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Pursuing A Claim For Posttraumatic Stress Disorder (PTSD)
When pursuing a claim for posttraumatic stress disorder (PTSD) it is important to understand the bureaucratic process toward your goal. PTSD is a psychological injury with political overtones. Due to the egregious injustices to Vietnam veterans during the 60s and 70s, the collective repair of mental health professionals today is to ensure that all veterans are given the benefit of doubt. Veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) are three times as likely to get a diagnosis of PTSD then veterans of the Persian Gulf War, Vietnam, Korea or World War II. Not because they actually have the disorder as understood in the Diagnostic and Statistical Manual for Mental Disorders (DSM), but due in part to mental health professionals wanting to “make up” with veterans from all war eras.
Due in part to guilt from mental health professionals, the overwhelming number of veterans filing for PTSD claims, have a well-crafted strategy, making it pretty easy to get diagnosed with PTSD.
Here’s how. Keep in mind, real or imagined your experiences are your realities. Therefore, when visiting a psychiatrist or psychologist in the civilian sector or your local Veterans Affairs (VA), you need to make sure your story is “heard.”
Mental health staff see many veterans and clients every day, and inherent in this process is a tendency for mental health staff to go “intellectually numb.” That is, your story is a blur in a long line of very similar stories. The details get lost, and it is perceived with subtle indifference by mental health staff. So, it is very important to make your story stand out. This does not mean to lie or deviate from the truth, what it suggests is for you to inject some degree of hyperbole and passion in your story. You’ve heard it a million times, “the squeaky wheel gets the oil” in any bureaucracy, especially the VA.
Who To See For A Confirmed Diagnosis
In order to get a diagnosis for PTSD, you must visit with a psychiatrist or a psychologist (PhD level). They will assess you for certain criteria which will qualify you for PTSD diagnosis or rule you out. Typically, the psychiatrist or psychologist you visit with will be at your local VA or an outside contractor.
Getting An Appointment
Contacting the mental health department at your local VA and requesting an evaluation for PTSD is not good enough. You need to integrate yourself in the system. You do this by contacting the mental health department and inform them that you have a set of symptoms that might suggest PTSD. For instance, inform them you are having nightmares about war trauma, anxiety attacks when you are in crowded places, anger outbursts for minor issues, and that you are so depressed about issues from the war that you cannot sleep. Also, you may want to let the intake coordinator know that you are so immobilized by your depression that you have no energy. That should be enough to get you an appointment for an evaluation. Again, no need to make up symptoms, just remember to explain your symptoms with passion and fervor.
How To Dress For Interview
Oftentimes, those with PTSD are so psychologically fragile and emotionally upset by their trauma that personal hygiene takes a back seat. Understand, to set the tone that you are suffering from this intense psychological injury, you must dress the part. A disheveled appearance works best. Unshaven face (for men), uncombed hair, mismatched clothing, dirty nails, tattered clothing, and a few days without a bath or shower will make the impression you need. Also, deprive yourself of sleep. Red, bloodshot eyes project trouble to mental health professionals. Try to get an appointment for Monday. That way, you have the weekend to excuse away hygiene of any sort.
Case in point. We know of a veteran who visited a psychologist at his local VA dressed in a beautifully tailored suit. As if going for a job interview, this veteran was perfectly styled and looked like a runway model.
Another veteran who followed the prescription above, well, needless to say, that veteran was given a diagnosis of PTSD and later awarded a service-connected rating of 100% for his psychological injury.
By the way, the veteran who dressed flawlessly for his psychological evaluation was sent home and given a few “best wishes” from VA staff members.
During your intake assessment interview with the mental health professional you will be under a psychological microscope. Some mental health professionals make a concerted effort not to make you feel as though you are being scrutinized. Either way you look at it, you are being scrutinized. Their job is to rule you out for PTSD. Your job is to prove to them that you have PTSD.
For instance, part of their assessment is to determine if you have good eye contact. If you do, in their clinical view, you are on the road to recovery, if not totally cured. One cagey veteran made it known to us that he always averts direct eye contact with his psychiatrist. In our opinion, this is a good strategy. Direct eye contact suggests a healthy self-image and good self-esteem. Veterans with PTSD do not have such attributes. Also, you want to give the impression of being distant and detached. In the mind of a mental health professional, this is a hallmark symptom of PTSD.
At some point during your interview the mental health member will ask you about your sleep. Veterans with PTSD are bombarded with nightmares, restless sleep patterns, and very little recuperative sleep. You need to let the mental health member know who is interviewing you that you are afraid to go to bed for fear of dreaming about war trauma. You also want to let them know that your significant other is afraid to sleep near you because of your violent and abrupt sleepwalking events. Additionally, your night sweats has caused you to be alarmed by the intensity of your dreams as well. Your mental health professional will see these as definitive signs and symptoms of PTSD.
You want to inform the psychologist that upon waking from your violent nightmares that you then conduct reconnaissance missions around your home. You check the windows, doors, under the bed, in all closets, and the perimeter of your home. You inform the clinician you are looking for the enemy. Your mental health professional will see this as hypervigilance, another sure sign of PTSD.
Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event is another surefire sign of PTSD.
Vietnam veterans with PTSD often recall certain smells that remind them of war trauma. For instance, aromas closely related to Asian spices bring back intense traumatic memories for Vietnam veterans. For OIF/OEF veterans, a common environmental cue that reminds them of war trauma is the contour of geographical landscapes. Especially those veterans that live in the West (i.e., California, Nevada, New Mexico, Arizona, and West Texas).