Do I Have PTSD? VA Claim Criteria Explained — Symptoms, Diagnosis & Next Steps

PTSD isn’t always obvious — especially to the person living with it. Many veterans minimize or normalize their symptoms, unsure whether what they’re experiencing “counts” as a mental health condition. The VA uses a standardized framework to determine whether someone meets the criteria for PTSD: the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). The DSM-5-TR outlines the specific symptom clusters and functional impairments that define PTSD, and it’s used by both VA examiners and independent evaluators to assess claims. In this guide, we’ll walk through those criteria in plain language — so you can better understand how your symptoms may align with what the VA looks for.

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Understanding the DSM-5-TR Criteria for PTSD

PTSD isn’t diagnosed based on symptoms alone — it begins with a qualifying traumatic event, or traumatic stressor. According to the DSM-5-TR, this is known as Criterion A, and it’s the foundation for everything that follows.

What counts as a traumatic stressor?

To qualify for a PTSD diagnosis, you must have experienced or been exposed to a traumatic event involving actual or threatened death, serious injury, or sexual violence. This exposure can occur through:

• Directly experiencing the traumatic event
• Witnessing the event as it occurred to others
• Learning that the event happened to a close family member or friend
• Repeated or extreme exposure to details of traumatic events (common for first responders or certain military roles)

There any many different types of traumatic events, but here are some examples:

• Sexual or physical abuse or assault
• Serious vehicle accidents
• Combat or war zone exposure
• Serious medical events
• Seeing death or dead bodies, including while at work
• Unexpected death of a loved one
• Natural disasters
• Arson or house fires
• Torture
• Domestic violence
• Witnessing or experiencing violence, such as a homicide or suicide
• Terrorism or mass violence

Important note: Even if the trauma wasn't formally documented at the time, credible statements and supporting evidence can help establish this connection for VA claims.

Once Criterion A is met, the diagnosis depends on how the trauma has affected your thoughts, emotions, and daily functioning. These symptoms are grouped into four main clusters.

What are the symptoms of PTSD?

There are four different categories of PTSD symptoms: Re-experiencing, Avoidance, Cognitive and Mood, and Arousal.

Re-experiencing Symptoms

These symptoms involve reliving the trauma in ways that disrupt daily life:

• Flashbacks—reliving the traumatic event, including physical symptoms, such as a racing heart or sweating
• Recurring memories or dreams related to the event
• Having distressing thoughts and/or physical reactions in response to reminders of the event

Avoidance Behaviors

Avoidance symptoms reflect efforts to block out reminders of the trauma:

• Going out of your way to avoid reminders of the event
• Avoiding thoughts or feelings related to the traumatic event

Negative Changes in Mood or Thinking

These symptoms affect how you view yourself, others, and the world:

• Trouble remembering key features of the traumatic event
• Negative thoughts about oneself or the world
• Exaggerated feelings of blame directed toward oneself or others
• Ongoing negative emotions, such as fear, anger, guilt, or shame
• Loss of interest in previous activities
• Feeling isolated or disconnected from others
• Difficulty feeling positive emotions, such as happiness or satisfaction

Hyperarousal and Reactivity

These symptoms reflect heightened alertness and difficulty regulating emotions:

• Being easily startled
• Feeling tense, on guard, or on edge
• Having difficulty concentrating
• Having difficulty falling asleep or staying asleep
• Feeling irritable and having angry or aggressive outbursts
• Engaging in risky, reckless, or destructive behavior

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Can I Still Qualify for a VA PTSD Claim If I Don’t Meet Every Symptom?

Someone with PTSD won't necessarily experience every symptom, but PTSD is only diagnosed when the criteria for every category of symptoms is met.

‍To be diagnosed with PTSD, you need symptoms in each cluster:

• At least one Re-experiencing Symptom
• At least one Avoidance Behavior
• At least two Negative Changes in Mood or Thinking
• At least two Hyperarousal and Reactivity symptoms

Those symptoms must have lasted longer than a month and must be severe enough to interfere with aspects of daily life, such as relationships or work.

PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.

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Military Sexual Trauma (MST) vs PTSD: What’s the Difference in VA Claims?

Military sexual trauma (MST) refers to sexual assault or sexual harassment that occurs during military service. While MST is a traumatic stressor that can lead to PTSD, it's important to understand that:

• MST and PTSD are not the same thing — MST describes the traumatic event, while PTSD describes the potential mental health response
• Not everyone who experiences MST develops PTSD — trauma responses vary greatly between individuals
• MST can lead to other mental health conditions besides PTSD, such as depression or anxiety disorders
• Special provisions exist for MST-related claims, often requiring less documentation than other trauma types

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Common Misconceptions About PTSD Claims

Many veterans hesitate to pursue claims due to misunderstandings about the process:

• "My symptoms aren't severe enough" — Even moderate symptoms that interfere with daily functioning can qualify for compensation
• "I should be able to handle this on my own" — Seeking help demonstrates strength, not weakness
• "It wasn't formally documented during service" — PTSD symptoms may not appear until after discharge; credible statements can support your claim
• "I'm functioning okay at work" — PTSD affects different areas of life; difficulties in relationships or daily activities still count‍
• "But I was told I don't have PTSD" — Many veterans receive diagnoses other than PTSD for what may actually be undiagnosed PTSD, which has significant implications for their disability claims and access to appropriate evidence standards.

Next Steps for VA PTSD Claims

You have options regardless of where you are in the claims process:

• First-time filing — Begin gathering your service records and documenting current symptoms
• Appealing a denial — Consider an IME or Nexus Letter to provide additional evidence
• Seeking treatment — Mental health support can improve your quality of life while strengthening your claim

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Get personalized guidance based on your situation.

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