PTSD
Nexus letters and independent medical opinions for Post-traumatic stress disorder (PTSD) VA disability claims, prepared exclusively by licensed psychologists and board-certified psychiatrists. We conduct the structured diagnostic evaluation, connect your verified stressor to the current diagnosis, build marker-based support for military sexual trauma claims, and document occupational and social impairment in the language of Diagnostic Code 9411, the evidence that separates a 30% rating from 70%.
DC 9411
About PTSD VA Claims
Post-traumatic stress disorder (PTSD) is the most claimed mental health condition in the VA system, and one of the most misunderstood at rating time. The reason is structural. Every mental health condition is rated under one General Rating Formula, and that formula does not measure the diagnosis. It measures occupational and social impairment: what the condition does to work, relationships, memory, judgment, and daily functioning. A PTSD diagnosis alone supports a 0% rating. The impairment evidence is what supports everything above it.
Service connection rests on three elements. A current diagnosis from a qualified mental health clinician. A verified in-service stressor. And a medical opinion linking the two. The stressor rules are more flexible than most veterans believe. Combat and fear of hostile military or terrorist activity carry relaxed verification standards, and military sexual trauma has its own evidence rules built around markers rather than official reports, because the VA recognizes most MST was never reported.
The recurring failure point sits at the exam. A C&P evaluation is a short snapshot, and veterans trained to hold composure often present well for thirty minutes while their daily reality looks very different. Our clinicians address both halves of the problem: a structured diagnostic evaluation, including the CAPS-5 where the case calls for it, that produces measured findings a rater cannot dismiss, and functional documentation that covers the time the snapshot never sees.
Three Ways PTSD Connects to Service
Different stressor types carry different verification rules. Knowing which rule applies to your claim changes what evidence you need, and what you do not.
Combat Stressor
RELAXED VERIFICATION
For veterans who engaged in combat, the lay statement itself can establish the stressor when it is consistent with the circumstances of service. No incident report is required. The work shifts to the diagnosis and the functional evidence.
Fear of Hostile Activity
NO SINGLE INCIDENT NEEDED
Veterans who served where attack was a real, ongoing threat can establish the stressor through the circumstances of deployment confirmed by a VA psychiatrist or psychologist, or one the VA contracts with. Convoy duty, indirect fire, base attacks. The rule exists precisely because no one documented every close call.
Non-Combat & Military Sexual Trauma
EVIDENCE SUPPORTED
Non-combat stressors need supporting evidence such as unit records or buddy statements. Military sexual trauma has its own rules: because most MST was never officially reported, claims can be supported by markers, including changes in performance evaluations, a transfer request, health visits around the time of the event, or a statement from someone you confided in.
Why PTSD Claims Are So Often Underrated
Where Ratings Fall Short
A PTSD rating is built on evidence of impairment. These are the three gaps we see most.
1
The file shows a diagnosis, not a life.
Treatment notes confirm PTSD but say nothing about the job that ended, the marriage under strain, or the crowds a veteran cannot enter. The rating formula measures exactly those things, so a file without them rates low no matter how real the condition is.
2
The exam captured thirty composed minutes.
Veterans are trained to hold it together, and many do exactly that at the C&P exam. The examiner records what they saw. The fix is evidence across time and settings: treatment records, statements from family and coworkers, attendance and work history.
3
Lay evidence was never gathered.
A spouse's statement about nightmares and hypervigilance, or a supervisor's account of missed days and conflicts, is competent evidence the VA must weigh. Most files contain neither, and the rating decision fills the silence with the exam snapshot.
What These Claims Look Like
In Practice
Rated 30%, but the work history says 70%
A veteran holds a PTSD diagnosis and a 30% rating, yet has lost three jobs in four years to conflicts, absences, and an inability to tolerate supervision. The evaluation documents impairment across work, family, and mood in the formula's own terms, and lay statements from a spouse and a former supervisor cover the years the exam never saw.
Rating increase · Functional evidence
Denied for lack of a verified stressor
A veteran who ran convoy security was denied because no single incident appeared in the record. The claim is rebuilt under the fear of hostile military or terrorist activity rule: deployment records confirm the circumstances, and the clinician confirms the stressor is adequate to support the diagnosis.
FEAR OF HOSTILE ACTIVITY · DENIED CLAIM REBUILT.
Military sexual trauma with no report on file
A veteran never reported the assault and assumed that ended the claim. A careful and private record review finds what the VA calls markers: a sudden drop in performance evaluations, a transfer request weeks after the event, and a statement from the friend she confided in at the time. The evaluation and opinion are built on that foundation, at her pace.
MST MARKERS · HANDLED WITH CARE
What's Included
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Frequently Asked Questions
About PTSD Independent Medical Opinion / Nexus Letters