Anxiety states, which include post-traumatic stress disorder (PTSD), can affect every aspect of a veteran’s life. When you’re not experiencing a panic attack, you may experience a fear of the panic attack happening, also known as agoraphobia. Veterans’ anxiety also shows up as situations of social phobia in crowds or large places.
Fortunately, VA disability benefits for anxiety can help compensate veterans for lost earning capacity due to disability.
In This Guide to VA Disability for Anxiety:
Five Anxiety Disorders Considered for VA Disability Rating
A little bit of anxiety is good. Anxiety is a natural response to danger and keeps you safe. Anxiety deliberately puts you on edge, so you are prepared to fight or flee. Veterans may ask, “is fight or flight a panic attack?” The answer is no, but both arise from the same limbic system in your brain.
Anxiety triggers the release of two hormones – adrenaline and cortisol. Adrenaline increases your heart rate, respiration, and blood pressure so you are ready to react.
Cortisol causes your blood vessels to contract – this conserves blood for your heart and lungs – and tells the liver to convert glycogen into glucose to raise your blood sugar levels. These physiological changes place your body in the perfect condition for fight or flight.
However, your body is not designed to experience anxiety all the time. Too much cortisol can lead to depression, weight gain, type II diabetes, and a suppressed immune system. Worse yet, you can enter a hyper-vigilant state that is characteristic of an anxiety disorder.
Symptoms of an anxiety disorder include excessive worry, difficulty concentrating, rapid heartbeat, hyperventilation, cold and clammy hands, tremors, restlessness, jumpiness, edginess, insomnia, and lightheadedness. Anxiety states are divided into five categories, with specific symptoms associated with each one.
1. Generalized Anxiety Disorder
Generalized Anxiety Disorder is a constant state of worry about many different things without any specific concern. Veterans with Generalized Anxiety Disorder may jump from worry to worry throughout their day. You may feel anxious about finishing a project at work, getting the kids to school on time, having enough money to pay the bills or any other detail of daily life.
These anxieties and the physiological changes that accompany them can lead to insomnia, irritability, depression, fatigue, gastrointestinal problems (like indigestion or ulcer), and muscle tension. Periods of worry may be accompanied by increased heart rate, hyperventilation, sweating, and tremors.
2. Obsessive-Compulsive Disorder (OCD)
OCD is an anxiety disorder in which the brain compensates for obsessive thoughts and worries by compulsively following rituals. The obsessive thoughts trigger anxiety. For example, obsessive thoughts could take the form of worries about germs, disorganization, taboo subjects, or violent impulses.
The brain attempts to relieve the anxiety produced by the obsessive worries by compulsively following rituals. However, the rituals provide only temporary relief. Eventually, the rituals become so entrenched that they cannot be broken without inducing heightened anxiety. Examples of rituals include hand washing, cleaning or straightening up, and counting things.
3. Panic Disorder and/or Agoraphobia
Panic disorder is an anxiety state characterized by sudden and repeated panic attacks. These panic attacks may be caused by specific triggers or may occur under completely unexpected circumstances. Agoraphobia is a type of anxiety disorder that creates extreme fear of entering open or crowded places, leaving one’s home, or being in places where escaping is difficult.
Typically, panic attacks create feelings of extreme fear or discomfort that are so intense that they can overwhelm all the other senses. These feelings are frequently accompanied by physical symptoms including a racing or irregular heart rate, labored breathing, dizziness, shaking, chest and stomach pain, and sweating. These physical effects may even cause the person to pass out.
People with panic disorder can have a life dominated by fear. During panic attacks, the person may fear unconsciousness, loss of control, or even death. Between panic attacks, the person may fear another panic attack. This fear of panic attacks is called agoraphobia. People with panic disorder can become obsessed with reordering their lives to try to avoid triggering panic attacks or suffering a panic attack in public.
For many veterans, panic disorder makes it impossible to be around large crowds and open spaces, attend concerts or baseball games for grandchildren or even drive on the freeway to go to work due to fear that a panic attack will strike unexpectedly. This can lead to depression and a reduced level of confidence.
4. PTSD
Almost all people suffer from some lingering effects after a traumatic event. However, most people recover relatively quickly. PTSD, however, is a long-running, severe response to trauma. The types of trauma that can cause PTSD can vary from person to person. For some, the trauma arises from a frightening, dangerous, shocking, or life-threatening event. For others, the trauma can arise from something unexpected, like the death of someone close.
Anxiety is a fear response that prepares you for fight or flight. PTSD is the same fear response that is ongoing or recurring long after the traumatic event is over. The symptoms include jumpiness, nervousness, emotional outbursts (sadness and anger being the most common), insomnia, and flashbacks reliving the traumatic event.
Ruminating thoughts of guilt, worthlessness, and joylessness may dominate the mind and cause sufferers to experience depression, detach from friends and family, and turn to drugs and alcohol for relief. Over time, the symptoms of PTSD can interfere with work and relationships.
5. Social Anxiety Disorder
Social anxiety disorder is also referred to as Social Phobia. Social anxiety is found to be at the root of performance anxiety, test anxiety, and stage fright. However, social anxiety disorder is much more severe than the nervousness that you felt in school at a school dance or before a math test.
Social anxiety disorder is an intense fear of social situations or circumstances in which you are being evaluated. This fear relates to the shame, embarrassment, and judgment that you may fear from others. In social anxiety disorder, this fear and anxiety is so strong that you change your routine to avoid triggering your anxiety. This could mean dropping out of school, quitting work, skipping tests or job interviews, refusing to date, or even avoiding public restrooms.
Treatment for Veterans and Anxiety Disorders
Treatment for anxiety disorders usually falls into two categories, medication and therapy.
1. Medications for Anxiety Disorders
Psychiatrists are able to prescribe medications to relieve the symptoms of anxiety disorders. Many veterans with anxiety disorders have an imbalance of serotonin in their brains. Selective serotonin reuptake inhibitors (SSRIs), such as Prozac, Zoloft, and Paxil, prevent nerve cells from absorbing serotonin. These non-addictive medications reduce feelings of anxiety and help you to better regulate your mood.
Other medications, such as benzodiazepines, tricyclic antidepressants (TCAs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) are prescribed less frequently because they can cause side effects, lose effectiveness when used over the long term, and can be habit-forming.
2. Therapy Options for Anxiety
Anxiety medications are most effective when combined with therapy. That is, medications control the physical symptoms while therapy helps you work through the behavioral, social, and psychological issues that underly the anxiety disorder.
Psychotherapy (or talk therapy) helps you to address the causes of your anxiety. For example, veterans who suffer anxiety disorders caused by guilt or shame over a traumatic event may benefit from discussing the event and working through those feelings.
Cognitive-behavioral therapy (CBT) helps veterans identify and cope with the triggers and symptoms of their anxiety disorders. Rather than avoiding triggering situations altogether, CBT may help you to identify the anxieties that arise from those situations and deal with those anxieties rather than avoiding them.
VA Disability Ratings for Anxiety Disorders
VA disability ratings for anxiety disorders can be obtained for almost any recognized anxiety state including generalized anxiety disorder, specific phobia, social anxiety disorder (social phobia), obsessive-compulsive disorder (OCD), other specified anxiety disorder, post-traumatic stress disorder (PTSD), panic disorder and/or agoraphobia, and unspecified anxiety disorder.
The disability ratings for these anxiety states depend on the extent of the symptoms experienced and the occupational and social impairment they cause. The specific anxiety disorder that you suffer from will not alter your disability rating because all of the anxiety states are rated using the same criteria, including the VA rating for anxiety disorder NOS (Not Otherwise Specified).
For example, an anxiety state that is associated with gross impairment in thought processes or communication and an intermittent inability to daily living activities such as hygiene would be rated at 100% under the VA’s general rating formula for mental disorders. Conversely, an anxiety state that is associated with mild or transient symptoms that only impair you during periods of high stress would be rated at 10% under the VA’s formula.
There are a few principles that can help you to obtain a VA disability rating for anxiety disorder. First, under the VA’s regulations, any mental disorder that (a) is brought about by a highly stressful event and (b) results in the veteran’s discharge from military service must be rated at least 50% disabling for the first six months after the veteran’s discharge.
Second, under the VA’s rules for interpreting its rating formulas, veterans do not need to experience all the symptoms under a higher rating category to qualify for that rating. Thus, if you are a veteran that experiences two of the seven anxiety symptoms associated with a VA disability rating of 100%, you would be entitled to the 100% rating. This is generally true even if you experience other symptoms associated with lower ratings. For example, if you experience five anxiety symptoms under the 70% rating and two anxiety symptoms under the 50% rating, you will be entitled to the higher VA rating percentage for anxiety.
Third, the VA’s rules for secondary service-connected disabilities allow the VA to rate each condition separately and aggregate the ratings using VA math. For example, the VA disability rating for major depression and anxiety would combine the VA disability for depression percentage with the VA disability for anxiety percentage.
Service Connection for Veterans and Anxiety Disorders
As with physical disabilities, anxiety states must be connected to your military service to qualify for VA disability benefits. It is possible to establish a service connection for your anxiety by showing that it predated your military service and was worsened by your time in the military. However, this is an unusual situation since an anxiety state might preclude you from joining the military. Nevertheless, if you have a diagnosis of an anxiety state that predated your service, and you suffered from a decline in your anxiety disorder during your service, it may be possible to establish a service connection and qualify for VA disability benefits.
Most anxiety states, however, are shown to be service-connected by either an in-service diagnosis or a post-service diagnosis that was caused by an event or condition experienced during your service.
1. In-service Diagnosis
When your anxiety state, particularly PTSD, is diagnosed during your military service, it is almost certainly service-connected. As mentioned above, if your anxiety state occurs due to an event that you experienced during your service and is so serious that you are discharged from the military, the VA automatically pays VA disability benefits for six months until you can be re-evaluated. This acknowledgment that anxiety disorders can and do arise during military service is welcome validation for many veterans. This also confirms that the VA recognizes anxiety disorders as disabling.
If your anxiety state did not result in your discharge, you will need to apply for benefits and obtain a VA disability rating. However, a diagnosis from a military doctor or corpsman of PTSD or anxiety during your service should be sufficient to establish the required service connection.
2. Post-Service Diagnosis
Many veterans are not diagnosed with PTSD until after discharge. PTSD, for example, can surface months or years after the trauma was originally experienced. Moreover, PTSD can continue for years after it first surfaces.
One way to connect anxiety states to your service is to show that the anxiety disorder manifested during your service but was only correctly diagnosed after your discharge. For example, if you suffered from panic attacks during your service, but you were misdiagnosed as having a heart condition, you may be able to show a service connection with competent evidence showing that you do not suffer from a heart condition and that the correct diagnosis should have been panic disorder.
Another way to connect anxiety states to your service is to show that you were a prisoner of war (POW). POWs do not need to prove a service connection between their service and any anxiety states. Rather, a service connection is presumed regardless of the length of captivity or when the anxiety disorder was diagnosed.
For veterans whose anxiety states did not manifest until after discharge, the VA has a regulation explaining the evidence needed to establish a service connection for the anxiety state. Under this regulation, if the anxiety state is related to a specific stressor, you need only provide credible evidence of the stressor (including your testimony) and the burden shifts to the VA to develop clear and convincing evidence that the stressor did not occur.
For example, a service member who asserts that combat or a training accident caused your PTSD need only show the combat or the training accident occurred. The VA must accept the service connection unless there is clear and convincing evidence to the contrary.
For service members who have trauma from military sexual assault or fear of hostile activity, the level of evidence required is higher. Specifically, your testimony must be supplemented with additional evidence that the stressor occurred. However, once credible evidence is submitted, if the VA wants to deny your claim, they have to produce clear and convincing evidence that it didn’t happen.
Find Your VA Disability Rating for Anxiety Disorders
Anxiety states are real disabilities. When your medical records show an anxiety state and your service records show a service connection, the VA must provide VA disability for anxiety unless it has clear and convincing evidence against you.
There are many VA disability for anxiety Reddit forums and other online sources of information. However, a certified VA attorney has actual experience with disability claims for anxiety disorders regardless of where you are currently located and whether you were deployed.
Contact Woods & Woods today to get all of your VA benefit questions answered.
Yes, there are even different forms of anxiety that are each classified as a VA disability. Make sure you have a clear diagnosis so that all of your symptoms are counted in your complete VA rating.
No, you can apply from home. We do everything over the phone and electronically with the VA in Washington, so there is no reason to find a VA attorney nearby.
Yes, mostly. At some point, we’ll have to have you sign off to give them permission as a privacy safeguard, but otherwise, we’d be happy to work with your representative to get your VA benefits.
No, they are all rated along the same scale. Once you talk to our professionals about your symptoms and how they affect your daily life, we’ll know the best approach to take for your VA disability application or appeal. That’s why your call is free. We need to figure out what kind of case you have.