Sexual assault occurred after military service and high sexual risk behavior due to PTSD

[DSIG]

I'm not sure where to post this because it's not MST but is about sexual trauma and is also a sensitive topic.  This article details a study that was conducted on Veterans who have PTSD and also exhibit sexual risk behavior https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684959/

PTSD can result in high risk behavior such as promiscuity.  I'm service connected for PTSD and was sexually assaulted after I was discharged from the military.  I was service-connected rated for PTSD at 70% in 2012.  The sexual assault happened in 2017.  I recently filed for a PTSD increase.  In my DBQ and nexus letter, my treating physician of 11 years talked about my high risk behavior broadly but also documented the sexual assault to show the relationship between high risk behavior and sexual assault.  I also told the C&P examiner that I felt that my promiscuity resulted in the sexual assault.

Again, not sure if this is the right forum.  I wanted to ask how the VA may perceive this relationship and do they look at claims seriously that document sexual assault.  Has anyone experienced this or is aware of any documented cases.  Unfortunately, high risk sexual behavior in veterans who have PTSD is alarmingly an issue and uncomfortable to admit and also to discuss.  

[broncovet]

Im pretty sure PTSD is rated the same as MST.  They are both rated on "symptoms" once service connected.  Generally, the "symptoms" of the criteria for rating mental health disorders are in 2 categories:

1.  Symptoms which affect employment, (occupationals).  

2.  Social symptoms, such as the inability to get along with others.  

      For mental health conditions, "all" disorders are lumped into one and rated the same way: Occupational and social impairment, once SC.  

Pyramiding prevents being compensated for any one twice.  Example:  Lets say you have PTSD and bipolar disorder.  Lets further assume, for this example, that you have the symptom, "anxiety attacks" (panic attacks).  You wont get paid for those twice, only once.  

[Banned]

I'm not signing on to this one, I just don't see it.

The Military caused me to take risks that I normally would not have taken otherwise, i.e., promiscuity.

Following this logic, as an example,

I leave the Military, and 10 years later, and because of what happened to me in the military and where they sent me, I have no fear and accept the risk of going into a shady place.  While there, I get my ass handed to me and end up loosing the use of my right leg. 

Now I should be able to claim my loss of use, right leg, because the Military trained me to take risks.

I don't see it, but I could be all wet,

Hamslice

There has to be some limit to cause and effect, or we will be going down into a deep hole.

[DSIG]

Hamslice,

There is extensive scientific research on the relationship between PTSD and high risk behavior.  See enclosed document.

I was asking to what extent if any does the VA consider this relationship.

With all due respect, just because you don’t agree on a behavior or the relationship of it to PTSD you should at least consider the science first just as much as scientific evidence and not moral judgment should be the VA’s basis for deciding a rating.

DSIG

nihms867653.pdf

[Banned]

DSIG,

I do not doubt the science,

I just don't see the VA opening that can of worms and where it would lead.

There is a mountain of evidence to prove that young Veterans buy more motorcycles, and therefore, take more risks.

It is the first question on the psychological test for becoming an Officer in the Army, or at least OCS (Officer Candidate School).

1. Do you like to ride motorcycles, yes or no.

Almost everyone gets it wrong.  The correct answer is no, because, yes means you take risks.  I answered yes, but still passed.

So, yes, I agree with the science, just not the premise,

Hamslice

 

[Banned]

There was an actual case were the spouse was trying to get DIC after her husband died in a motorcycle accident.  He was not in the service, but she felt that his service connected PTSD cause him to drive fast (risky), etc., if I remember correctly.

I do not know how that ended and am still looking for it, but it would fit,

Hamslice

[Banned]

https://www.va.gov/vetapp15/Files2/1513239.txt

We'll, I was close.  He was suicidal and suffered from depression.  The family went through the trouble of getting PTSD added to his death certificate, which previously stated trauma from the accident.  I don't know how they did that, but, it didn't matter.  It was denied.

And I like how the board said PTSD and or Depression, same thing, don't matter.  I think she lost before she started, as they (VA) were not going to open the can (of worms). 

Remember, if they are going to pay DIC, then they would pay for compensation.  So, in the above case, if she would have prevailed, then the same would be said if he hadn't died and instead lost his leg(s).  He could claim his lost legs secondary to his PTSD, or Depression in this instance, due to a motorcycle accident 10-20 years after service.

FWIW,

Hamslice

 

[DSIG]

It's been a while since I took my oath as an Army Officer but I don't remember the part about the motorcycle question.  All joking aside, I understand what you are saying about the causal link between risk, motorcycle and accidents but  you can also do a risk assessment and mitigate the risk by wearing a helmet.  There are no such risk assessments your mind can process against the risk behaviors inherent with these mental disorders and the only real risk mitigation you have is therapy.  

I read the decision that you posted and noticed it was based on facts, even though the VA empathized with the appellant.   The appellant knew she didn't have a case an added PTSD to the death certificate, which was the incorrect service-connected disability anyway, as stated in the decision.   The facts about the veteran's view on suicide spoke for themselves.  It really comes down to facts and science, as I previously noted.  

Edited February 24, 2021 by DSIG (see edit history)

[broncovet]

In reference to VA benefits, I will try to make it simple:  Its all about what the doctor's report says.  As always, for Service connection you need the Caluza elements, for an increase, you need to demonstrate additional symptoms that were not noted in previous exams, and that those increased symptoms approximated the "next higher" criteria level.  

Im not going to opine whether or not PTSD's "high risk behavior increase" resulted in promiscuity.  My opinion on that wont matter, anyway.  You need to discuss this with a doctor, and if he agrees with your assessment, or other wise provides favorable evidence, then send VA that exam.  

As with most Vets, it often takes an independent medical opinion, (IMO) or independent medical exam (IME) to refute any VA doctors negative opinions in your file.  If doctors "did not opine" on your issue, then you would need an opinion linking your current diagnosis either to military service, or to an already SC condition, such as PTSD.  

You stated you were 70 percent PTSD in 2010.  To get an increase in your rating to 100 percent for mental disorders only (including PTSD, MST, depression or any other disorder you are diagnosed with RELATED TO SERVICE, you would need to demonstrate "Total OCCUPATIONAL and Social IMpairment".  Source: https://www.law.cornell.edu/cfr/text/38/4.130

Specifically, the critieria for 100 percent for mental disorders (PTSD, MDD, MST etc) is indicated in the link, above.  

Further, if you are unable to work due to SC condtions, (as evinced by a doctor), you should be eligible for TDIU under 38 CFR 4.16:

https://www.law.cornell.edu/cfr/text/38/4.16

   My advice, if your goal is to increase your VA benefits, is to check the links, above, and to check your medical records to see if the evidence is already there.  If evidence is lacking to support 100 percent, then you would likely need an IMO or IME to get there.  

    An additional diagnosis, such as MST probably would not help you get to 100 percent "unless" you had additional symptoms documented, likely a key one is did your MST prevent you from obtaing and maintaing SGE (substantial gainful employment).  

     Its my opinion that, unless you are not working (or earn less than the poverty level about 11,000 per year) , you are unlikely to get 100 percent even if you were diagnosed with MST and even more mental health disorders.  Reason:  Pyramiding prevents you from being compensated for a symptom TWICE.  As an example, if you are SC for PTSD for symptoms of anxiety, inability to get along with others, etc., and you get rated for MST, then you wont get paid for the same symptom twice.  You have to have "new symptoms" you were not already compensated for with PTSD, and those new symptoms need to meet the TOTAL OCCUPATIONAL AND SOCIAL IMPAIRMENT as so stated in the critieria.  The VA has no choice but to rate you ON THE CRITERIA published. 

 

Edited February 24, 2021 by broncovet (see edit history)

[Buck52]

About all you can do is file for it and wait for the decision

Veterans can claim PTSD years after his/her military service   simply because a lot of Veterans are in denial about this Mental Health Issue

And tired of coping with it and having marital /family problems/struggles

He/She would still need to prove his stressors  (what happen/ date/ time  or close to it the trauma event took place ,his unit and company commanders name/rank  If the VA checks this all out and has merit and if approved  his claim would start the date the VA Received it.

I would say the odds are against an approval...its very hard to get claims approved  if something happen after Military service

In other words if you were approved for PTSD After your military service   and anything that happens after that  would not be service connected...ALL Veterans need to be service connected to file for compensation...if you were diagnose with PTSD After Military service and had this Issue come up   then they would denied because it was not military related  although you may have a dx FOR PTSD @70%  THE EVENT TOOK PLACE AFTER YOUR MILITARY SERVICE  THEREFORE DEINED FOR THIS REASON.

However a  smart attorney maybe able to get you though the loop hole  as to prove your 70% PTSD has worsen  but he would have a hill to clime (jmo)

Edited February 24, 2021 by Buck52 (see edit history)

[broncovet]

Buck, this Veteran did not state in her posts, whether or not she was working.  If she is unable to work due to sc conditions, she should be increased to 100 percent or TDIU regardless of whether her symptoms were attributed to PTSD, or to MST or other mental disorders.  The criteria is mostly about its affect on employment.  

[Buck52]

Right I understand that  but in this case its similar to the Motor Cycle Accident that caused a veterans death  who also was diagnosed  for PTSD...he was doing stunts on his motor cycle  or showing off  his widow filed for DIC due to she says it was his PTSD that made his behavior act out this trauma event that took his life   according to hamslice  she lost her case.

she maybe diagnosed for PTSD after military service and this event or what ever the reason is for the increase would not be military related  although she may have a 70%diagnose  but anything that happens after military would not fly

 

Like me I have a 70% Dx for combat trauma ...I could possibly be increase if my PTSD CAUSED ME TO BE DEPRESSED  NO i CAN'T with this  we can't have two mental health claims...BUT something like this in her case would be hard to prove  only a Qualified Dr would need to state her increase would be caused by/RELATED to her dx 70% PTSD THAT SHE IS CLAIMING

It would be hard to find a Dr in his right mind that would give a favorable opinion on this type of increase

Being a ' promiscuity''person can cause all types of ailment's/diseases...from depression cancer to heart disease   not to mention STD's 

They would need to prove being a Promiscuity  Person  PTSD would be related to or caused these other problems.

[Buck52]

I would think a Dr would need to show a Contributing factor  that is caused by  or related to her PTSD that caused the problem or problems she is claiming.she would need to prove it was her SERVICE CONNECTED CONDITION (PTSD) was the cause of her to be a ' promiscuity''person after military service

It would be a lot easier if she had records/documents of the promiscuity '' during her military (jmo)

Edited February 24, 2021 by Buck52 (see edit history)

[DSIG]

Broncovet and Buck52 thank you for your feedback.

 

My private non-VA treating physician of 11 years specified high risk behavior broadly in the narrative or nexus part of his report and also documents the sexual trauma in the DBQ. There is no mention of promiscuity and he doesn’t make an inference between the high risk behavior and the sexual assault. He explained in a session to me that the VA rater should understand that high risk behavior is a manifestation of PTSD.  I told the C&P examiner that I felt that my promiscuity resulted in the sexual assault.  It’s up to the doctors to present the facts and the VA examiners to make the inference, but that’s not always intuitive to the VA.

 

I want to note that evidence of high risk behavior is not the only evidence in my claim for an increase and is not intended to be used as a sole basis for deciding on the increase.

 

My doctor also specified OCD as a secondary condition in the DBQ, which is a condition not present or documented back in 2012.

 

The disability description for my 70% rating from 2012 is PTSD with Major Depressive Disorder.

 

If it’s helpful I can upload for your review a redacted copy of my doctor’s report and DBQ which were submitted as evidence.

[DSIG]

In the appeal decision that hamslice posted the veteran’s widow did not allege that the veteran was speeding due to his service connected disability. She alleged that the motor vehicle accident was a suicide and the VA refuted it with evidence from the veteran’s treating doctor.

[pacmanx1]

21 hours ago, DSIG said:

I'm not sure where to post this because it's not MST but is about sexual trauma and is also a sensitive topic.  This article details a study that was conducted on Veterans who have PTSD and also exhibit sexual risk behavior https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684959/

PTSD can result in high risk behavior such as promiscuity.  I'm service connected for PTSD and was sexually assaulted after I was discharged from the military.  I was service-connected rated for PTSD at 70% in 2012.  The sexual assault happened in 2017.  I recently filed for a PTSD increase.  In my DBQ and nexus letter, my treating physician of 11 years talked about my high risk behavior broadly but also documented the sexual assault to show the relationship between high risk behavior and sexual assault.  I also told the C&P examiner that I felt that my promiscuity resulted in the sexual assault.

Again, not sure if this is the right forum.  I wanted to ask how the VA may perceive this relationship and do they look at claims seriously that document sexual assault.  Has anyone experienced this or is aware of any documented cases.  Unfortunately, high risk sexual behavior in veterans who have PTSD is alarmingly an issue and uncomfortable to admit and also to discuss.  

I will only add to be careful what you ask the VA to do. Since you are already rated 70% service connected. The VA can only continue your current rating, or they can increase your rating. I doubt if they would try to reduce your rating but that is possible to, but I will not go there. I am more interested in informing you that the VA can increase your rating to 100% schedular or 100% TDIU and then propose that you are incompetent to handle your own financial funds and try to assign you a fiduciary to manage your VA compensation pay.

[DSIG]

Pacmanx, my doctor checked on my DBQ yes, the veteran is capable of managing his/her finances. Wouldn’t the VA take that under advisement?

[pacmanx1]

7 minutes ago, DSIG said:

Pacmanx, my doctor checked on my DBQ yes, the veteran is capable of managing his/her finances. Wouldn’t the VA take that under advisement?

Yes, you should be fine. I helped a veteran get non-combat 100% PTSD and the VA found him incompetent to handle his own funds. He was not worried because he told me that his wife manages his funds anyway. I just try to inform veterans of the possibilities.

Edited February 24, 2021 by pacmanx1 (see edit history)

[DSIG]

Thanks, my PTSD is from combat, not that it matters in this case, but I didn’t make it clear at the beginning. Both my stressors are from combat service in Iraq....the sexual assault became a collateral issue after my military service. 

[Buck52]

You will most likely be denied the increase  just my opinion , however I am not saying you will be denied but most likely you will  due to this (''There is no mention of promiscuity and he doesn’t make an inference between the high risk behavior and the sexual assault'')

 a secondary condition to your PTSD, Is Your best bet is to file a secondary that your Dr has mention in the record, I don't think they will give a secondary condition for Depression   Veterans can't have two mental disorders rated at the same time, but just go with a secondary  or maybe two secondary's that  your PTSD would cause or be related to   as like you mention this is not a MST Claim

even if you have sleep apnea that would be a good secondary to your PTSD and also if your Dr. requires you to use a C-PAP Machine  medically to use  that is an automictic 50%...these other secondary's may not be enough to get you up to the 100% from the 70%  a 50% rating would.

I believe you will need an additional 50% rating to make it to the 100%scheduler rating.

However if you can't work due to this 70%PTSD Rating   then that's all together a different horse with a different color...if your Dr would state due to your PTSD AND THE SYMPTOMS FROM YOUR PTSD   this Has cause this Veteran to not be able to do find any  type employment  to include sedentary work.

Once your 100% or TDIU/P&T  Then its better to file for increase on different contentions   once you reach a 60% rating and with your already being 100% this opens up the SMC Door.  OR IF THE RATING YOU HAVE NOW AT 70%  IF ITS CONSIDERED A TOTAL RATING    you should have no problem getting the 100%schedule filing for the TDIU P&T.   

a Total Rating for a Veteran when he/she is under the 100%  actually means this Veteran is 100% Total disabled.  the difference between a Total rating and being TDIU P&T is the VETERAN on TDIU P&T under the 100% is being paid at the 100%rate....and it counts if this Veteran files for a separate or distinct condition from his/her original condition with a rating of 60% or higher will open the door for the SMC-S Housebound  or possible A&A

[Buck52]

I need to ask  if you already had your C&P for this increase your asking for?

If you have

   then you will need to wait for the decision  unless you can get the C&P REPORT before your decision

.IF you have it post it  we can help you better...black out any personal information   name address claim #ect,,,ect,,

If your denied post their reasons and bases of the denial  cover/black out your personal information.

 

*Note*You posted this under the MST Claim Forum...PTSD Claim forum is another forum  but its OK THAT YOU POSTED IT HERE  YOUR GETTING A LOT OF FEEDBACK.