so
hello and welcome to another edition of cck live my name is emma peterson and today i'm joined by
my colleagues michelle de torre and matt fusco and we are going to be talking about a pretty serious
subject um mst ptsd va disability claims um so we're gonna be talking about military sexual
trauma and post-traumatic stress disorder um and like i said a little bit of a heavy topic
so just want to give everyone a heads up before we dive in so according to the us department of
veterans affairs military sexual trauma or mst is a psychological trauma that results from physical
assault or battery of a sexual nature or sexual harassment and va defines sexual harassment as
repeated or unsolicited verbal or physical contact of a sexual or threatening nature
and if a service member experienced sexual trauma well on active duty active duty for
training or in actual even potentially um they could be considered to have experienced an mst
um some examples include you know what you would think being pressured overpowered or physically
forced into sexual activities um sexual contact or activities without your consent including when you
were asleep or intoxicated any type of touching in a sexual manner that made you feel uncomfortable
comments even about your body or sexual activities that you found
threatening and unwanted sexual advances that you found threatening threatening excuse me
so matt um how does this relate to ptsd sure so post-traumatic stress disorder abbreviated as
ptsd is a mental health condition that occurs as a result of experiencing a distressing
shocking or otherwise traumatic event unfortunately many veterans develop
ptsd from events that they witnessed or experienced during their military service
and some of the most common symptoms of ptsd include things like re-experiencing their trauma
through intrusive distressing recollections of the event flashbacks and nightmares emotional numbness
and avoidance of places people and activities that are reminders of the traumatic event
and also increased arousal such as difficulty sleeping and concentrating feeling jumpy and
being easily irritated and or angered as well so michelle can you tell us about the relationship
between mst and ptsd sure so va doesn't consider mst to be a diagnosis it's actually in va terms
it's a traumatic event or experience so therefore you can't compensate a veteran for mst itself
however what va will do is they will grant service connection for conditions that result from the
mst the most common diagnosis is ptsd you'll often see va refer to it in their correspondence as ptsd
due to mst um and the difference between filing a standard ptsd claim and an mst due to ptsd claim
is that the form is a little different they actually require the va form 21 210781a
and you'll notice it's still the statement in support of claim for service connection for ptsd
but secondary to personal assault because it has a little bit of different criteria and
information that they require for that just keep in mind mst is not related it's not related just
to ptsd claims though ptsd is the most common mst doesn't always result in a diagnosis of
ptsd it can also be associated with depression or anxiety or maybe even a physical diagnosis
so to file a claim for ptsd due to mst in general just in general service connection
for ptsd requires a current diagnosis of ptsd by a medical professional evidence of an in-service
stressor or stressful event the event that causes the ptsd and a nexus or link between the two and
so in the case of ptsd resulting from msd the stressor would be the military sexual trauma event
and once service connection is established va will assign a rating based on the severity of the pstsd
secondary to the mst it's important to note that um the identity or characteristics of the
perpetrator don't matter it doesn't legally matter whether the perpetrator was a service member of
any rank a civilian a male a female non-binary you know whether he or she or they were on or off base
that is not really what matters what matters is what happened to you um in filing that claim so
matt um can you go over the importance of establishing a stressor in mst case
yes so establishing a stressor is really essential to mst related ptsd claims
not only because a confirmed stressor is necessary for granting service connection but also because
a plausible stressor is necessary for va to order a compensation and pension exam as well
sexual assault in general is such a personal and sensitive experience that it's often difficult
or maybe even impossible for an mst survivor to report or document the stressor when it actually
happens to them along the same lines for many valid reasons veterans often do not report mst
events while they are in service and therefore finding credible supporting evidence of a stressor
is often more difficult in military sexual trauma cases than let's say in other types of ptsd claims
fortunately however va has recognized that it is unreasonable to expect all mst survivors to have
direct documentation of their traumatic event given the difficulty of reporting the direct
documentation that we're kind of thinking about here is things like service medical records or an
official report of some type of that mst incident actually occurring so as a result the evidence
standard for establishing the stressor in certain types of ptsd claims has been liberalized or made
easier for claimants uh va allows the claimant to use a wide range of evidence to indicate that
the event actually occurred it is worth noting however that since va adjudicators do not always
accurately follow these more liberal standards it's important to be aware of them in case you
might need to appeal your particular claim if it's denied on that type of basis so mst related
ptsd claims fall under the category of personal assault for ptsd claims and for claims that fall
under this category objective documentation of the actual stressor is not necessary so va guidelines
instruct the adjudicators of mst claims to look beyond the claimant's military records alone
and as a matter of law the veterans failure to report the event at the time it occurred cannot
be used against them in these particular claims so michelle matt mentioned that um you know v
is going to look at a wide variety of evidence you don't need objective evidence in these cases
um can you talk to us about markers and how those come into play in verifying a stressor in an msc
case yeah so when there's not objective evidence or documentation that exists in service records
the adjudicators are then supposed to then go searching for markers which are signs
events or circumstances that indicate or mark that a stretcher may have occurred
so there are two types of markers that va will look for records which are records
in this circumstance other than service records and behavior changes so for sources of records
you could have maybe pregnancy tests that should that help cooperate the event
sexually transmitted disease testing hospital or physician records keep in mind when i say hospital
and physician records they don't need to be specifically talking about the mst they can
be talking about maybe because of msc there was additional injuries that were occurred that these
cooperate maybe after the mst you had stomach problems and you were consistently going to see
the doctor because now you just were so anxious that you're it was causing stomach problems having
records of that could maybe help ripe crisis treatment or any mental health center treatment
law enforcement records police reports again as emma said it doesn't necessarily have to be
an in-service person that did it to you um it just you know happens usually when you're on active
military service so there could be outside records that cooperate the stressful event
um late statements from fellow service members clergy family friends um maybe somebody that
knew of the event that you spoke to about maybe someone that can attest to
behavior changes or injuries that were obtained during a certain time or maybe fear of somebody
examples of behavior changes so this could be a request for a transfer to another military duty
assignment uh poor a change in uh performance and work keep in mind it doesn't have to just be
poor performance it could actually be improvement sometimes people get so nervous that something
else might happen they don't want to stand out at all so they all of a sudden are doing a lot better
in their performance substance abuse is very common to see episodes of depression panic
attacks anxiety without an identifiable cause or unexplained economic or social behavioral changes
so according to va standard training on mst related claims any marker appearing
during the approximate time frame of the msc stressor serves as sufficient evidence to go
forward with scheduling a va examination so if you can show these markers um that are not you
know necessarily standard service records showing that the event happened they should
process the next step and schedule an examination unfortunately this doesn't always happen
but that is what the next step should be and just to back up because i'm not sure we really hit this
in in a general ptsd claim not mst or personal assault um a veteran well veteran will talk
about their stressor va has to corroborate and verify that that stressor actually occurred um
unlike some other claims where perhaps just based on your late testimony and the circumstances of
your service va will just accept that whatever happened happened in ptsd claims they go out
and try to verify that the stressor really occurred and so that's why it's so important for
personal assault mst cases that this relaxed standard exists um because as matt mentioned
it can be next to impossible to produce evidence to verify that these particular events occurred
um and so along those lines you know va has a long history of incorrectly adjudicating msd claims
um an example from the va inspector general's office in 2018 found that in just a six month
period in 2017 one year prior um va officials improperly refused benefits more than 1300
veterans so that's just a six month window in one year
most of whom were female so due to va's failure to follow the liberalized standards for mst related
ptsd claims special training began all the way back in december 2011 to improve competency
va retrained all regional office personnel who process mst related claims as well as
the mental health clinicians conducting examinations related to these claims
and this ongoing training focuses on getting va officials to recognize markers
instead of looking for direct objective evidence to verify a stressor and so because all this was
going on va allows veterans who filed an msc related claim prior to december 2011 to request
a re-evaluation from their local va regional office they will accept new evidence to be
reviewed when a claim is reevaluated and it's best to send any new evidence you might have
military sexual trauma specialists and or women veteran coordinators can help veterans
determine what type of information is best to submit one of those reevaluations veterans who
require a re-evaluation should contact their local ro or mst coordinator to determine how to go about
filing one of these you certainly also could reach out to any veteran service organization
an accredited representative or an attorney if you need assistance with that
all right um matt and michelle matt first any final thoughts for those out there watching
yeah i guess you know these are just inherently really complicated claims that we're discussing
so i think this is a situation where we'd really underscore considering seeking out the help of
an accredited representative or attorney or veteran service organization to kind of
you know consolidate the records that you might need in order to prove one of these cases to va
so that can that can really you know put your case across the finish line in terms of making
a winning case to kind of seek out that extra help in order to put the necessary pieces together in
order to you know make your claim a winning claim and how about you michelle i would just say these
are extremely under reported it is not often that you see these documented in service records
and i would say that if this was something that did happen to you don't think that that counts you
out don't think the fact that you didn't talk to anybody about it in service counts you out
you know obviously like that said it's you know reaching out to somebody because these
are complicated cases but i would just say that you know if this was something that you
experienced just don't think because there's no immediate evidence that you see that you no
longer who do not have a claim so i would highly recommend still reaching out and discussing it
with someone if you feel comfortable great thanks michelle well thanks to everyone for tuning in
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