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Posted on 11/25/2025 8:25:47 AM PST by ducttape45
As many of you know, my retirement has been, well, interesting, and there has been nothing more interesting than dealing with the VA section for disability claims. They recently granted me a 10% for tinnitus, which got my medical benefits back which the VA tried to take away from me earlier in the year.
But they keep denying claims for hearing loss and PTSD. They are trying to schedule me for a sixth appt to see an audiologist, which I will absolutely not attend. They have all the evidence they need to process that claim, and all they should need to do is look at the fact that I have a 30% hearing loss in each ear to approve it. So far they have not.
The claim for PTSD, however, has gotten even harder to navigate, and that is now because the VA says your case has to fall within guidelines set forth DSM-5-TR, which is "Diagnostic and Statistical Manual of Mental Disorders." See link below. Basically, that's a book put together by over 100 psychiatrists that provide guidelines for what is PTSD and what is not. Yep, you heard that correctly. The VA is now outsourcing who tells them what is PTSD and what is not.
To say I am angry, befuddled, outraged, etc, is an understatement. I remember when there were only two criteria used to diagnose PTSD. Then it jumped to five. Now we are up against 100 psychiatrists and a book in order to prove our claims.
I plan on filing an appeal, and when I do it will not be kind. Of that I guarantee you. But I wanted to put this out to all of you so you will be "forewarned and forearmed" if/when any of you decide to file a disability claim for PTSD.
So much for the new VA department head making things easier huh?
Thoughts?
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This is the link to the book I alluded to above.
A letter I wrote helped a friend with his claim, but it was behavior I experienced, being around him.
As long as convicted felon scumbag ex-CONgresscritter Jesse Jackson (Grifter) Jr. gets $8,000/month in disability (poor guy is bi-polar doncha know) it’s all good.
Okay, wait a minute.
VA healthcare is denied to veterans IF THEY MAKE TOO MUCH MONEY. This is not new. Phrasing it as getting your health benefits back is a stretch.
You made too much money. The income restriction ends if there is even 10% of service connected disability — which you applied for and got approved. It wasn’t some arbitrary refusal of healthcare going on. You made too much money. The tinnitus claim got approved and the income limit on healthcare ended.
Hearing loss as a disability is a high bar to get over. The requirements are laid out. https://www.hillandponton.com/va-hearing-disability-calculator/
An audiologist, preferably a VA audiologist, has to provide a diagnosis derived very specifically from the above Puretone test — or speech recognition stuff. You can ask AIs about this. Much faster look up. “The vast majority of veterans with hearing disability are rated only 10% for hearing loss.” While you are with the audiologist, now that you have healthcare benefits restored, ask him/her if you should have a hearing aid. Free through the VA.
As to PTSD, no, you are not up against 100 shrinks. You have 100 shrinks trying to get you what you claim. Qualify under their specifics and you get rated. If you don’t, then you should be glad you don’t have it.
Oh, and one more thing.
That 10% tinnitus claim is paying for your healthcare right now. Every new claim you make opens an overall review of your situation, in ALL aspects. This is called “poking the bear”.
You have free healthcare for life. And you’re now making a claim for hearing loss that may add (probably) just 10% more -— OR -— it may get your tinnitus claim re-visited. And ended.
You really want to poke the bear? This is a lot of risk for just 10% more reward.
As far as I know, the VA always used the DSM.
Every claim I have filed with them was easy and quickly approved.
Unsolicited advice: If you fill your appeal with vitriol you diminish your chances.
My brother went thru the same thing twenty years ago. A VA appeals court judge ruled in his favor, but the state VA org ignored the ruling. The appeals court never responded to calls requesting enforcement of the decision.
Finally, he got a psychologist AND a U.S. senator on board, and only then did the VA grant him 100% disability. In the meantime, two cousins who were Vietnam veterans committed suicide when they started having flashbacks.
One was even a nurse, but he had been USAF security police, doing patrols outside the perimeter at Cam Ranh Bay. All he ever said, even to his wife, was that yes, he had been involved in close combat.
This sort of story is not pleasant, but the fact it exists is the proper reply to people that think VA disability is all fraud.
A guy raised his right hand and took the oath and then did annual firearms training starting age 18 and onwards. His ears have had ringing in them for decades. For the rest of his life.
The VA calls this 10% disabled. Worth about $180/month.
Then one day a coworker sees him walking out to his car. And hears that “Jim is on VA disability”. This generates rage. “I just saw him walking to his car. He’s not disabled!! What total fraud! I’m reporting him!”
Right here is where we’re supposed to say that all veterans are saints that would never lie.
I’m a veteran and have seen LOTS of scamming with this stuff.
Hopefully you have a Veterans Service Organization (VSO) helping you. Navigating the VA system by yourself is frustrating and time consuming. A good advocate can get you set up, get your paperwork filed, and have you getting your exams in very short order. There is usually an advocate office co-located or very nearby the VA office.
Basing claims on that “book” of standards has been the case for ages. Maybe not at the VA, but everywhere else in the world. The basis for all mental health claims are changing all the time based on research and treatments.
That said, when I have had friends battling the VA processes they found three paths that helped them: One was the American Legion. They usually have people who can assist with claims and the process—which can be daunting.
The second is their Congressional office. They too have people dedicated to these processes.
Finally, at least in MA, there are state VA related agencies who can help.
I am sorry this is being so tough to settle. My Son in Law has a 10% hearing disability based on his time in an artillery unit. He is also looking at a PTSD claim based on issues from his time in Somlalia. Good luck to you!
I have never understood PTSD. I am aware it generates big VA ratings.
I am also aware law firms with VA focus-of-practice maneuver every possible way to get PTSD awarded. They know the specifics.
But the veteran has to exhibit the required symptoms and has to do it with a trained shrink.
My suspicion is the shrinks refuse many of these claims, because they failed one of the requirements during the exam.
I have heard far more stories of guys who probably deserved ratings get denied them, than guys who didn’t deserve a rating and got it. Why do I say this?
Because the process is really difficult. I have listened to former enlisted who just can’t understand the process and file the wrong forms and say the wrong things on them, or miss appointments or whatever. It’s really difficult and the vast majority of vets (the majority are enlisted, not officers) can’t figure it out. So they file, get refused and shrug and move on.
Lawyers bypass the difficulty, but they won’t take cases that are not going to generate their fees. They have to have good confidence the veteran is going to qualify or they won’t step in (to take their 30% of backpay or whatever).
Nah, the VA is not stupid. They know guys will try to fake something. And their process weeds that out most of them. Maybe over-weeds.
Hardly anyone gets anything for hearing loss unless it is documented directly soon after the event which caused it. I also have the 10% for bi-lateral tinnitus and just got my hearing aids last Friday. Total game changers!
Some history. I was a VA psychologist for 22 years, 1974 to 1996. The PTSD diagnosis didn’t exist until 1980, when the existing DSM (DSM II) was revised into DSM III. I worked with countless veterans both in treating PTSD and conducting C&P exams, The exam you go through when applying for disability compensation. When I retired from the VA in 1995 we were up to DSM IV, with DSM V soon to follow. I continued doing both ends of the work in private practice until about 2020.. The diagnosis has changed somewhat throughout these revisions, but the basic criteria have remained.
It is essential to know a few things: First, the VA has always used the existing DSM to make diagnoses; This is not new.
Second, VA psychiatrists and psychologists, among many others, have been involved from the start in defining the criteria for PTSD, and the combat veteran experience has been a part in defining the condition. For the revision of DSM III, the DSM III-R, I was on the PTSD committee myself. The committee was heavy with VA people who had been involved, like me, in treatment of vets for years.
Third, the process of determining VA disability has two basic steps: the diagnosis comes first, by a clinician, who writes up a clinical evaluation; and second the disability determination, by a different person, based on the outcome of the exam. The psychiatrist you see for the exam does not decide on disability.
Disability determination depends on a number of criteria mostly which relate to post-trauma functioning: not only symptoms of post-traumatic anxiety but also problems in various domains of functioning. I don’t have DSM-5-tr but from DSM 5, the key criterion for disability is this: “The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning,” A statement like this has been included in every rendition of the diagnosis. The only thing new that you may be encountering is the wording in DSM5tr.
To be clear, it may sound cold, but the compensation is for this loss of functioning, ie disability to function, not simply for the pain and suffering that goes with it. Hope this helps.
Also, there are a lot of us who won’t go to the VA because we believed it’s only for the guys who got torn up in combat, but it isn’t. Those who served honorably and saw no combat signed the same dotted line. The guy who lost an arm in Iraq and the guy who broke his back falling off a loading dock while humping a case of .45 acp in GTMO signed the same paperwork. Both are lifelong injuries, and both earned the disability. It took me awhile to learn that, but a one-armed combat vet showed me the light.
“for a sixth appt to see an audiologist, which I will absolutely not attend.”
That’s not going to help you at all.
The test orders could be coming from different offices or organizations. All need confirmation or re-confirmation to approve the disability or move your case along. It could also indicate your AD records are lost somewhere or not yet received.
All my stuff occurred LoD. Most of it was entered into my service med. records at the time. Since then they’ve been verified after service and are current to this day (as with you). They only granted many of them on appeal AFTER going thru all the testing.
Then at 1 year my PCP re-tested when I went to 6-month checkup. I am very fortunate to have a great VA doctor and I have definite symptoms.
I have bad balance and trouble and walking. I never get griefed in Disabled parking spaces.
Took 22 years to get fully rated using 1/3 of the injuries....
Second, yes, hearing loss is a high bar to get over. I'll check out webpage.
Third, the requirements for PTSD used to be based on only two requirements, which was then expanded to five. But I shouldn't have to go against 100 shrinks. For the VA to adopt the standards in that book is, in my view criminal, and a disservice to veterans across the board.
Good advice
That’s good data, but slightly off.
The award is a 3 step process. Not 2. First, a current diagnosis, which you listed. The 3rd step you also listed, an evaluation of extent.
The 2nd item is nexus. There has to be an evaluation that the diagnosis derives from active duty service. In most cases of all disability, not just PTSD, there would need to be evidence of ongoing issues (though some issues are intermittent and need not prove this).
Nexus is in the form of an evaluation by someone, maybe . . . often . . . the C/P examiner that “the current diagnosis is at least as likely as not” derived from active duty events.
The linkage of diagnosis can be less than 50% likely derived from active duty, 50/50 likely linkage (as likely as not), or certainly linked (an amputation for example occurring at a battlefield hospital).
As I said above, it is a difficult process. Cheating is not a trivial thing to do.
So have I, trust me, but I’ve also seen Army vets where were injured during training (their back) and the VA still hasn’t granted him a disability rating though there is ample proof it happened.
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