ptsd 2010 Ptsd Regulations

[Berta]

Governing Laws and Regulations for PTSD

The establishment of service connection for PTSD has unique evidentiary requirements. It generally requires: (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a) (i.e., DSM-IV); (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304(f). See also Cohen v. Brown, 10 Vet. App. 128 (1997).

If it is established through military citation or other supportive evidence 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. 38 C.F.R. § 3.304(f)(2). See also 38 U.S.C.A. § 1154(b) and 38 C.F.R. § 3.304(d); Gaines v. West, 11 Vet. App. 353 (1998) (Board must make a specific finding as to whether the veteran engaged in combat). To gain the benefit of a relaxed standard for proof of service incurrence of an injury or disease, 38 U.S.C.A. § 1154(b) requires that the veteran have actually participated in combat with the enemy. See VAOPGCPREC 12-99.

If VA determines either that the veteran did not engage in combat with the enemy or that the veteran did engage in combat, but that the alleged stressor is not combat related, the veteran's lay testimony, by itself, is not sufficient to establish the occurrence of the alleged stressor. Instead, the record must contain credible supporting evidence that corroborates the veteran's testimony or statements. 38 C.F.R. § 3.304(f); Stone v. Nicholson, 480 F.3d 1111 (Fed. Cir. 2007); Cohen v. Brown, 10 Vet. App. 128, 147 (1997); Moreau v. Brown, 9 Vet. App. 389, 395 (1996).

However, corroboration of every detail of a claimed stressor, including the veteran's personal participation, is not required; rather, a veteran only needs to offer independent evidence of a stressful event that is sufficient to imply his or her personal exposure. See Pentecost v. Principi, 16 Vet. App. 124, 128 (2002) (quoting Suozzi v. Brown, 10 Vet. App. 307 (1997)). In other words, the veteran's presence with the unit at the time such attacks occurred corroborates his statement that he experienced such attacks personally. Suozzi v. Brown, 10 Vet. App. 307, 311 (1997).

The final requirement of 38 C.F.R. § 3.304(f) is medical evidence of a nexus between the claimed in-service stressor and the current disability. However, such after-the-fact medical nexus evidence generally cannot also be the sole evidence of the occurrence of the claimed stressor. Moreau, 9 Vet. App. at 396.

Effective July 13, 2010, if a stressor claimed by a veteran is related to that 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 PTSD and that a 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 that veteran's service, a veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304(f)(3) (2013).

"[F]ear 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. See id.

A veteran must have experienced, witnessed, or have been confronted by an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of that veteran or others, and that veteran's response to the event or circumstance must have involved a psychological or psycho-physiological state of fear, helplessness, or horror. The occurrence of an actual event or circumstance is necessary. In making this determination, VA must duly consider the places, types, and circumstances of a veteran's service as shown by the service record, the official history of each organization in which such a veteran served, a veteran's medical records, and all pertinent medical and lay evidence. The new rule is limited to cases in which the claimed stressor is related to a veteran's fear of hostile military or terrorist activity. See 75 Fed. Reg. 39843 (Jul. 13, 2010).

Source:http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp14/Files1

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[Pete53]

Thanks Berta

[Berta]

bumping it up

[john999]

You know those new PTSD regs. could just about connect any vet who is even close to a combat zone. If a vet is in a combat zone and hears an explosion or gunshots he/she is probably fearing that those bullets or bombs may be coming in their direction. From what I read that is enough for a PTSD stressor/DX. Am I getting this wrong?

[Berta]

Not wrong at all John.... this regulation was intended to help OND,OIF, and OEF vets.

And certainly could help combat vets of other wars, with proof of time and place, stressor etc.

The problem with this regulations ( and hundreds of us fought this and lost) was that the VA would only accept a diagnosis of PTSD from a VA MH professional for vet claimants falling under the timelines in the regulation.

But you are a Vietnam Vet John....like many of my friends and my husband was.

There was incoming sometimes on a daily basis and Hanoi Hannah alone could create 'fear of hostile activity."

My husband ( USMC Danang 64 to 65) was in many firefights,incoming , etc, but most of his stressors had nothing to do with the combat ( that is.... not the ones he told VA about)

they mainly involved the deaths he witnessed.....or caused.

Since Marines are amphibious, they ( 1srMarDiv, Amphibious Tracker Battalion 1964 July) were told to get out of the ship and amtraks and walk through the waves to get on to the shore of Vietnam.,.

They all were thinking of movies and documentaries about Operation Warlord ( Normandy Beach ) expecting to be cut down by the En as soon as they hit the sand.

Of course that didn't happen.

But I bet that alone was enough to give some of them the beginnings of PTSD, not to mention the day they DEROSed to the 'world' again, and were received by our ungrateful and disgraceful nation,with disdain.

Thank God the public is supportive, for the most part, of our war veterans now.

Now it is the VA itself that treats them with disdain and callous disregard for their sacrifice.

Edited May 23, 2014 by Berta

[john999]

That rule that says only VA can diagnose PTSD needs to be overturned pronto. My private shrink evaluates local police officers who have been involved in violent incidents for PTSD. The VA won't accept his expertise. This is a crime.

[Officemate24]

I have a hard time reading long things like this…. what if you weren't deployed? I was sent to be an instructor at one of the most realistic training facilities in the country. would this harm my claim for PTSD?