PTSD Claims

While the basic three factors for service connection (diagnosis, nexus, and symptoms) remain the same for all mental health claims, PTSD claims operate under fundamentally different evidence rules than other mental health conditions. Understanding these differences is crucial because these special provisions only apply to PTSD diagnoses—not to other mental health conditions, even those caused by military trauma.

‍PTSD Claims: Understanding the Different Standards

For Non-PTSD Mental Health Claims

With conditions like Major Depressive Disorder, Anxiety Disorder, or Bipolar Disorder, the VA requires evidence of your mental health symptoms during military service. This means your service treatment records (STRs) need to show documentation such as:

• Clear symptoms: Notes about "depressed mood," anxiety, or mood swings
• Behavioral indicators: Personnel records noting attitude or behavior changes
• Physical manifestations: Documentation of sleep difficulties, weight changes, or concentration problems

The challenge: If your military records don't contain evidence of these symptoms, establishing service connection becomes significantly more difficult. Your only options would be:

• ‍Comprehensive records review: Sometimes symptoms were documented but not obviously labeled
• ‍Buddy statements: First-hand accounts from fellow service members, family, or friends who observed symptoms during your active duty

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For PTSD Claims: Focus on the Stressor

PTSD claims work differently because the traumatic stressor event is treated similarly to a symptom. Instead of needing documentation of mental health symptoms in your service records, you need evidence or verification of the traumatic event itself.

The evidence requirements vary by stressor type:

Combat/Hostile Events: Relaxed standards—if your service is consistent with combat exposure, additional verification may not be needed.

Non-combat Events: Requires verification through military records, accident reports, or reasonable assumptions based on your Military Occupational Specialty (MOS).

Military Sexual Trauma (MST): Special "markers" standard that accepts indirect evidence of behavioral changes following the trauma, even without direct reporting.

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Why This Distinction Matters

Understanding these different evidence standards is particularly important when reviewing denied claims. Many denials cite "No Nexus" as the reason, but the appropriate evidence framework depends entirely on accurate diagnosis and proper application of PTSD-specific standards.

If you have a trauma-related condition but receive a non-PTSD diagnosis, you lose access to these more flexible evidence standards. Even when your condition clearly resulted from military trauma, without documented symptoms in your service records, the claim may face denial under standard mental health criteria.

Understanding these different standards empowers you to pursue the most effective path for your specific situation. The key is ensuring you receive the correct diagnosis and that your claim is evaluated under the appropriate evidence framework.

‍Learn more about PTSD → 

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How the VA Handles MST-Related Claims: A Different Standard of Evidence

Military Sexual Trauma represents a unique category within PTSD claims, with its own specialized evidence standards. The VA recognizes that MST often goes unreported during service due to understandable concerns about confidentiality, retaliation, or not being believed.

For PTSD due to MST claims, you do not need to have reported the incident when it happened, and there does not need be a record of it in your service file for a successful claim. For these claims, the VA also accepts both direct and indirect evidence.

Direct Evidence

Direct Evidence includes statements or records from:

• Chaplains or clergy members

• Counseling, health, or military training facilities

• Family members, roommates, or fellow service members

• Rape crisis centers or centers for domestic violence assistance

• Civilian police reports

• Medical reports from civilian providers who treated you after the MST

• Personal diaries or journals

Indirect Evidence ("Markers")

Direct Evidence isn’t always available, though. MST often goes unreported due to understandable feelings of humiliation, shock, emotional pain, worry about being blamed, fear of not being believed, concern about retaliation, and limits of confidentiality.

For that reason, the VA has adapted the way they process claims related to MST.  If you don’t have direct evidence, you can submit Indirect Evidence of changes in your life or your behavior after the MST. The evidence doesn’t need to show a clear cause.

You may hear the Indirect Evidence referred to as “markers.” These markers include:

• Pregnancy test results

• Requests for transfer to another military assignment

• Tests for sexually transmitted infections

• Medical appointments without specific diagnosis

• Treatment for unexplained physical injuries

• Changes in work performance evaluations

• Significant weight or eating pattern changes

• Relationship difficulties or divorce

• Sexual dysfunction treatment

• Substance use problems

• Unexplained social withdrawal or financial difficulties

• Documentation of mental health symptoms

A comprehensive clinical evaluation can be essential in connecting these markers to your in-service experience, helping establish the nexus between observed changes and the traumatic event.

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Previously filed a claim for PTSD due to MST?

If you previously filed a PTSD claim related to MST and it was denied, the VA encourages you to request a decision review under the new process. If you’d like to request a decision review, contact a Veterans Benefits Administration MST outreach coordinator at your local VA regional office.

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