Winning Your Claim For PTSD Disability Benefits

Why are Veterans who file for PTSD Disability Benefits frequently denied?

The three main reasons PTSD claims used to be denied are:

1.      (1) The rating officer provided a lower rating than was justified by the clinical presentation.

2.      (2) The VA concluded that the stressor the veteran experienced was not “an event that is outside the range of usual human experience and would have been markedly distressing to almost anyone.”

3.      (3) There was no evidence that the veteran was actually in combat.

These conclusions by the VA are no longer acceptable reasons for denial of benefits!

Recent VA rulings, Court rulings, and the replacement of the DSM-III-R with the DSM-IV as the basis for determination of disability, have dramatically changed the way the VA rates, or should rate, veterans applying for disability benefits.  The Department of Veterans’ Affairs has recently published a new manual, “Best Practice Manual for Posttraumatic Stress Disorder (PTSD) Compensation and Pension Examinations.”  With the publication of this manual, the VA has declared: “The Veterans’ Benefits Administration (VBA) and Veterans’ Health Administration (VHA) are committed to improving these services to veterans, and improving the quality of compensation and pension examinations for PTSD.”  The manual changes many of the assumptions that led to denial of PTSD claims in the past.  Review of this manual is thus critical to claimants and their attorneys.

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What is the VA Disability Rating System? by Dr. David Anaise, MD

Disabled VA Benefits‎

What is the VA disability rating system?

Unlike the SSA, which grants benefits for persons who are unable to work at any job in the national economy, the VA grants benefits for persons whose impairment can potentially decrease their ability to earn a living.  The VA disability rating system provides degrees of impairment from 0-100% in increments of 10.  The lowest compensable rating is 10% which pays a claimant $115/month (as of December of 2006).  A 100% rating provides for monthly benefits of $2,471.

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Rating Table for Selected Symptoms – Veterans’ Disability

Veterans’ Disability Ratings Table

Below, I’ve used a ratings table to illustrate how selected neurological and psychological symptoms rate on the veterans disability rating system.

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Rating Table for Digestive Issues – Veterans Disability

Below, I’ve used a digestive disability ratings table to illustrate how selected issues and symptoms rate on the veterans disability rating system.

Digestive Disability Rating Table

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Rating Table for Heart and Lung Disability Symptoms

Below, I’ve used a heart and lung disability rating table to illustrate how these selected issues and symptoms rate on the veterans disability rating system.

Heart and Lung Disability Rating Table

§ 4.71a   Schedule of ratings—musculoskeletal system. -Heart and Lung Disability (more…)

Bone and Joints Disability Rating Table

Below, I’ve used a bone and joints disability rating table to illustrate how these selected issues and symptoms rate on the veterans disability rating system.

Bone and Joints Disability Ratings Table

§ 4.71a   Schedule of ratings—musculoskeletal system. (more…)

Veterans’ Claims: RK v. Shinseki 13-2908

United States Court of Appeals for Veterans Claims

Vet. App. No. 13-2908

RK, Appellant,

v.

ERIC K. SHINSEKI, Secretary of Veterans Affairs, Appellee.

BRIEF FOR APPELLANT

David Anaise, MD, JD Benham & Anaise, LLC 1001 W. San Martin Dr. Tucson AZ 85704 (520) 219-7321

TABLE OF CASES, STATUTES, AND OTHER AUTHORITIES Cases   Brief Page: (more…)

Veterans’ Claims MU v. Shinseki 09-3570

United States Court of Appeals for Veterans Claims (more…)

Veterans’ Claims: EW v. Shinseki 12-2155

BRIEFING CONFERENCE MEMORANDUM

TO:                 Elizabeth M. Hessman-Talbot, Esq., Central Legal Staff, U.S. Court of

                        Appeals for Veterans Claims

                        Shanti L. Hageman, Esq., Office of the General Counsel, Department of

                        Veterans Affairs

FROM:           David Anaise, MD, JD

DATE:           October ____, 2012

SUBJECT:    EW v. Eric K. Shinseki, Secretary of Veterans Affairs,

                        Vet. App. No.12-2155

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Veterans’ claims: HH v. Shinseki 11-1612

            (more…)

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