PTSD Review

I am often asked why some veterans receive a “Total and Permanent” rating on their first application for PTSD compensation. I’ve also recently heard from a vet who got 100% P&T on his first claim attempt. There is no real answer to that question because receiving 100% the first time around is a rare event. But there could be several reasons in such cases when they do occur.
A veteran may have a history of never being able to hold a job or even function in society. This would warrant 100% T&P. A veteran may have been treated in the system for years without ever filing a claim, but has an obvious sporadic employment record and a diagnosis of severe PTSD. This could also possibly warrant %100 P&T.

In rare cases, a veteran could have had such a horrible wound to the head or face that no one would hire him. Although, the wound wouldn’t rate total disability, the psychological damage of having to face the war each day from the disfiguring wound and not being able to secure employment because of the wound would rate 100% T&P for PTSD. If you have had a long term history of employment and are currently employed, getting 100% on an initial claim is not going to happen.

Some veterans worry that their PTSD percentage will be cut during yearly Comp Exams. This is not likely because PTSD does not go away. It may improve on a temporary basis, but it will never go away. Once you have a PTSD percentage, it will likely go up, and never go down.
Another veteran wanted to know if it is necessary to attend therapy to receive a service connection for PTSD.

After you are service-connected, it is up to you whether you want to continue therapy. If you intend to go for an increase, therapy is important because it shows you are seeking help. If you are satisfied with your percentage, you do not have to attend therapy. Therapy is something that should be done on an individual basis according to need. If you feel further therapy won’t help you, then go only when you feel the need to talk to someone. Once again, your percentage isn’t likely to be cut because you don’t want to see a therapist constantly.

Another veteran wanted to know if Unemployable veterans can get same day treatment at a VA Medical Center for a bad tooth, ingrown toenail, or a painful boil. You can receive treatment for all these conditions, but it is different at each VA Medical Center as far as immediate treatment. It would be best to call ahead and make sure you can get in on an emergency basis, and make sure you let them know you are 100%, especially for dental work.

Also, if you are in a Voc Rehab program, you receive treatment the same as 100% while you are in the program. If this is your case, I would request documentation from the Regional Office to allow emergency treatment, because if you just go in and say you are in Voc Rehab, the Medical Center won’t treat you without an okay from the Regional Office. Since this could take a month or longer, a bad tooth won’t wait that long.

Also, if you have a dental emergency while in Voc Rehab, call your service organization officer and they should be able to help you get in right away or you may also try your Voc Rehab case worker.

Finally, for veterans filing an initial claim, it would be best before you file to go to a VA Medical Center Out-Patient Clinic and request to talk to someone about PTSD. This gets it on record that you are seeking treatment and puts you in the system. You may also be able to get an immediate diagnosis of PTSD.

(The picture above was taken at the wall by another Marine Nam vet and childhood friend, Bill Maag. Thomas W. Mills was our childhood friend killed by a sniper around May of 1968. We called him Bo. During visitor day in boot camp, the DI screamed at me that my brother was here to see me. I didn't have a brother but I kept my mouth shut and went to the visitor center. It was Tom, down from Pendelton and pretending to be my brother. He bought me smokes and I had about three chocolate malts before the visit was over. That visit allowed me to make through the last few weeks of boot camp. I still think of him each day.)