facie evidence of a PTSD diagnosis, such as

- outpatient treatment reports showing treatment for PTSD or PTSD symptoms, or

- the veteran’s description of symptoms indicative of PTSD.

request additional evidence from JSRRC, NARA, or the Marine Corps, as appropriate.

Important: Do not schedule a VA examination before receiving corroboration of the claimed stressor from JSRRC, NARA, or the Marine Corps.

Note: JSRRC researches Army, Navy, Air Force, and Coast Guard records only.

Reference: For more information on requesting evidence from JSRRC, NARA, or the Marine Corps see

M21-1MR, Part IV, Subpart ii, 1.D.15.

j. Making a Decision (continued)

If … Then …

a VA medical examination fails to establish a diagnosis of PTSD deny the claim on that basis.

Note: If the existence of a stressor has not been determined, do not include a discussion of the alleged stressor in the rating decision.

k. Requesting Evidence from JSRRC, NARA, or Marine Corps

A denial solely because of an unconfirmed stressor is improper unless

· the veteran has failed to provide the basic information required to conduct research, or

· JSRRC, NARA, or the Marine Corps, as appropriate, has confirmed that the claimed stressor cannot be verified.

If JSRRC, NARA, or the Marine Corps requests a more specific description of the stressor in question, immediately ask the veteran to provide the necessary information. If the veteran provides a reasonably responsive reply, forward it to the requesting agency. Failure of the veteran to respond substantively to the request for information will be grounds to deny the claim based on an unconfirmed stressor.

Reference: For more information, see M21-1MR, Part IV, Subpart ii, 1.D.15.

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  • HadIt.com Elder

Wings excellent advice. As we all know once it goes in your C File it is buried forever cause hardly anyone at VA reads the file

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