Are you a combat veteran, law enforcement officer, rescue worker, first responder? If you have seen action, it's possible that you could be suffering from Post Traumatic Stress Disorder (PTSD). More than 101,978 U.S Veterans received compensation for PTSD as of March, 1998. Of course, not every veteran who has seen action suffers from PTSD. In many cases, what seems like PTSD is simply a response to everyday stress.

The stress of everyday life, often referred to as ADJUSTMENT DISORDER, can appear to take on some of the symptoms associated with PTSD. So, how do you know if it's PTSD that you're suffering from or everyday stress?

According to the ICD-10 Classification of Mental and Behavioral Disorders, as published by the World Health Organization (WHO), Geneva, people who suffer from PTSD commonly experience a repeat of the event or events that caused their chronic problems. These visual and auditory experiences are often referred to as INTRUSIVE MEMORIES or INTRUSIVE DREAMS. Another common term for this is FLASHBACKS.

Included are the following symptoms:

• feelings of emotional and physical numbing
• detachment from people
• unresponsiveness to surroundings
• avoidance of situations and activities that resemble the trauma
• state of autonomic hyperarousal with hypervigilance
• enhanced startle response
• insomnia

"Commonly there is fear and avoidance of cues that remind the sufferer of the original trauma. Rarely, there may be dramatic, acute bursts of fear, panic or aggrerssion, triggered by stimuli arousing a sudden recollection and/or re-enactment of the trauma or of the original reaction to it." (ICD-10)[1]

People who suffer from PTSD also often experience high levels of anxiety, depression, and, at times, feelings of suicide. Use of alcohol and/or drugs, which further agrivate the already existing condition, are also common.

According to WHO, in most cases, after a traumatic event has taken place, people rarely continue to exhibit PTSD symptoms for more than 6 months. In a minority of cases, the individual may continue to experience symptoms of PTSD, which, if left unchecked over a period of years, can lead to substantial, long-lasting effects, such as adverse personality changes.

Proving PTSD

One of the most difficult things for the layman to understand is how V.A. decides who has PTSD and who does not. The fact is, it's not the people who care for veterans in the 124 special PTSD clinics positioned throughout the United States that determine this. Instead, this decision is made by the "Compensation and Pension Service," a division of the Veteran Benefits Administration, an arm of the V.A.

In order to qualify for PTSD disability benefits and compensation (comp), it must first be determined that a requesting veteran suffered a stressor. A STRESSOR is any situation that, in the judgement of the VA, could have caused the veteran's present PTSD disability. In most instances such a stressor will be linked to a combat situation, but not always. Simply witnessing the return of those who have died in combat could cause PTSD in support personnel, but such a final determination would have to be derived by the appropriate people in Compensation and Pension Service.

A veteran contemplating a PTSD claim should also be aware that the VA also considers the possession of certain awards and decorations as proof that he/she was involved in a combat situation. These awards and decorations include:

• Combat Infantryman Badge
• Purple Heart
• Bronze Star with V Device

Regulation 38 CFR 3.304(f), 19 May 1993, provides the mechanism whereby the VA must consider veterans who possess such an award(s) or decoration(s) as having experienced a combat stressor. If you recall having received such a medal or decoration and you no longer have it in your possession, you can request one/them using the following contact information:

U.S. Navy Coast Guard and Marines	U.S. Navy Liaison Office National Personnel Records Center, Room 3475 9700 Page Ave. St. Louis, MO 63132-5100
U.S. Army	U.S. Army Reserve Personnel Center Attn: ARPC-VSE 9700 Page Ave. St. Louis, MO 63132-5100
U.S. Air Force	National Personnel Records Center (Military Personnel Records) 9700 Page Ave. St. Louis, MO 63132-5100

When requesting medals, include the following information:

• Veteran's full name, printed or typed for clarity
• Veteran's signature (or next of kin if veteran is deceased)
• Veteran's branch of service
• Veteran's service number or Social Security Number (SSN)
• Veteran's approximate dates of service rendered
• Veteran's (copy only) discharge or separation document (WDAGO Form 53-55 or DD Form 214)

NPRC prefers that the above request be submitted via an SF180 form, "Request Pertaining to Military Records," available on the U.S. Veteran Information (non-governmental) web site.

Filing a PTSD Claim

The basic steps that the veteran must take when filing a PTSD claim are as follows:

1) You must file a formal claim with the VA using claim forms provided by the Veteran Benefits Administration.

2) You must undergo a thorough interview where the following areas are examined by a VA representative:

1. social history before, during, and post military experience
   • family
   • work
   • education
2. psychological symptoms
   • past
   • present
   • the trauma event itself

Because of the complexity of the PTSD disability claims process, it is prudent if a veteran who suspects that he/she is suffering from PTSD utilize the assistance of a Service Officer.

"Service officers are familiar with every step in the application and interview process, and can provide both technical guidance and moral support. In addition, some Service Officers particularly specialize in assisting veterans with PTSD disability claims. Even if a veteran has not been a member of a specific Veterans Service Orgaization, the veteran still can request the assistance of a Service Officer working for that organization. ...you can directly contact the local office of any Veterans Service Organization or ask for recommendations from other veterans who have applied for VA disability, or from a PTSD specialist at a VA PTSD clinic or a Vet Center." (A National Center Fact Sheet)[2]

Forms and information on the application process can be obtained by the Benefits Offices at VA Medical Centers, Outpatient Clinics, and Regional Offices.

Bibliography:

[1] ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization, Geneva, 1992.
[2] A National Center Fact Sheet, Title: Help for Veterans with PTSD; Veterans Affairs; URL: http://www.dartmouth.edu/dms/ptsd/Help_for_Vets.html

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