ptsd New Post Defining A Stressor

[Berta]

I guess the old links dont work.

These are notes from a SVR show I did that might help:

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 prove 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

[JT24usn]

http://www.scribd.com/mobile/doc/56836424

http://www.benefits.va.gov/WARMS/docs/admin21/m21_1/mr/part3/subptiv/pt03_sp04_TS_consolidated.doc

Look at the above link and find area where it starts TL 10-05. From there it will give information on the manual the va must use, or is supposed to use.

http://www.benefits.va.gov/WARMS/M21_1mr1.asp

Edited March 24, 2013 by T8r

[JT24usn]

If you had new and material evidence like a diagnosis of PTSD due to the assault.

[Berta]

2E151 I think that is a quote from a post I made on stressors.

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

This is the first time I've heard of the phrase "nature of war", doesn't that contridict the new PTSD guidelines?

I think this case explains it:

“The Veteran served in Vietnam and Iraq during wartime. In the rating decision and statement of the case, the RO's reason for denying the claim was that the Veteran did not actually witness the verified incident, and thus the stressor was not an event outside of the range of usual experience, or outside of the normal realm of war. See Criterion A, Posttraumatic Stress Disorder, DSM-IV. “

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp12/Files1/1200150.txt

The BVA remanded the claim

On REMAND, the RO must consider the amended criteria to VA's adjudication regulations governing service connection for PTSD, which provides that:

“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. “

This above claim fell under the new PTSD criteria.

The statement “we took incoming” is too general a statement and over the last 2 decades I have seen the BVA once in a while consider a vague statement like that as the 'usual nature of warfare 'and not a stressor.

If the veteran says 'we took incoming and my buddy was killed or we had many WIAs in our unit,' this is something that can be verified and is a stressor.

As the BVA defines it, above:

“thus the stressor was not an event outside of the range of usual experience, or outside of the normal realm of war. See Criterion A, Posttraumatic Stress Disorder, DSM-IV. “

This vet had what appeared to be a very strong stressor. The remand wanted the RO to re- look at the stressor and any proof of it, to see if it was an actual stressor.

There is no diagnosis if PTSD,

Does a AXIS I diagnosis of PTSD from the VA mean a nexus has been conceded?

NO.