PTSD: Symptoms, Treatment Options, and VA Disability Rating Guide

Bottom Line Up Front: PTSD is a treatable condition affecting 10-30% of combat veterans. Symptoms include intrusive memories, avoidance, negative mood changes, and hypervigilance. Treatment (therapy + medication) is 70-80% effective. VA disability ratings range from 0% to 100%, with most combat veterans qualifying for 50-70%. Getting help does NOT end your military career or security clearance.

What Is PTSD?

Definition

Post-Traumatic Stress Disorder (PTSD) is a mental health condition triggered by experiencing or witnessing a traumatic event.

Common Triggers in Military

• Combat exposure
• IED attacks
• Witnessing casualties
• Military Sexual Trauma (MST)
• Serious vehicle accidents
• Deployment stress

PTSD vs. Normal Stress

Normal stress/grief:

• Fades over time (weeks to months)
• Doesn't interfere with daily life
• Improves with time and support

PTSD:

• Persists for months/years
• Interferes with work, relationships, daily functioning
• Doesn't improve without treatment

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PTSD Symptoms (DSM-5 Criteria)

1. Intrusive Memories (Re-experiencing)

• Flashbacks (feeling like you're back in the traumatic event)
• Nightmares about the event
• Intrusive thoughts that won't go away
• Intense distress when reminded of the trauma

Example: Hearing a car backfire and immediately dropping to the ground, heart racing, feeling like you're back in a firefight.

2. Avoidance

• Avoiding places, people, or activities that remind you of the trauma
• Avoiding talking or thinking about the event
• Emotional numbness
• Detachment from loved ones

Example: Refusing to watch news about the war, avoiding veteran gatherings, not talking to family about deployment.

3. Negative Changes in Mood and Thinking

• Persistent negative beliefs ("The world is dangerous," "I can't trust anyone")
• Distorted blame of self or others
• Persistent negative emotions (fear, anger, guilt, shame)
• Loss of interest in activities you used to enjoy
• Feeling detached from others
• Inability to feel positive emotions

Example: Believing "I should have saved my buddy" and feeling overwhelming guilt, even when you did everything you could.

4. Hyperarousal (Increased Reactivity)

• Irritability, angry outbursts
• Hypervigilance (constantly scanning for threats)
• Exaggerated startle response
• Difficulty concentrating
• Sleep problems
• Reckless or self-destructive behavior

Example: Always sitting with your back to the wall at restaurants, scanning exits, unable to relax even at home.

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PTSD Treatment Options (What Actually Works)

1. Cognitive Processing Therapy (CPT)

What it is:

• Structured therapy (12-16 sessions)
• Helps you understand how trauma changed your thoughts
• Challenges unhelpful beliefs ("It was my fault")

Effectiveness: 60-70% of patients see significant improvement

Where to get it:

• VA Mental Health Clinic
• Vet Centers
• TRICARE-covered providers

2. Prolonged Exposure (PE) Therapy

What it is:

• Gradual, repeated exposure to trauma memories
• Helps reduce avoidance and fear
• 8-15 sessions

How it works:

• You retell the traumatic event in a safe environment
• Therapist helps you confront avoided situations
• Over time, memories lose their power

Effectiveness: 60-80% of patients improve significantly

3. Eye Movement Desensitization and Reprocessing (EMDR)

What it is:

• Uses eye movements (or tapping) while recalling trauma
• Helps brain "reprocess" traumatic memories
• 6-12 sessions

Effectiveness: 60-70% improvement rate

Why it works:

• Engages both sides of the brain
• Reduces emotional intensity of memories

4. Medications

SSRIs (Selective Serotonin Reuptake Inhibitors) - First-line:

• Sertraline (Zoloft) - Most commonly prescribed
• Paroxetine (Paxil) - Also effective
• Fluoxetine (Prozac) - Alternative option

How they help:

• Reduce intrusive thoughts
• Improve mood
• Reduce hyperarousal
• Takes 4-6 weeks to work

SNRIs:

• Venlafaxine (Effexor) - For those who don't respond to SSRIs

Prazosin:

• Specifically for nightmares
• Taken before bed
• 70-80% effective for reducing combat-related nightmares

5. Combination Therapy (Best Approach)

Most effective treatment:

• Therapy (CPT or PE) + Medication (SSRI)
• Success rate: 70-85%

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VA Disability Ratings for PTSD

How VA Rates PTSD

Rating scale: 0%, 10%, 30%, 50%, 70%, 100%

Based on:

• Frequency and severity of symptoms
• Impact on work and relationships
• Level of functional impairment

Rating Breakdowns

0% (No Disability)

• Diagnosis of PTSD, but symptoms don't impair functioning
• Rare, mostly for service connection without current symptoms

10% (Mild)

• Occasional sleep disturbance
• Mild anxiety
• Symptoms controlled by medication

30% (Moderate)

• Occasional decrease in work efficiency
• Mild memory loss
• Chronic sleep impairment
• Mild depression/anxiety

50% (Moderately Severe)

• Reduced reliability and productivity
• Difficulty understanding complex commands
• Impaired judgment
• Disturbances of motivation and mood
• Difficulty maintaining relationships

70% (Severe)

• Deficiencies in most areas (work, school, family)
• Suicidal ideation
• Near-continuous panic or depression
• Difficulty with routine daily activities
• Neglecting self-care

100% (Total Occupational Impairment)

• Cannot work
• Cannot maintain personal hygiene
• Cannot maintain relationships
• Persistent delusions/hallucinations
• Grossly inappropriate behavior

Average Ratings

Most combat veterans with PTSD: 50-70%
Severe cases: 70-100%
Mild cases (well-controlled with treatment): 10-30%

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How to File a VA PTSD Claim

Step 1: Get Diagnosed

1. See VA mental health provider OR private psychiatrist/psychologist
2. Get official PTSD diagnosis (must meet DSM-5 criteria)
3. Request copy of diagnosis for your records

Step 2: Establish Service Connection

You need to prove:

1. You have PTSD diagnosis (current)
2. You experienced a traumatic event during service (in-service stressor)
3. The PTSD is linked to that event (nexus)

Evidence to gather:

• DD-214 (discharge paperwork)
• Service medical records
• Buddy statements (fellow service members who witnessed event)
• Combat Action Ribbon, Purple Heart, or combat-related awards
• Lay statement (your own description of the event)

Step 3: File the Claim

1. Go to VA.gov
2. File disability claim (VA Form 21-526EZ)
3. Upload supporting documents
4. Request Compensation & Pension (C&P) exam

Step 4: Attend C&P Exam

• VA will schedule psychiatric evaluation
• Be HONEST about symptoms (don't exaggerate, but don't minimize)
• Describe your worst days, not your best days
• Answer every question fully

Step 5: Wait for Decision

• Typical timeline: 3-6 months
• Check status at VA.gov
• You'll receive rating decision by mail

Step 6: Appeal if Needed

• If rating is too low, you can appeal
• Get help from VA-accredited attorney or VSO (Veterans Service Officer)

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PTSD Disability Compensation (Monthly Payments)

| VA Rating | Monthly Compensation (2025) | With Spouse | With Spouse + 1 Child | |--------------|--------------------------------|----------------|--------------------------| | 10% | $171 | $171 | $171 | | 30% | $524 | $586 | $633 | | 50% | $1,075 | $1,154 | $1,213 | | 70% | $1,716 | $1,823 | $1,899 | | 100% | $3,737 | $3,946 | $4,072 |

Tax-free income: VA disability is NOT taxed.

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Common PTSD Myths (BUSTED)

❌ Myth #1: "Only combat veterans get PTSD"

Reality: MST (Military Sexual Trauma), vehicle accidents, witnessing death, and non-combat trauma can all cause PTSD.

❌ Myth #2: "Seeking help will end my career"

Reality: Thousands of service members get PTSD treatment and continue serving. Only severe, untreated PTSD leads to discharge.

❌ Myth #3: "PTSD means I'm weak"

Reality: PTSD is a biological response to extreme stress. Your brain is doing what it's supposed to do after trauma. Seeking help is strength.

❌ Myth #4: "Therapy won't help"

Reality: 70-80% of people who complete PTSD treatment see significant improvement. It works.

❌ Myth #5: "I'll lose my security clearance"

Reality: Seeking mental health treatment does NOT automatically disqualify you. UNTREATED mental health issues are what hurt clearances.

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When to Seek Help Immediately

Red Flags (Don't Wait):

• Suicidal thoughts
• Plans to harm yourself or others
• Severe substance abuse
• Can't function at work/home
• Violent outbursts
• Self-isolation for weeks

Crisis Resources:

• 988 Suicide & Crisis Lifeline: Call or text 988
• Veterans Crisis Line: Call 988, press 1 | Text 838255
• Nearest ER: Go immediately if in danger

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Action Steps

If You Have PTSD Symptoms:

1. ✅ Call VA Mental Health (877-222-8387) or Military OneSource (800-342-9647)
2. ✅ Schedule appointment with mental health provider
3. ✅ Get diagnosed
4. ✅ Start treatment (therapy + medication if needed)

If You Want to File VA Claim:

1. ✅ Gather evidence (DD-214, medical records, buddy statements)
2. ✅ File claim at VA.gov
3. ✅ Attend C&P exam
4. ✅ Get VSO help if needed (free)

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Related Guides

• TRICARE Mental Health Coverage Complete Guide
• VA Disability Claims: Step-by-Step Process
• Deployment Stress vs. PTSD: Knowing the Difference

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Remember: PTSD is treatable. You're not broken. You're not weak. You experienced something traumatic, and your brain is responding normally to an abnormal situation. Treatment works. Get help.