About 10% of veterans in the United States report elevated levels of anxiety, and this can vary depending on the time of military service. Research also shows that about 7% of veterans have been diagnosed with an adjustment disorder.
However, some veterans experience a more complex mental illness called Adjustment Disorder with Anxiety. Adjustment disorders can make household and occupational tasks challenging, affecting daily life.
If you are a former military service member suffering from chronic Adjustment Disorder with Anxiety, you may be eligible for disability compensation through the U.S. Department of Veterans Affairs. This guide will break down the basics of Adjustment Disorder with Anxiety and what you should know when building your veteran’s claim.
What Is an Adjustment Disorder With Anxiety?
As published in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a diagnostic code by the American Psychiatric Association, “Adjustment Disorder with Anxiety” is one of the six base types of adjustment disorders. Adjustment disorders are caused by an identifiable stressor or stressors, and the stressor causes noted emotional or behavioral symptoms (beyond an expected response).
Adjustment disorders occur when an individual struggles with adjustment to a stressor or life change. If an adjustment stressor leads to anxiety that disrupts normal life, the individual is said to have Adjustment Disorder with Anxiety. This mental condition can affect socialization, work efficiency, and the ability to complete tasks and general self-care. Symptoms of this psychiatric condition include, but are not limited to:
- Excessive worry
- Fear
- Jitteriness
- Nervousness
- Panic Attacks
- Irritability
- Difficulty Sleeping
- Separation Anxiety
- Suicidal Ideation
- Mild Memory Loss
Related conditions may include other categories of adjustment disorder such as depressed mood and disturbance of conduct. If the disturbance of conduct is present, the individual might have poor impulse control. Some people with adjustment disorders may also have difficulty maintaining social relationships (varying levels of social impairment) and exhibit inappropriate behavior.
How Can Veterans Establish Service Connection for Adjustment Disorder with Anxiety?
Establishing a direct service connection for Adjustment Disorder with Anxiety is the more common way to demonstrate service connection. In order to qualify for this connection, veterans must provide records that the Adjustment Disorder with Anxiety began during active military service. The three elements needed for a successful direct service claim include:
- A current diagnosis of Adjustment Disorder with Anxiety
- An in-service incident or occurrence that was the direct cause of the issue or such incident aggravated an existing claim.
- A medical nexus that connects the current, diagnosed disability to the in-service occurrence (or incident).
In-service incidents that may be the cause of Adjustment Disorder with Anxiety could include but are not limited to: active-duty combat, long deployments, time spent on ship or sub, frequent transfers, and other incidents. It is important to note that Adjustment Disorder with Anxiety could be caused by a seemingly incidental occurrence that triggered this disorder.
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Secondary Service Connection for Adjustment Disorder with Anxiety
An additional way to prove service connection for Adjustment Disorder with Anxiety is through secondary service connection. What occurs, in this case, is that the veteran has a different service-connected condition that either caused or aggravated the Adjustment Disorder with Anxiety. An example could be that the veteran sustained a hand injury during military service. If this injury causes ongoing pain and prevents the veteran from completing day-to-day activities or work, the result could be Adjustment Disorder with Anxiety, as the change in the veteran’s life causes ongoing anxiety.
In a case like this, an individual may be able to show a secondary service connection for their Adjustment Disorder with Anxiety as a result of the other injury or issue. It is important to remember that medical nexus must still be obtained. This record shows that the other service-connected condition caused or aggravated Adjustment Disorder with Anxiety.
Service Connection by Aggravation: What If You Were Diagnosed With Adjustment Disorder With Anxiety Before Service?
If a veteran has been diagnosed with Adjustment Disorder with Anxiety before he or she joined the military, VA disability benefits may still apply. In a case like this, the veteran would have to prove that serving in the military worsened (aggravated) the already-existing Adjustment Disorder with Anxiety beyond how it would have otherwise progressed. The process for establishing a connection by aggravation is similar to proving direct causation. However, the VA would need to see the worsening of the preexisting condition as it connects to service.
Compensation & Pension (C&P) Exams for Adjustment Disorder with Anxiety
Compensation & Pension (often referred to as C&P) exams are the standard method for the VA to decide if there is a nexus (connection) between the Adjustment Disorder with Anxiety diagnosis and the time spent in service. During the appointment, the examiner will mainly ask questions and discuss medical history. The exam may include questions about current symptoms, time in the service, and any previous signs or symptoms. The examiner may also assess the severity of the disorder.
Anyone seeking a disability rating for Adjustment Disorder with Anxiety must attend their C&P exam or contact the VA to reschedule if it is not possible to make it. Failing to attend a C&P exam may result in an automatic denial of the case.
After the C&P exam, the veteran should ask for a written copy of the results. Veterans are entitled to this upon request. When you have the notes, double-check the details to make sure there are no noticeable problems or discrepancies. If there are discrepancies, or you get an unfavorable review of your case, details may be adjusted by providing additional evidence to the C&P examiner.
Evidence for Adjustment Disorder with Anxiety Claims and Appealing Under The AMA System
When filing a claim for Adjustment Disorder with Anxiety, you are entitled to submit evidence in favor of your condition if you do not agree with the initial determination that is made in your case. Evidence may include medical evidence from a health care provider, lay statements from family members, friends, or co-workers that detail the onset or aggravation of symptoms, and personal notes describing why the C&P exam wasn’t an adequate determination of the issue.
There is a relatively new appeals system that determines how your review works. The Appeals Modernization Act allows you to choose between three different review options. These options include:
- Higher Level Review – The case is reviewed at a higher level, but you do not submit additional evidence.
- Supplemental Claim – You may submit additional evidence as long as it is considered new and relevant.
- Notice of Disagreement – There are three different dockets (direct docket, evidence docket, or hearing docket). The direct docket does not give you the option to submit additional evidence, but the other two do.
VA Ratings for Adjustment Disorder With Anxiety
The VA follows a general rating formula for mental disorders. So, the rating schedule for Adjustment Disorder with Anxiety is in line with other mental illnesses like depression, anxiety, obsessive-compulsive disorder, and other adjustment disorders. Mental health conditions, such as Adjustment Disorder with Anxiety, can incur VA ratings of 0 to 100 percent. The ratings take into account both the socialization and occupational impairment a veteran may have as well as the severity of those symptoms that are said to cause the impairment.
If, for example, an applicant has only mild symptoms of Adjustment Disorder with Anxiety, and the disorder is controlled by medication, there may be a 10 percent disability determination. However, a veteran who has non-stop fear, hallucinations, and is unable to work because of gripping anxiety may be rated up to 100 percent. Suicidal behavior may also rate the veteran at 100 percent though it needs to be mentioned that obtaining 100% is difficult and tough to win a claim.
There are, of course, ratings between 10 and 100 that may best fit an individual’s symptoms. It is also important to note that the veteran does not need to show ALL symptoms of Adjustment Disorder with Anxiety to receive a rating—only to have specific symptoms within certain disability rating levels.
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