I know, it’s absurd to think that the way a Veteran looks could impact his or her VA Disability claim. Before I worked for a law firm I would have laughed it off and said that it could never happen. I mean it’s a claim for disability, not a beauty contest. It turns out that I was wrong. So, I want to tell you about the time I learned how a Veteran’s appearance could impact their claim. However, before we get there, we have to learn a little about how PTSD is diagnosed, and how the VA rates this condition.
PTSD is a big issue facing a lot of Veterans. As you may be aware there are different ratings for PTSD according to the VA. PTSD is rated from 0% to 100% through the VA. In other words, it’s not something you simply have or don’t. With this knowledge, we can assume that a Veteran who is rated at 0% has a very mild case of PTSD and a Veteran rated at 100% has a very severe condition. The ratings in-between are where there are some issues.
So, the problem lies in several areas. One of the main problems is that PTSD does not have 10% increments. Actually, the ratings for PTSD are 0, 10, 30, 50, 70, and 100. The lower ratings don’t prove to be much of an issue, but the higher ratings are. The gap from 50 to 70, and then the gap from 70 to 100 leave huge holes in the process.
Here are the rating criteria for a Veteran who is 70% for PTSD. I apologize, but this is a bit of a read.
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships
Ok, now that you have an idea of how the VA rates PTSD at 70%, I’d like to share with you a story about a client of mine. Now, to protect his identity I won’t be sharing his name, his branch, or much about his personal case, or even where he is from. This client had at least three tours in combat, he was in infantry and he was clearly not the same person he was when he left to join the military. His case for PTSD was strong. He had a diagnosis, he had regular treatment, and he had almost everything listed above. He had severe panic attacks on a regular basis; he couldn’t keep a job and was not able to go to school. He was extremely irritable and he would have emotional outbursts on the phone with us often. His PTSD should have been rated at the 70% rating easily. However, there was an issue with his appearance.
So, what was the issue? If this Veteran had all of the issues listed above, why was he turned down? Well, this young man was cursed with being very attractive. Now, before you start to write hate comments, please note that his appearance was noted as being one of the reasons why he was denied. I reviewed his medical records, and two different medical professionals noted his appearance as one of the reasons they thought he was malingering. In other words, because he was visually appealing, he was faking his condition. This is not just my opinion. So, he was a good-looking young man, who, even if he let himself go, would look better than me on my best day. Also, most people would agree that he was above average in attractiveness. I am not trying to say that he was movie star attractive, though. On a grid from Maggie Gyllenhaal to Jake Gyllenhaal, he was somewhere in the middle. Kidding aside, this Vet also kept up his appearance. Which, let’s face it, for most men, it’s not that hard to do. He kept his hair short, he shaved regularly, and he always wore clean clothes when he went in for his appointments, and he bathed regularly. This client also had a spouse who would make sure that he kept his appearance neat. So, in the mind of the VA, or more specifically, this medical professional, this client was not suffering the effects of PTSD at the 70% rating, partially because of the way he looked. That is absurd.
I know this may be hard to believe, but hot people get sad too. Trust me; there is nothing more heartbreaking then sad Jennifer Lawrence in the film Silver Linings Playbook. I once saw Amy Schumer cry, and I couldn’t leave my bed for three days. As a society, we often think that just because someone looks nice, they couldn’t be sad. Or in this case, this Veteran has a nice shirt and a pretty smile, so there’s no way he could have PTSD. In all honesty, his PTSD was among the worst of any Veteran I’ve talked to in my six years with the firm.
This problem reflects a bigger issue with the way many people view Veterans with PTSD. I believe many people think someone who suffers from PTSD has to be strung out on drugs, homeless, totally unkempt, unable to work, and overall, non-functioning. That is simply not true. PTSD takes on many forms. I’ve met a lot of Vets who are incredibly functional. They would remind you of everyone else you encounter when they are in public, but at night, they have night terrors or drink themselves to sleep. PTSD is not a black and white issue.
Luckily we were able to get this Veteran a second opinion and he did get to the 70% rating. I said that this Veteran was cursed with being attractive, but he was actually cursed with some bad medical opinions. I’m not a psychologist, but I studied some psychology in undergrad. Even I could tell this Veteran wasn’t faking his conditions and should have been rated at the 70% level for PTSD. Please note that not all examiners are as obtuse as the individuals this Veteran had to deal with at the VA. In fact, I can’t think of many other cases I’ve seen in which a Veteran was denied based on their appearance. But, the fact that it occurred even once is tough to take.
One last thing. Letting your appearance go will not help you get approved quickly either. Though the CFR notes that lack of oral hygiene and physical appearance are contributing factors for the rating code, letting your appearance slip does not guarantee that you will get approved. I’ve seen a lot of Veterans who have let their hygiene go have the same difficulty as the Veteran in this blog. VA Disability as a whole, but especially PTSD claims, is nuanced. Claims can get complicated and each one has to be approached differently.
If you’re not happy with your rating decision, call us. We’d love to talk to you about your case and even give you a free consultation. Our toll-free number is 1-877-526-3457. If you can’t chat now, fill out this form so that we can call you at a better time.