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MST Denied Claims Review Process

During a 2012 Congressional hearing in which the VA conceded that errors were being made in the adjudication of claims following sexual trauma, I asked for—and received—an agreement that any previously denied claim following MST could be reviewed for accuracy.  My request came after hearing from countless veterans whose claims had been inappropriately denied and who had suffered for years while their claims worked their way through the appeal process before they received the benefits they had earned and deserved.
  
Starting in 2013, the VBA provided guidance to VA regional offices stating that any previously denied PTSD claim resulting from MST could be reopened and reviewed based on a claimant simply submitting a request to reopen.  The reviews were focused on whether acceptable secondary evidence (markers of trauma) was overlooked in deciding individual claims.

In fact, the VA sent letters about this option to some of those veterans who had been denied between 2009 and 2013, although the opportunity was not just limited to those receiving letters. The option to request a review of your previously denied claim for PTSD following MST remains available and is described here.    

This review is different than the appeal process in that there are no timelines associated with making the request.  That means that there is not a requirement that you would have kept your denied case “live” by filing a Notice of Disagreement or Request for Reconsideration within one year of your denial.  Neither are you required to submit new evidence. However, this does not eliminate the need to meet the requirements necessary for service connection  (a diagnosis of a chronic physical or mental health condition, evidence of the event or stressor, and a nexus, which is a link between the diagnosis and the in-service event).  

In 2017, the VA Office of the Inspector General conducted another review to evaluate whether VBA staff were correctly processing and deciding veterans’ MST-related claims.  Unfortunately, their 2018 report showed that approximately half of VBA claims for disability compensation following sexual assault or harassment in the military were still not being adjudicated in accordance with current policies.  Further, it showed that earlier protocols which had increased accuracy of claim decisions had been abandoned in an effort to manage claim backlogs.  Since that time, the VA has reviewed all MST-related claims denied between October 1, 2016 and June 30, 2018, for possible adjudication errors.  In addition, they have provided additional staff training, reintroduced specialized teams to work these challenging and often very complex claims, and implemented a supervisory review of every denied disability claim where sexual trauma was the stressor. 
 
Additional resources:
http://maketheconnection.net/conditions/military-sexual-trauma
https://www.mentalhealth.va.gov/docs/mst_general_factsheet.pdf

MST Denied Claim Review FAQ

  1. What has the VA sent to veterans regarding the review?
  2. Do I have to be contacted by the VA to get my case reviewed?
  3. What kind of errors have been made?
  4. What cases are being reviewed?
  5. Will my case be reviewed automatically?
  6. How can I have my case reviewed?
  7. Where is my local VA Regional Office?
  8. What other resources can I take advantage of to get help in the review process?
  9. Do I have to wait for a decision from the VA to get counseling for my PTSD?

Share Your Feedback on the Review Process

1) What has the VA sent to veterans regarding the review?

In 2013, the VA sent a letter to some veterans whose MST-related PTSD claim had been denied after 2012.  The letter conceded that, in some cases, appropriate evidence had been overlooked. The option is still available for a veteran to request that the VBA review a previously denied claim for PTSD resulting from sexual trauma.   

2) Do I have to be contacted by the VA to get my case reviewed?

No. Any veteran may request that a previously denied claim for PTSD following MST be reviewed.  See page 4 here.

3) What kind of errors have been made?

In 2002, the VA conceded that most survivors of MST do not report their experiences and thus, evidence in official military records is rare.  At that time, evidence standards for these claims was relaxed to include secondary evidence or “markers” of trauma.  In most instances, inappropriate denials were the result of the VA  overlooking this secondary evidence or markers, which include, but are not limited to:

  • Records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals, or physicians.
  • Pregnancy tests or tests for sexually transmitted diseases.
  • Statements from family members, roommates, fellow Servicemembers, clergy members, or counselors.
  • Request for transfer to another military duty assignment.
  • Evidence of deterioration in work performance.
  • Substance abuse.
  • Episodes of depression, panic attacks, or anxiety without an identifiable cause.
  • Unexplained economic or social behavioral changes.
  • Relationship issues, including multiple failed relationships, divorce, or the inability to be in relationships.
  • Sexual problems, including erectile dysfunction or female sexual interest/arousal disorder.

4) In what instances can a review be requested?

The VBA will only review fully denied claims for PTSD where MST is the claimed stressor.   Only claims filed since 2002 may utilize markers as evidence, and only claims for PTSD.   

5) Will my case be reviewed automatically?

No, veterans must request the review themselves if they think they were wrongfully denied.  (Note: This does not include those denied in 2017 and 2018 which received an automatic review)

6) How can I have my case reviewed?

Call the VA's toll-free number at 1-800-827-1000, log into your eBenefits account (https://www.ebenefits.va.gov/), or contact your local VA regional office to ask for a review. These two links to VA forms may be helpful.

7) Where is my local VA Regional Office?

You can find the closest office to you and its contact information here.

8) What other resources can I take advantage of to get help in the review process?

Veterans service organizations (VSOs) can assist veterans in filing their VA claims, appealing denied claims, and advocating for a review of previously denied PTSD claims following MST.  Contact your local organizations to see how they may be able to help you. 

Members of Congress also offer help to constituents in districts they represent. Go here to find your Representative and go here to find your Senator.

9) Do I have to wait for a decision from the VA to get counseling for my PTSD?

No. VA Regional Medical Centers, VA Community-Based Health Centers, and community Vet Centers all provide free counseling and treatment for MST-related disabilities--verification of an MST event is NOT required. In addition, if you need additional resources, visit the National Center for PTSD website at www.ptsd.va.gov.

Share Your Feedback on Your VA Claim following MST

As I work to push the VA to make the MST claims process easier for veterans, hearing about your experiences with the VA's review process would be helpful. If you are having your denial reviewed, please share your feedback on the process here. --Chellie

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