How Does The Process Work
You receive a Ticket in the mail. You take this Ticket to any Employment Network or State Vocational Rehabilitation agency , and if you both agree to work together, the EN or VR will help you with job training, finding employers, information about work incentives, materials to send to prospective employers, and other tasks that will help you go to work. Participating in the Ticket to Work program means that youre protected from a Continuing Disability Review based on your potential ability to work.
Disability Compensation For Veterans With Ptsd
The VA will acknowledge PTSD is a service-related disability provided you can verify that your PTSD symptoms are directly linked to your military service. The VA considers the following scenarios to be traumatic events, or stressors, in a veterans claim for disability benefits based on PTSD:
- you sustained serious injury, personal or sexual trauma, or sexual violation, or
- you were threatened with injury, sexual assault, or death
The VA reports that PTSD is the leading mental health issue suffered by troops returning home from combat. As stated by the VAs National Center for PTSD, many veterans of recent combat operations experience PTSD, including:
- 11 to 20 out of every 100 veterans who participated in Operations Iraqi Freedom or Enduring Freedom
- 12 out of every 100 Gulf War Veterans who participated in the Gulf War
- 30 out of every 100 Vietnam veterans who participated in the Vietnam War had PTSD in their lifetime.
- PTSD can relate to a traumatic sexual event. A distressing number of veterans have suffered sexual assault, abuse, and harassment while serving in the armed forces, referred to as military sexual trauma .
Eligibility for disability benefits for PTSD from the VA is based on the following:
Remember, if you are a veteran diagnosed with PTSD, you may qualify for VA compensation, Social Security Disability Insurance benefits, or both.
The Ssdi Payment Schedule For Everyone Else Depends On Their Birthday
Payments for those who haven’t been receiving SSDI money since 1997 or before follow the same schedule as Social Security. Here’s how it works:
- If your birthday falls between the 1st and 10th of the month, your payment will be sent out on the second Wednesday of the month.
- If your birthday falls between the 11th and 20th of the month, your payment will be sent out on the third Wednesday of the month.
- If your birthday falls between the 21st and 31st of the month, your payment will be sent out on the fourth Wednesday of the month.
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Ssi/ssdi And Va Disability Benefits
Veterans may be eligible for Supplemental Security Income or Social Security Disability Insurance , in conjunction with, or as an alternative to VA disability payments. They may also use the Medicaid and Medicare health benefits that come with SSI/SSDI to supplement VA health services.
The definition of disability and application process is different for SSA and VA disability benefits, and Veterans may begin receiving SSA benefits while they are waiting on a VA benefit decision.
How The Va Appeals Process For Ptsd Works
The denial or award letter you received comes with a statement from the VA on how they reached their decision, so make sure you hang on to it. You can use this information to determine what new evidence you should submit with your appeal. Once you get a rating decision from the VA, you have a year to appeal. The general plan for appealing a claim is as follows.
- Have a VA-accredited claims agent or attorney review your claims file.
- Request any pertinent records that are missing from your claims file.
- If necessary, get buddy statements from friends and family, and additional statements from doctors.
- File the appeal with the new evidence and send a brief to your VA Regional Office or the Board of Veterans Appeals.
Not every appeal follows this pattern to a T, so its best to consult with an experienced claims agent to get a better sense of how things will go.
Now lets take a closer look at types of evidence that can help you show that your PTSD rating is in need of revision.
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Coordination Between Va And Ssa
VA and SSA are required by law to share the following types of information:10
- Medical evidence and hospital records.
- Disability determinations.
- Benefit receipt and payment amounts.
In processing a DI claim, a DDS requests the medical evidence it deems necessary from service providers. A DDS may request records from a VA regional office or a VA hospital. In 2010, SSA made an estimated 154,000 medical record requests to VA for over 100,000 claimants.
In turn, VA directs its medical-evidence requests to SSA at one of two centralized locations: the National Records Center, for information on claimants older than age 55 and the Operations Megacenter, for records of those aged 55 or younger. VA generally requests records by fax, but SSA has tested and is rolling out a process by which medical evidence is requested by and returned to VA through the Government Secure Online Messaging System.
Generally, both SSA and VA are required to consider the other agency’s disability decision in making their own determinations, although neither agency’s decision is binding on the other.11
SSA provides Social Security number verification, Social Security and SSI benefit status, and limited payment histories to the VA via its Federal Online Query system. VA provides beneficiary data to SSA through a data exchange agreement. SSA and VA use the benefit receipt and payment data as income verification for their respective means-tested programs .
What Are The Other Eligibility Requirements For Ssdi Benefits
Proving that your PTSD is severe enough to be considered a disability is only half of the battle. You will also need to meet the SSAs work credit requirement.
You earn work credits by working and earning income. In 2020, you will be awarded one work credit for every $1,410 of income you earn. But you cannot earn more than four work credits per year regardless of your income.
You must have enough work credits on your record to qualify for SSDI benefits. The number you will need will depend on the age at which you became disabled. But in general, the younger you are, the fewer work credits you will need to qualify.
If you are considered disabled and meet the work credit requirement, the SSA will approve your application for SSDI benefits for PTSD.
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Evidence Disabled Veterans Need For Their Va Disability Claim
You will need to provide medical evidence that proves you have a mental or physical disability that is ongoing and prevents you from working and carrying out everyday tasks. The injury or illness must have taken place while serving in the military.
The documents you will need are:
- your DD214 document
- your treatment records while in service
- medical evidence provided by your current physician including the diagnosis, x-rays, CT scans, medical test results and anything else that proves you are disabled.
Does Having A 100% P& t Rating Guarantee Social Security Disability For Veterans
Unfortunately, no. Having a 100% P& T rating wont guarantee that you qualify for Social Security disability benefits. For example: If your 100% P& T rating is for a short-term issue, you may not meet the criteria for SSD benefits. Social Security disability for veterans is available solely for claimants whose impairments last 12 months or longer.
The SSA looks at how much your health problems limit your ability to work when determining your eligibility for monthly SSD benefits. More specifically, applicants must still meet the SSAs definition of disability in order to get those payments. If youre unfamiliar with how the SSA defines disability, heres a brief overview from their website:
- Your medical issue must stop you from holding a job that pays enough to cover your monthly expenses
- Your doctor must expect your condition to last at least 12 months in a row, or result in your death
In addition, you must meet these technical eligibility requirements, regardless of your health problems:
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Multiple Applications For Di And Final Decision Outcomes
Thus far, we have analyzed veterans’ first applications for DI disabled-worker benefits after receiving the VA rating of 100% or IU. DI applicants who are denied benefits may reapply, generally after exhausting all appeals. To determine the final allowance rate for this population of disabled veterans, we also considered decisions on all subsequent applications.
Chart 18 shows the number of totally disabled veterans who applied for DI by the number of times they applied after receiving the VA award of total disability. We include the 6,559 applicants with technical denials of their first applications because those individuals are eligible to reapply. Nearly 8,500 disabled veterans applied more than once, and individuals applied as many as seven times.
Chart 19 shows the medical decision on the most recent DI application filed by veterans after receiving their 100% or IU rating from the VA that is, it provides the final allowance rate for those veterans as of 2010, the time of data extraction. The final allowance rate for veterans with a 100% rating was 78 percent, compared with 73 percent for those with a medical decision on their first application those rated IU had a final allowance rate of 71 percent, compared with 65 percent for those with a medical decision on their first application.
Applying For Social Security With Ptsd
Post-Traumatic Stress Disorder , added to the Diagnostic and Statistical Manual of Mental Disorders in 1980, is a trauma-induced mental disorder that affects many soldiers who have returned from duty. The figures range depending on service area, maxing out at an estimated 30% of all Vietnam Veterans experiencing PTSD in their lifetime.
The symptoms of PTSD can include flashbacks, nightmares, and severe anxiety that may come with physical reactions such as nausea, sweating, or a pounding heart when confronted with reminders of the traumatic event. Some also experience a loss of interest in life and daily activities, numbness, and detachment from other people.
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The Disabling Symptoms Of Post
PTSD can be acute or chronic, with a broad scope of severity. Once the threat is gone, intense, adverse emotions leave sufferers with a jumble of imagery, sounds, smells, and other vivid memories of the event. PTSD symptoms can include:
- Flashbacks Reminders of past events that trigger flashbacks, where the person suddenly relives the event as though it is happening again, without control. Triggers can be physical surroundings, smells, sounds, certain people, or other reminders of the painful experience.
- Dissociation Emotional numbness, a sense of being disconnected from yourself and detached from others. The person can lose awareness of whats going on around them, being taken totally back mentally to the traumatic event.
- Nightmares Intrusive memories of the event can be in the form of dreams and night terrors.
- Intense fears Episodes of intense, debilitating fear memories may be accompanied by periods of horror and helplessness, also referred to as emotional paralysis.
Further common symptoms of PTSD include:
- Anxiety and depression
- Angry outbursts, exaggerated startle response
- Avoidant behavior
Symptoms normally begin soon after the traumatic event however, PTSD can also suddenly be triggered years later.
Post Traumatic Stress Disorder
Post Traumatic Stress Disorder is a potentially debilitating anxiety disorder triggered by exposure to a traumatic experience. It is important to remember that if you have PTSD and Social Security disability benefits would help you, you may also be eligible for both VA benefits and Social Security disability benefits. Although the common understanding of this illness is that it affects only combat veterans, it impacts many victims outside of the military arena. It can be a factor with victims of violent crimes or sexual abuse. A mugging, rape or even a terrifying burglary can trigger the illness.
The definition of Post Traumatic Stress Disorder has updated after a decade-long revision of the Diagnostic and Statistical Manual of the American Psychiatric Association, published in May of this year. These are the first changes since the condition was identified in 1980.
In the DSM-5, PTSD is in a new chapter on Trauma and Stress Related Disorders. It includes a sharper definition of traumatic events now specifically including sexual assault, and a new recognition of the cumulative effect of trauma on people like first responders or police. The terminology of the DSM differs from that of Social Security regulations, and it takes careful work to develop the evidence to clarify the severity and functional impact of PTSD, and win Social Security benefits.
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Is Ptsd A Disability
The Social Security Administration recognizes that symptoms from PTSD can prevent you from working. For example, you might have recurring flashbacks and nightmares that can disrupt your daily routine. Other symptoms of PTSD can include:
- angry outbursts
- extreme fear that the traumatic event will happen again
- being overly alert and aware of your surroundings , and
- a tendency to be easily startled.
If you’re experiencing these symptoms, it’s best to contact a psychologist or psychiatrist to determine whether you have a post-traumatic stress disability such as PTSD or PTSI. Your doctor will conduct a “mental status examination,” where you’ll answer questions about your history, your current mood, and your thought process. Your answers will help your doctor make the right diagnosis.
Doctors offer many ways to treat PTSD. Your doctor will likely recommend that you see a counselor or therapist. A therapist can help you develop stress management skills to better handle your PTSD symptoms. Your doctor can also recommend antidepressant or anti-anxiety medications to improve any problems you might have with sleep or concentration.
Winning Social Security Disability Benefits For Ptsd
The SSA defines post-traumatic stress disorder as recurrent and intrusive recollections of a traumatic experience, which are a source of marked distress.
You may qualify for Social Security Disability benefits for PTSD if you satisfy several criteria specified in the SSAs medical Listing of Impairments.
PTSD is categorized as a Trauma and Stressor-Related Disorder, under SSA Listing 12.15. The medical requirements are spelled out in three parts, A, B, and C. Your symptoms must satisfy the requirements of paragraphs A and B OR A and C.
Part A is about medical evidence and documentation. Part A specifies five characteristics to diagnose a stress or trauma-related disorder, and all must be present.
Part B, which requires the extreme limitation of one, or of two, of the following areas of mental functioning:
Part C of the medical listing for Trauma and Stressor-Related Disorders requires that post-traumatic stress disorder is serious and persistent that is, you have a medically documented history of the existence of PTSD for at least 2 years, and there is evidence of both:
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Important Items Of Note For Veterans Seeking Ssdi
Being approved for SSDI benefits from the SSA does not disqualify you from other benefits or forms of compensation. Below are some important items of note for veterans seeking SSDI:
- You can obtain medical coverage through TRICARE and Medicare at the same time even while receiving SSDI from the SSA
- Your eligibility for SSDI benefits is not impacted by earning an income from the military
- You can file an application for SSDI benefits at any point after becoming disabled, regardless of your status with the military
- You can file for SSDI benefits and VA benefits at the same time
Five Questions Asked By The Ssa
In general, the Social Security Administration has a five-part questionnaire that helps determine or establish a veteran with PTSDs ability to qualify for SSD benefits. The following questions are taken directly from SSA literature and you should expect the same discovery process with your own case if you are submitting an application for SSD.
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Ssas Purpose Is Different From Va
SSA is looking for problems with your capacity to work. It follows a five-step process to decide if you cannot work, and therefore would qualify for disability benefits.
SSA does not require a veterans PTSD or other impairment to be linked to military service or discharge status.
There are no rating percentages of disability. Basically, under SSAs all-or-nothing definition of disability, you no longer have the capacity to work for at least one year, or until death.
Conversely, the objective of VA compensation is to pay veterans who suffered disabling physical and mental health conditions while serving in the military, on a graduated scale, based on the degree of the veterans disability. You can be partially disabled and still receive disability under the VA.
Characteristics Of Va Awards For Veterans Rated 100% Or Iu
Before we delved into the data, we expected to find that MC/WW service membersthat is, those serving in the Afghanistan and Iraq conflictswould dominate the count of VA disability compensation awards with 100% and IU ratings. However, the analysis revealed something quite different: More than two-thirds of the individuals awarded compensation based on VA ratings of 100% or IU during fiscal years 20002006 were Vietnam-era veterans . Veterans who served during the Gulf War era, which VA defines as including not only the Afghanistan and Iraq conflicts but also the 1990 Gulf War and the intervening period, accounted for only about one in seven awards.15 Only 13 percent of awards based on ratings of 100% or IU represented the veteran’s first VA benefit award. Within that group, Vietnam-era veterans constituted 72 percent of the awards and Gulf War-era veterans represented 21 percent. Progressive conditions and policy changes acknowledging the health effects of exposure to the herbicide Agent Orange likely contributed to the large share of initial VA awards for Vietnam-era veterans.
As one might expect, the predominance of Vietnam-era veterans among the awardees is reflected in the concentration of awards in older age groups . Claimants aged 5064 represented 52 percent of awards based on ratings of 100% or IU. Less than 4 percent of awards based on those ratings went to individuals aged 1834.
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