Is PTSD a Disability?Updated July 7, 2020 Veterans Disability
Post-traumatic Stress Disorder (PTSD) is a mental health disorder that can interfere with daily living and lead to long term disability. It is a common disorder among veterans, though it can happen to anyone who has experienced a traumatic event or series of events. Many PTSD sufferers can qualify for VA disability benefits.
Common Symptoms of PTSD
- Reliving trauma (e.g. flashbacks, nightmares)
- Intrusive thoughts
- Trouble sleeping
- Difficulty controlling temper and anger
- Emotional numbness
- Anxiety and panic attacks
- Sadness or depression
- Easily startled
- Always being on guard
- Guilt or shame
- Difficulty concentrating or completing tasks
Who Is at Risk for PTSD?
Certain subpopulations are at higher risk for post-traumatic stress disorder. Stressor events and traumatic incidents that can lead to this serious mental health condition include: being the victim of a violent crime, experiencing the violence of war; or experiencing one or more adverse childhood events (ACEs) such as the death of a parent, witnessing domestic violence, experiencing abuse or neglect, being the victim of severe bullying, or surviving a life-threatening illness or physical injury.
Groups that are particularly vulnerable to suffering from PTSD because of the high potential for experiencing a stressor event include active duty service members, veterans, child or adolescent victims of abuse, police officers, EMTs, firefighters, social workers, incarcerated or formerly incarcerated persons, or witness of community violence.
PTSD in veterans is one of the more well-known manifestations of PTSD, but it is less commonly understood by the public that some of these other groups suffer in larger numbers as well.
When Is PTSD a Disability?
Having some PTSD symptoms or a mental health disorder related to PTSD does not automatically qualify you for disability benefits. If you have symptoms of mental health problems that do not completely impair your day to day functioning, you will likely be denied a PTSD disability benefit.
To the extent that you have developed a mental illness, documentation must be completed by a mental health professional that shows that the onset of this mental illness was directly related to a traumatic event and is disabling enough to impair daily functioning. A traumatic event cannot be imagined or fantasized. A traumatic event that leads to PTSD symptoms must be documented to get disability benefits. Hallucinations, fantasizing, or paranoia may be indicative of a different mental illness. These symptoms should be assessed by mental health professionals and could potentially be documented in a separate disability claim.
Why is PTSD a Disability?
The level of social impairment resulting from PTSD varies from person to person, but PTSD can be a long-term disability. Symptoms can interfere with personal relationships and relationships with peers and coworkers. These symptoms can be debilitating enough to prevent one from working. Suffers may be distracted, unable to concentrate, and unable to fulfill work responsibilities and work-related tasks. If PTSD and its concurrent mental health challenges prevent an individual from working, the person may be eligible for VA disability benefits or SSDI.
Common Symptoms of PTSD
Reliving Trauma (Flashbacks, Nightmares)
Common symptoms of post-traumatic stress disorder include flashbacks and nightmares that bring the sufferer back to the traumatic event. These symptoms became widely documented after Vietnam veterans returned from war in the 1970s. Scientists have identified areas of the brain associated with involuntary (automatic, not induced) reliving of traumatic events including the amygdala, striatum, rostral anterior cingulate cortex, thalamus, and ventral occipital cortex.
Not all sufferers of PTSD are involuntarily reliving an event but instead have intrusive thoughts about the event, their safety, or their loved one’s safety. These intrusive thoughts can be indicative of a separate but related mental health condition called Obsessive Compulsive Disorder (OCD). Along with unwelcome intrusive or obsessive thoughts, repetitive behaviors are a key symptom of OCD and may make the sufferer feel more in control, but these behaviors can become a major social impairment. There is evidence that PTSD sufferers who develop OCD are at higher risk of developing other serious mental illnesses and more serious symptoms of PTSD such as “suicidal thoughts, self-mutilation, panic disorder with agoraphobia, hoarding, compulsive spending, and greater anxiety or depression.”
Sleeping difficulties can certainly be a disabling symptom of post-traumatic stress disorder. Sufferers who cannot get a full night of sleep due to insomnia, flashback, or nightmares will not be able to function at work or home due to continuous exhaustion. Lack of sleep can also lead to mental illness such as depression, weight gain, and a lowered immune system.
Sufferers of post-traumatic stress disorder may have difficulty with relationships because they can not engage with partners or children on a deep emotional level. They may even seem disconnected from daily family life. Intrusive thoughts, lack of sleep, anger, depression, or any other symptom of PTSD can interfere with a PTSD sufferer’s ability to be present, remember birthdays or anniversaries, or joyful. They may also feel like they have less in common with family members because the traumatic event has come to define their existence and reality, which is something family and friends have not directly experienced.
Emotional numbness can be a symptom of a dissociative disorder that is characterized by loss of memory and even feelings of being out of one’s body. Some PTSD sufferers develop dissociative disorders because their minds and bodies are trying to protect them from highly disturbing triggers and memories by literally numbing the senses and dissociating the persons from their conscious and unconscious thoughts.
Difficulty Controlling Temper and Anger
Another stereotypical symptom of PTSD is rage and anger. This does not occur for every person battling posttraumatic stress disorder, but it is common. Difficulty controlling one’s temper can be linked to a mental illness, such as depression or anxiety, that has developed or a more serious mental illness such as bipolar disorder. PTSD sufferers may lash out at friends or family randomly or have angry outbursts that seemingly come out of nowhere and are not directed at anyone in particular. Some PTSD sufferers can even develop a mental health condition called intermittent explosive disorder (IED) which has been studied in U.S. military veterans. IED involves bursts of anger and yelling, throwing things, potentially destroying property, and even assault. Sufferers do not always clearly remember how they acted or what occurred during an episode. IED is often suffered in conjunction with other mental illnesses.
Anxiety and Panic Attacks
Mild, moderate, or severe mental illnesses, including Generalized Anxiety Disorder (GAD), are common in PTSD sufferers. Anxiety is often associated with PTSD, as well as depression and agoraphobia. Some people with GAD or another type of anxiety disorder suffer from panic attacks. These are episodes where the sufferer feels their heart pounding out of their chest, has sudden sweating or shaking, and can feel like they are having a heart attack. A panic attack is fleeting and is not life-threatening but can seem so in the moment. There are many effective therapeutic (counseling and medications) treatments for GAD and panic attacks.
Sadness or Depression
PTSD sufferers may have persistent sadness related to the death of a loved one (a traumatic event), actions they were engaged in or witnessed, or about the perceived loss of a part of themselves as a result of a traumatic event. Sadness may also rise to the severity of depression which is marked by loss of interest in hobbies, people, and life, changes in eating habits, physical aches and pains, and sometimes suicidal thoughts or even suicide attempts. OCD, depression, anxiety, and PTSD are often co-morbid and each needs to be diagnosed separately and treated comprehensively. Depression can lead to major cognitive, emotional, and social impairment but there are many effective treatments for depression.
This mental health disorder can be a major impairment and quite disabling for those suffering from PTSD. Depending on the traumatic event, those suffering from agoraphobia may be quite literally afraid to leave their home, or they may avoid certain places or people that trigger memories or flashbacks.
When veterans have suffered a traumatic event, they may become easily startled by everyday sights or sounds that remind them of the event and sometimes triggers flashbacks. For example, veterans have increasingly put up signs on their lawns around the Fourth of July, asking neighbors to be sensitive to the face that fireworks or celebratory gunfire could severely startle them or cause flashbacks. Sufferers may even be easily startled by everyday things in their environment such as sounds in their home, a family member speaking loudly, their dog barking, or sounds and images on television.
Always Being on Guard
Those with PTSD may also always be on guard to avoid being triggered by a sound, event, or image. They may obsessively try to control their surroundings to protect themselves (and could indicate the onset of OCD). They may put up signs warning neighbors or others to stay away, get guard dogs, or have a consistent sense of hyper-vigilance where they are prepared to fight or to confront something unseen.
Guilt or Shame
Some PTSD sufferers may have feelings of persistent guilt and/or shame due to their actions during a traumatic event. This can occur among non-military sufferers, as well. For example, a parent who has lost a child may have intrusive thoughts that they should have done something to prevent their death.
Difficulty Concentrating or Completing Tasks
Along with memory loss, another symptom of PTSD which can greatly affect work is difficulty concentrating or completing tasks. A sufferer may have never been diagnosed with ADHD or ADD but suddenly finds themselves unable to focus at work or school. They may be easily distracted by intrusive thoughts or spend all their energy being on guard. They may lack interest in their work which could indicate depression, but they also may find completing routine or mundane tasks unimportant or uninteresting. This symptom is highly intercorrelated with other symptoms and mental health disorders stemming from PTSD.
How Is PTSD Documented?
Physicians and psychiatrists must demonstrate that sufferers of PTSD have had exposure to “actual or threatened death, serious injury, or violence.” They also must document that the claimant has had involuntary – meaning not induced or brought out through hypnosis or other therapeutic techniques – intrusive memories, dreams, or flashbacks. Major avoidance of reminders of the events must also be demonstrated. Mental health issues stemming from the event or threat should also be documented. This might include evidence of a mental illness such as anxiety or depression. Furthermore, increased reactivity in the form of hyper-awareness or being easily startled must be described.
The claimants’ physician must further document that PTSD has diminished the claimant’s ability to interact with others and/or function well in their day to day responsibilities. This requirement establishes the specific symptoms that make a claimant unable to complete daily tasks such as the inability to concentrate, remember things, or manage one’s behavior in an acceptable and professional manner.
In the absence of documentation of the aforementioned limitations, the claimant must have documentation that they are receiving therapeutic care but that for two years or more, “you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life” (see 12.00G2c).
How to Get PTSD Disability from the VA
Veterans may also make a separate VA disability claim. Many veterans with PTSD quality for VA disability benefits. They should file a claim for monthly tax-free compensation with Veteran Affairs they are suffering from PTSD as a result of a traumatic event that occurred while they were on active duty. Claims must be made in writing and submitted to the appropriate VA regional office.
Each VA disability claim receives a VA disability rating based on how much the disorder interferes with daily functioning. Veteran’s PTSD is one of the most common disorders claimed by veterans. It is highly recommended that claimants hire a veterans disability attorney for support in reapplying for benefits if their initial claim was denied.
Veterans who are suffering from a PTSD disability should also consider applying for a VA loan which can be used for buying, repairing, or refinancing a home or for retrofitting a home for specific disabilities stemming from a physical injury or other impairment.
If you are experiencing the debilitating effects of PTSD stemming from a traumatic event in your past, you may be eligible for SSDI from the SSA or VA benefits from the Veterans Benefits Administration. Speak to your medical team about your symptoms and how they are interfering with daily functioning. Ask them about helping you make a claim and whether they think you will be awarded benefits. Do additional research online and consult with an attorney, if possible.
There are numerous symptoms of PTSD that can interfere with daily life and even result in long term disability. You are a victim of circumstances that caused your illness and you should not feel any stigma in applying for benefits. Just like any other illness, if you have been injured to such an extent that you can no longer support yourself, you are entitled to receive assistance from the government.