New Requirements to Acquire VA Disability for PTSD

11/25/2025 | Ducttape45

[ducttape45]

The local VSO's, sad to say, are a sorry bunch. I won't say where I am, but there is no one in my area that is any good at their job. I know there are good ones out there, but I haven't met any.

I even had a law firm try and couldn't get anything done. I got the tinnitus rating on my own.

[HereInTheHeartland]

Are there people that can help you navigate through this?

[ducttape45]

That helps. Thanks.

[Owen]

First, I don’t know where my income came into this picture, but no, I did not exceed the limits. I proved that to the VA (I keep detailed records), and they denied it anyway. It wasn’t until my tinnitus diagnosis and approval did that become a mute point.

///////////////////////////////////////////////////////

Don’t know what it is you proved.

VA income is HOUSEHOLD INCOME and it has nothing to do with the IRS. The IRS definition of income IS NOT USED BY THE VA.

For example, you have a Roth IRA and you withdraw money from that. This is not taxable income. The IRS ignores this. It’s not income. But the VA does NOT ignore it.

VA income is money that comes into the veterans hands and is available for healthcare, as its top priority. This means no deductions can reduce income. Mortgage interest deduction? Nope, VA does not allow that. The income is not reduced. That money is in your hands and can pay for healthcare as top priority. Mortgage interest is 2nd priority or 3rd or whatever.

This is why VA healthcare is rare for guys pre retirement. They have a salary. It blows past the income restriction (which is now about $69K I think). But come retirement, $69K is rather a lot of Soc Sec.

Oh, and then there is the wife, or maybe her mom lives with you. That’s HOUSEHOLD. Both their incomes count.

Your 10% tinnitus award got past that.

[Seruzawa]

I got 10% hearing disability easily. Vietnam gunboat service and a few years in a destroyer engine room did the trick. I wouldn’t poke the bear. I already have lifetime free medical and it isn’t worth the risk.

[ducttape45]

No, there is no one locally who is capable. My local doctor has been hard pressed to find anyone she can refer me to.

[ducttape45]

The income restriction is $41,000 (ish), and I was regularly paying for many of my medical supplies, especially my CPAP stuff. All totally, my medical expenses were to the tune of about $3,000 - $4,000 annually. Take that amount from the $41,000 and I fell well below the limit. And no, I had no other income other than my government salary, and I live alone.

[ducttape45]

Wise words, and I will definitely take that into consideration. I have an appt with my doctor in about an hour. I’ll see what she recommends. She, BTW, is the wife of an AF veteran, so she’s knowledgeable on all this stuff.

[Owen]

$41K is the limit for no copays. (drug copays yes, but other copays no)

You can still be enrolled with VA healthcare, WITH copays, up to about $69K.

We could track down how you blew past $41K to get denied. Some possibilities . . . Yes, if you paid personally for CPAP, medical costs do reduce income.

One item I have seen ... if you sold an investment, this gets reported to the VA and total sales price is VA INCOME. But only if you do not send them the details on the original purchase price.

Meaning, sales price is income if the VA has not been provided purchase price, which they do not get from the IRS. you have to proactive do that yourself.

[Owen]

Oh one other thing. If you sell your personal residence, the VA will NOT call that income. If you sell real estate that is not your personal residence, then that IS VA income.

[Mr Rogers]

PTSD is a grossly abused excuse. It is real for some. But my Dad suffered from nightmares his entire life - from WW2 and Korea - yet rose to the rank of Colonel and died in Vietnam.

One uncle in the Merchant Marine had 2 ships sunk under him. He was also blown overboard during a torpedo attack and no one can explain how he survived over 24 hours in the North Atlantic on a piece of wood.

He came home, built a life and was a wonderful guy.

PTSD does exist, but it has been abused to create jobs for VA administrators.

[mosaicwolf]

Don’t let it bother you too much. When I returned from Vietnam nobody ever heard of PTSD. We survived and just drove on with our life.

[Seruzawa]

I quit going to the local VA office because the guys there wouldn’t leave me alone about applying for PTSD. “You were on gunboats. You have to have PTSD.” Yada yada yada. I refuse to let one of those f***ing brain butchers get their mitts on me. Psychiatrists will ruin your life. They have destroyed several friends and acquaintances of mine. Not me. No way.

[maddog55]

Getting anything for hearing loss you have be damn near deaf. 30% deaf in each ear isn’t how it’s measured and there’s tight requirements to get anything.

I’m just shy of 2000 days for a BVA claim on shoulder issues clearly documented in service medical records but have been denied over and over. I have a NEXUS connection via 4 orthopedic surgeons this time but I’m not holding out much hope.

Took 26 years of fighting to get the back issues right. You heard that right but they finally got it right 7 years ago.

I’d like to file for PTSD just because of how F’d up the VA is but I’d be dead by then which is precisely what they hope for.

[maddog55]

VA healthcare is denied to veterans IF THEY MAKE TOO MUCH MONEY.....

Where does it say that anywhere?

[TonyM]

I am a retired VA Rater and getting a diagnosis of PTSD was absurdly easy. I use to say that psychiatrists, especially VA psychiatrists, would diagnose a rock with PTSD just to help create a “client base” to ensure the need for their questionable profession. With a diagnosis all you need is a stressor linking it to service which is also a cinch for event the least creative mind. I personally believe that fully 90 percent or more of PTSD claims are bogus. It’s become an easy to obtain retirement fund for anyone dishonest enough to take it.

[Owen]

https://www.va.gov/health-care/eligibility/

If none of these descriptions apply to you, you may still qualify for health care based on your income. Find out if you may be eligible for free or reduced cost health care based on your income.

Learn more about income limits and your VA health care

https://www.va.gov/health-care/income-limits/introduction

[lastchance]

What criteria did the VA use in the past to establish a diagnosis of PTSD? If it simply relied on the physicians diagnosis remember his diagnosis was likely based on a recognized criteria such as the DSM which has been in existence for a long while.

Most likely probably on the VA website you will find a list of finding necessary to establish the diagnosis. It is possible that you meet the required criteria and to still be turned down. That is why there are lawyers who specialize in taking your case through the process exist. They can also help with the administrative appeal if it comes to that. So see an attorney.

FYI https://www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp

[maddog55]

It’s actually based on your priority group..

Overview of VA Priority Groups

The Department of Veterans Affairs (VA) assigns veterans to one of eight priority groups based on their service history, disability ratings, and income levels. These groups determine eligibility for health care benefits and the costs associated with them.
VA Priority Groups Breakdown
Priority Group Eligibility Criteria Benefits
1 Service-connected disability rated 50% or more, or deemed unemployable Full health care with no copays
2 Service-connected disability rated 30% or 40% Lower copays for care
3 Former POW, Purple Heart recipient, or service-connected disability rated 10% or 20% Lower copays for care
4 Catastrophically disabled or receiving aid and attendance Lower copays for care
5 Non-service-connected disability with income below VA limits Lower copays for care
6 0% service-connected disability or specific service history Copays may apply
7 Non-compensable service-connected veterans with higher income Copays apply
8 Non-service-connected veterans with income above VA limits Copays apply; new enrollments are currently not accepted
Factors Influencing Assignment

The VA considers several factors when assigning priority groups:

Military Service History: Length and type of service.
Disability Rating: Ratings assigned for service-connected disabilities.
Income Level: Financial status compared to VA income thresholds.
Other Benefits: Eligibility for programs like Medicaid or VA pensions.

[zeestephen]

Re: "Diagnostic and Statistical Manual of Mental Disorders"

The DSM series (5 editions) has been used since at least the 1980s to evaluate Social Security Disability claims.

DSM-1 was published in 1952. Much of the original data came from US Army doctors.

DSM is recognized around the world, and it has been thoroughly integrated into the USA legal system.

Internationally, there are similar publications. Some of those publications challenge and disagree with DSM data.