Guides
PTSD and Military Sexual Trauma VA Disability Claims
PTSD claims often turn on the link between current symptoms and service. Here is how the VA evaluates them and what a denial means.
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What does 38 C.F.R. § 3.304(f) require for PTSD service connection?
Service connection for PTSD generally requires three things: a current medical diagnosis of PTSD that meets the diagnostic criteria, credible supporting evidence that the claimed in-service stressor occurred, and medical evidence establishing a link (nexus) between current symptoms and the in-service stressor (38 C.F.R. § 3.304(f)). The diagnosis must be made by a qualified mental-health professional. The stressor must be related to service.
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The VA does not require the stressor to be the sole cause of symptoms. It is enough that the stressor contributed. Talk to your doctor about any treatment or records that document the diagnosis and history. Compensation is tax-free monthly pay for disabilities caused or worsened by service (38 U.S.C. §§ 1110, 1131). A discharge other than dishonorable is also required.
How do combat or fear of hostile activity relax the proof needed?
When a veteran engaged in combat with the enemy and the stressor is related to that combat, the veteran’s own testimony alone can establish the stressor if it is consistent with the circumstances of service and there is no clear and convincing evidence to the contrary (38 C.F.R. § 3.304(f)(2)). A similar rule applies when the stressor is related to the veteran’s fear of hostile military or terrorist activity (38 C.F.R. § 3.304(f)(3)).
In those cases the VA does not always need independent corroboration of the specific event. Lay statements from the veteran or others who served with the veteran can be important. The relaxed standard does not apply to every claim; the facts of service must support the combat or fear finding. Secondary conditions that develop because of the trauma may also be considered under 38 C.F.R. § 3.310 if they are caused or aggravated by the service-connected PTSD.
What are the markers used in military sexual trauma claims under § 3.304(f)(5)?
For claims based on in-service personal assault, including military sexual trauma (MST), the VA may accept evidence of behavioral changes or other markers that are consistent with the claimed assault when there is no official report (38 C.F.R. § 3.304(f)(5)). Examples of markers include records of request for a transfer, deterioration in work performance, substance abuse, or unexplained economic or social behavior changes.
Medical opinions that link the current diagnosis to the markers and the claimed assault can support the claim. The regulation recognizes that many assaults are not formally reported at the time. MST claims still require a current diagnosis and a nexus. Talk to your doctor about any relevant history or treatment records.
How does the VA rate PTSD under the mental-disorder formula in § 4.130?
PTSD is rated under the General Rating Formula for Mental Disorders in 38 C.F.R. § 4.130. The levels are 0, 10, 30, 50, 70, and 100 percent based on the frequency, severity, and duration of symptoms and the resulting occupational and social impairment.
- 0 percent: A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.
- 10 percent: Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.
- 30 percent: Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal).
- 50 percent: Occupational and social impairment with reduced reliability and productivity.
- 70 percent: Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.
- 100 percent: Total occupational and social impairment.
The rating is based on the overall picture of impairment, not a simple checklist of symptoms. A higher rating requires evidence of more severe impairment. Combined ratings with other conditions use whole-person math under 38 C.F.R. § 4.25. The VA decides the final rating; no particular percentage is guaranteed.
Why might a PTSD claim be denied and what appeal options exist?
Common reasons for denial include lack of a current diagnosis that meets criteria, insufficient evidence of the stressor, or no medical nexus opinion linking symptoms to service. For MST claims, the absence of markers or supporting records can lead to denial. A denial is not the end of the process.
Under the Appeals Modernization Act, for decisions issued on or after February 19, 2019, veterans generally have one year to choose a Higher-Level Review, a Supplemental Claim with new and relevant evidence, or an appeal to the Board of Veterans” Appeals (Direct Review, Evidence Submission, or Hearing). Staying within one year of each decision (continuous pursuit) can preserve the original effective date (38 C.F.R. § 3.2500(h)). Board pending-age averages (not a promise) are about 7 months for Direct Review, 8 months for Evidence Submission, and 2.4 years for Hearing (BVA, 2026).
After a final Board denial, an appeal to the U.S. Court of Appeals for Veterans Claims must be filed within 120 days (38 U.S.C. § 7266). Accredited attorneys and agents may not charge for work before the VA’s initial decision (38 U.S.C. § 5904(c)(1)). After that, fees are usually contingent on past-due benefits; 20% or less is presumed reasonable. Veterans Service Organizations are always free. Accreditation can be checked at https://www.va.gov/ogc/apps/accreditation/index.asp and representatives found at https://www.va.gov/get-help-from-accredited-representative/. VA Disability Help is a marketing service that connects veterans with Milberg, PLLC for review of requests. Submitting a request does not create an attorney-client relationship. Not affiliated with or endorsed by the U.S. Department of Veterans Affairs, the U.S. Department of Defense, or any government agency.
Frequently asked questions
Do I need an official report of the assault for an MST claim?
Can PTSD be rated at 100 percent?
What if my claim was denied more than a year ago?
Is a nexus letter required?
Can sleep problems from PTSD be claimed separately?
Are PTSD disability payments tax-free?
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