PTSD Ratings: How the VA Reads Your Symptoms

Every PTSD decision comes back to one question from the VA’s mental disorders formula (38 CFR 4.130): how impaired are you at work and in your social life?

Raters look at three things for each symptom:

• Frequency: panic once a month reads very differently from panic most days.
• Severity: irritability vs. outbursts that end jobs or relationships.
• Duration: a bad stretch last winter vs. years of steady decline.

The lists of symptoms in the criteria are examples. You don’t need to check every box at a level, and symptoms the list doesn’t mention can still support a higher rating.

You’ll need a current diagnosis, a medical link, and evidence the stressor happened. The rules are friendlier than many veterans expect:

• Combat veterans can rely on their own account when it fits what their unit was doing.
• Fear of hostile activity, like rocket attacks, convoys or threats on base, can be established by your statement plus confirmation from a VA or VA-contracted psychologist or psychiatrist.
• Military sexual trauma has its own flexible evidence rules. See the MST guide.
• Other events, like crashes, training deaths or disasters, can be corroborated with unit records and buddy statements.

Nebraska PTSD exams are commonly held at the Omaha VA Medical Center, with a contracted examiner closer to home, or by video. Either way:

• Bring a one-page summary of your symptoms and how often they hit.
• Name specific consequences: jobs lost, write-ups, a marriage under strain, friends you’ve stopped seeing.
• Mention treatment, medications and anything you do to cope, like avoiding crowds or not driving.
• Consider a written statement from your spouse or a close friend.

Physical problems tied to PTSD, like sleep apnea, high blood pressure and erectile dysfunction from medications, can be rated separately.