Military Sexual Trauma: Claims Without a Report on File

You decide how much to share, with whom, and when. Filing a claim is one option, and getting care is another, and you can do either without the other.

• Care comes first if you want it. The VA provides free treatment for mental and physical health conditions related to MST. You don't need a disability rating, and you don't need documentation that the MST happened. Ask for the MST Coordinator at a VA health care facility, or contact a Vet Center, where MST counseling is part of the services offered. Around Wisconsin, that could be the Milwaukee, Madison or Green Bay Vet Center, the La Crosse Vet Center's location in Onalaska, or its Wausau outstation, and satellite sites in other towns offer select services.
• A claim can come later. There is no deadline to file for service connection. Your effective date is generally tied to when the VA receives your claim or an Intent to File, so starting the paperwork sooner protects back pay even if you need time to gather evidence.
• Crisis support is always open. If you are in danger right now, call 988 and press 1 for the Veterans Crisis Line, or text 838255. It is free and confidential.

The VA uses "military sexual trauma" for sexual assault or sexual harassment experienced during military service. That covers more than many people assume:

• Unwanted sexual contact of any kind, including when you were pressured, threatened, or unable to consent
• Repeated, threatening sexual comments or advances, even with no physical contact
• Incidents on or off base, on or off duty, by a superior, a peer, a subordinate, a civilian or a stranger

MST happens to service members of every sex, age, background and branch. Men file MST-related claims too, and the evidence rules below apply to everyone the same way.

For PTSD based on an assault in service, the regulation lets records from outside your service file back up your account. Examples include civilian police reports, rape crisis center or counseling records, hospital or private doctor visits, pregnancy or STD tests, and statements from family members, roommates, fellow service members or clergy.

Changes other people noticed

The VA also treats behavior changes after the event as evidence. These are often called markers, and they tend to be sitting in records you already have:

• Evaluations that dropped from strong to marginal with no clear reason
• A sudden request to change units, shifts, duty stations or jobs
• Alcohol or drug incidents, disciplinary action or an Article 15 that came out of nowhere
• Sick call visits for headaches, stomach trouble, sleep problems or panic with no physical cause found
• Pulling away from friends, ending a relationship, or money problems that started around the same time
• Letters, emails, journals or social media posts from that period that show a shift

The VA has to tell you about these kinds of evidence before it can deny an assault-based PTSD claim, and it can ask a mental health professional whether the evidence suggests an assault occurred. The VA's own guidance adds that indirect evidence doesn't need to show a clear cause.

One caution: the marker rule is written for PTSD, and the VA's claims manual says it applies only when the diagnosis is PTSD. The VA encourages claims for any mental or physical condition related to MST, but for a diagnosis like depression or anxiety the VA expects records that document the event itself. Outside records such as police reports, counseling notes or medical visits still count there. If your diagnosis isn't PTSD, ask about this before you file.

An MST claim follows the regular disability claim process with a few added supports:

• VA Form 21-0781 is the statement for mental health conditions tied to an in-service traumatic event. You choose how much detail to give. Dates, locations, your unit and anyone you told help the VA look for records and markers.
• Every VA regional office has MST coordinators, one male and one female, who can help with an MST-related claim.
• Claims processors who handle MST claims get specialized training, according to the VA.
• The exam is usually with a psychologist or psychiatrist. You can bring written notes so you don't have to retell everything from memory. The C&P exam guide explains what happens there.

Statements from people who knew you before and after can matter as much as anything in your file. A sibling who noticed you stopped calling home, or a friend from your unit who saw you change, can write a buddy statement without knowing what happened to you.

There is no rating for MST itself. The VA rates the condition it caused. For PTSD, depression, anxiety and most other mental health diagnoses, that means the General Rating Formula for Mental Disorders shown below, with one combined rating covering every mental health diagnosis you have. Physical conditions linked to MST, such as injuries or chronic pelvic or digestive problems, are rated under their own codes and combined with the mental health rating.