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Sunday, May 6, 2012

How to win a claim for PTSD due to MST

The following information was originally posted by advocate Susan Avila-Smith on Facebook.  With her permission is it being reposted here.


You will need:

1. A diagnosis of PTSD, Anxiety and/or Depression, from your Provider.

2. A Nexus, or link to service, which needs to be written by your provider as a letter or in your medical chart just like this (print this out and bring it to them):
"After reviewing ___________'s medical records it is my opinion, more likely than not, her/his PTSD, Depression/Anxiety (PTSD, Anxiety/Depression - what ever it specifically is you filed for in your claim and must match exactly) is a direct result of military sexual trauma s/he experienced while serving on active duty."

3. Evidence: VA form #21=0781a. - This is used as "Alternative Evidence".
You may want to ask for help to fill out this form. Most of us cannot do this ourselves.
Fill in your name and VA File # (SS#) information on top.
The date: "On or about (VERY important here - if it was July 11th, you could lose) July 12, 1986.
***IF you cannot remember the date, narrow it down to a three month time frame - a season, holiday, or event like the Presidential Elections. (This is used to check the paperwork and nothing else. If the paperwork is not there, then likely you will not win, so the date range is crucial.)
Enter your dates of Unit Assignment.
Description of the Incident "sexual assault" or “personal assault” by a known person - STATE THEIR NAME, THEIR UNIT INFORMATION and if they were punished and how.
“I was assaulted by John Doe, a corporal who was assigned to HOC 733rd MI Bn, Schofield Barracks, Hawaii - the same unit I was assigned to. He was not punished, but I was. I got an Article 15 during the month of July, 1986." OR
“I was assaulted at Darnell Hospital, Fort Hood Texas in the recovery room after surgery. I do not know the people who did this.”
Leave page two of VA Form 0781a with a line through it, and N/A (Not Applicable). ****Seriously - do not put another incident unless you are willing to wait for a very long time.
(To choose which incident if there is more than one, pick the one that has any military record, report or evidence you know of, no matter how small.)
Page three of VA Form 0781a - Address each of the items in #7 on the form. Explain EACH of the "markers" they list. This is KEY to your claim. If you had/did something say it, and if not, say you did not do this behavior.
Here is the list of Markers, and Examples of answers below each one.
• visits to a medical or counseling clinic or dispensary without a specific diagnosis or specific ailment
1. Yes, I went to counseling regarding the assault. Yes, I went to a clinic for testing.
• sudden requests for a change in occupational series or duty assignment
2. The Army involuntarily discharged me within a month after I reported the incident.
• increased use of leave without an apparent reason
3. Yes, I requested and was given a one-week leave immediately after the incident.
• changes in performance and performance evaluations
4. Yes, I received my first poor performance evaluation. Yes, I was always able to do my work, and became unable to do my work after I was assaulted.
• episodes of depression, panic attacks, or anxiety without an identifiable cause
5. Yes, I had panic attacks, felt depressed and had insomnia, and sought counseling for it. I recently requested a copy of my mental health records from Fort Irwin, California and was told they have no record, they had destroyed all old records after a few years.
• increased or decreased use of prescription medications
6. Yes, I increased my use of narcotic & other pain prescription medication at the time.
• increased use of over-the-counter medications
7. Yes, I started using over-the-counter sleep aids, NyQuil, Benadryl, Tylenol PM.
• substance abuse such as alcohol or drugs
8. Yes, I started drinking heavily for the first time in my life. No, I did not do any illegal drugs.
• increased disregard for military or civilian authority
9. Yes, I swore at my superiors. I took leave because I had it, instead of going AWOL.
• obsessive behavior such as overeating or under-eating
10. Yes, I gained 20 lbs. in two weeks. I started checking locks inside house & vehicle; washing my hands raw, and cleaning house obsessively. I also started hoarding & exercised excessively.
• pregnancy tests around the time of the incident
11. Yes, I took pregnancy tests though I had a tubal ligation surgery in June 1992 a few months before I was sexually assaulted.
• tests for HIV or sexually transmitted diseases
12. Yes, I went to an STD Clinic and requested to get tested for HIV & STIs.
• unexplained economic or social behavior changes
13 Yes, I lost my job, and started withdrawing from friends. My life changed forever in many ways breakup of a primary relationship
14 Yes, in 2002, I divorced from my husband after the incident.
This is the end of the list of Markers. Sign and Date the form, and add telephone numbers.
You DO NOT need to find your Military medical records and personnel files, the VA will do this for you. ANYTHING ELSE (JAG, MP, DAILY ROSTER, ETC.) YOU WILL NEED TO REQUEST THAT THE VA GET SEPARATELY as they can get it quickly. You will need to sign a Release of Information for the VA to get it.
4. A copy of anything showing you had problems in the military, such as being AWOL, ARTICLE 15 or a letter from someone who knew you at the time or before and after you served in the military and can attest to the major behavior changes you have shown. Everything should state "I swear this is accurate and true to the best of my ability."
5. A GAF score (Global Assessment of Functioning) can be assigned by your provider at each appointment. (Typically for PTSD the numbers would range around 35-45.) It may be that you are not telling everything to your provider, such as not bathing for days in a row, not caring if you live or die (but not being actively suicidal -- meaning you have a specific plan) etc.
U.S. Department of Veterans Affairs - Veterans Online Application System (VONAPP) Source:

VA will use this form as YOUR Evidence. The 21-0781a can be filed on line, and use the PDF - ONLY FILE FOR ONE INCIDENT.

This is used as "Alternative Evidence" which is only allowed for MST claims. VA will use this form in place of "hard" Evidence. (If VA denies a claim, it is likely they are not aware of this form or its use, or they are not trained in MST claims.)
You MUST have all of the above to win a claim IF you do not have a police report, hospital report, or other documentation - so any statement about court martial or punishment will be added insurance for your win.
Again, you need the Diagnosis, Nexus and Evidence to win your VA claim. Try to keep it simple.
If you are "HOMELESS" which according to the VA means you do not have a Rental Agreement, Mortgage or Lease - if you are couch surfing - you ARE HOMELESS. If you are Homeless, or have serious financial difficulty you must tell them you are in FINANCIAL DIFFICULTY, and will need to show them documentation. If this is your case, every sentence with every person at the VA should be "I am a homeless veteran, and need to get this ______________ Expedited ....." or "I am in serious Financial trouble, and need to get this ______________ Expedited ....." Expedited claims can be as little as 3 months.
Even with documents from Police or Hospitals, it is "insurance" for you to submit this form VA-21-0781a. Any statement from you about court martial or punishment of your perpetrator - with name, unit information, approximate date that the VA can look for, will be additional insurance for you to win your service connected VA claim for Military Sexual Trauma.
- Diagnosis, Nexus and Evidence will win your VA claim. Keep it simple.
Mail Everything in to the VARO RETURN RECEIPT

We have groups on yahoo and facebook for survivors of Military Sexual Trauma, both for men, and for women.

Please feel free to share this information with survivors of MST, providers to veterans and veterans service officers.
Susan Avila-Smith
Military Sexual Trauma Specialist
Director, VetWow

© Susan Avila-Smith


  1. Talking to my latest PTSD intake counselor, I realized she (unknowingly) was attempting to guide my answers into a model that portrayed me as a powerless victim of individual brutality.

    In the process, I realized that my core issue was not so much the wrong penis in the wrong place without my permission, but the institutional response and the daily debasement of my rank and position.

    The entire system assumes that assault on a certain class of members is acceptable.

    The legal subordination of that class to inferior standing while still allowing the displays of standardized rank and privilege creates a total disconnect with reality.
    They ARE driving us crazy. 

    They are also trying to bracket the problem under the rubric of sex.  Sex is the manifestation of the problem of gross failure to adhere to their own UCMJ. 


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