PEBFORUM Library

The Physical Disability Evaluation System (PDES) in accord with the National Defense Authorization Act of 2008 (NDAA) requires credible supporting evidence of the occurrence of an extreme in-service stressor associated with other diagnostic criteria for Posttraumatic Stress Disorder (PTSD).1

Credible supporting evidence that the stressor actually occurred includes evidence specifically documenting the Soldier’s personal participation in the event or evidence indicating the Soldier served in the immediate area and at the particular time in which the stressful event is alleged to have occurred, and supports the description of the event. Corroboration of every detail of the claimed stressful event is not required. The evidence may be sufficient if it supports and is consistent with a Soldier’s personal description of exposure to the stressful event. The Soldier’s testimony is to be appropriated weighted in

There are three contexts in which an extreme stressor is likely to occur which requires verification: Combat; Prisoner of War; and, Non-combat (Personal Injury).

(1) COMBAT: There is credible evidence that the Soldier engaged in combat with the enemy and the claimed stressor is related to that combat and is consistent with the circumstances, conditions, or hardships of the Soldier's service.

Engaging in combat with the enemy means personal participation in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality of war. It includes presence during such events either as combatant, or Soldier performing duty in support of combatants, such as providing medical care to the wounded.

Medical evidence of an injury that was clearly related to hostile action. (No other

Receipt of any of the following individual decorations supports exposure to combat-related stressors: (No other support is needed in such cases.)

· Combat Action Badge

· Combat Action Ribbon (Note: Prior to February 1969, the Navy

Achievement Medal with “V” Device was awarded.)

· Combat Aircrew Insignia

· Combat Infantry/Infantryman Badge

· Combat Medical Badge

· Distinguished Flying Cross

· Distinguished Service Cross

· Joint Service Commendation Medal with “V” Device

· Medal of Honor

· Navy Commendation Medal with “V” Device

· Navy Cross

· Purple Heart, and/or

· Silver Star.

Note: The medals listed below may be awarded for either combat or non- combat service. Their receipt does not necessarily confirm a Soldier’s participation in combat but may be supportive:

. Global War on Terrorism Expeditionary Medal Global War on Terrorism Service Medal Afghanistan Campaign Medal, and

Iraq Campaign Medal.

Statements from the Soldier’s chain of command who can verify the Soldier’s participation in the hostile action.

Statements from fellow service members who can verify the Soldier’s participation.

Medical record entries indicating assessment or treatment for injury or psychological trauma at or near the time of the incident.

Unit records documenting the Soldier’s presence with a specific unit at the time

of a hostile action of record.

Documents that support events consistent with the Soldier’s report, such as:

· unit and organizational histories

· daily staff journals

· operational reports-lessons learned

· after action reports

· radio logs

· deck logs and ship histories

· muster rolls

· command chronology

· war diaries

· monthly summary

· morning reports

· hazardous pay records (not in itself confirmatory, but with other evidence may offer verification support)

· contemporaneous letters and diaries of the Soldier

· performance reports

· press archives

Note: After-the-fact psychiatric analyses that infer the occurrence of a traumatic event based on the presence of symptoms consistent with PTSD do not, alone, qualify as supporting evidence.

(2) PRISONER OF WAR:There is credible evidence that the Soldier was a prisoner-

of-war and the claimed stressor is related to that prisoner-of-war experience.

Evidence:

Information similar to that noted under “Combat” above may apply.

Press reports of capture, rescue, etc. Debriefing reports

(3) NON-COMBAT (PERSONAL INJURY): There is credible evidence that the Soldier, while in the military, experienced a personal assault or traumatic injury; or, was exposed to extreme psychological stress from witnessing serious harm to others; or, was

in a circumstance in which there was a clear risk of serious bodily harm or death. Such stressors include but are not limited to:

· Motor vehicle accident involving actual or serious risk of bodily harm/death

· plane crash

· ship sinking

· explosion

· rape or assault

· domestic battering

· robbery and mugging

· stalking and threatening harassment

· unusually stressful duty such as

- on a burn ward

- in a graves registration unit, or

- involving liberation of internment camps

· witnessing the death, injury, or threat to the physical being of another person not caused by the enemy

· Records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals, or physicians

Note: The following evidence may need interpretation by a clinician in personal trauma claims, especially if the claim involves behavior changes.

· Statements from family members, roommates, fellow service members, or clergy.

· Evidence of behavior changes following the claimed assault is one type of relevant evidence that may be found in these sources.

Examples of behavior changes that may constitute credible evidence of the stressor include, but are not limited to: a request for a transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety

without an identifiable cause; or unexplained economic or social behavior changes.

- indicating increased use or abuse of leave without an apparent reason, such as family obligations or family illness, or

- describing episodes of depression, panic attacks, or anxiety, but no identifiable reasons for the episodes, and

· evidence of behavioral changes that occurred around the time of the incident, including

- visits to a medical or counseling clinic or dispensary without a specific diagnosis or specific ailment

- use of pregnancy tests or tests for sexually-transmitted diseases around the time of the incident

- sudden requests that the Soldier’s military occupational series or duty assignment be changed without other justification

- treatment for physical injuries around the time of the claimed trauma, but not reported as a result of the trauma, and/or

Disability Benefits/General Information: 1-800-827-1000 Insurance: 1-800-669-8477

Education: 1-888-442-4551 Health Benefits: 1-877-222-8387