Case Citation: A25048755 | Decision Date: June 3, 2025
The Hook
This veteran had PTSD symptoms documented in service. He had a positive PTSD screening at the VA. He was struggling so badly he became homeless.
The Board of Veterans' Appeals still denied his PTSD claim.
Here's what went wrong - and the critical lessons that could save your claim.
What Happened (The Quick Version)
- Service: Army, October 2020 to August 2023
- Claimed: Service connection for PTSD, anxiety, and depression
- VA Decision: Granted 50% for major depressive disorder + generalized anxiety disorder (GAD) + alcohol use disorder
- But denied: Separate service connection for PTSD
- BVA Decision: Upheld the denial
- Timeline: Claim filed 2024, decided June 2025
The veteran got benefits - just not for PTSD specifically. That's important context.
Why This Case Matters
This case shows three critical things:
- Having symptoms doesn't equal having a diagnosis (for VA purposes)
- What happens when a C&P examiner suspects you're exaggerating
- Why you can't get multiple ratings for the same symptoms (pyramiding rules)
Let's break down what actually happened.
The Evidence Timeline
In Service (May 2023):
- Diagnosed with adjustment disorder with mixed anxious and depressed mood
- Military provider specifically noted the PTSD evaluation showed "excessively elevated" scales
- Provider wrote: "likely exaggerated"
- Diagnosis given: Adjustment disorder, NOT PTSD
End of Service (July 2023):
- PTSD appeared on his problem list/medical history
- Records noted "significant PTSD symptoms reported" and evaluation indicated
- But no formal PTSD diagnosis was made
After Service (September 2023):
- Positive PTSD screening at VA
- Still no formal diagnosis
VA C&P Exam (January 2024):
This is where everything fell apart.
The VA psychologist (C.W.) examined the veteran and concluded:
"The appellant's symptoms do not meet the diagnostic criteria for PTSD under DSM-5... no mental health diagnosis was assigned in context of stated extreme exaggeration or feigning of symptoms."
The examiner then clarified:
"This does not mean genuine mental health symptoms are not present, but that it was impossible, without speculation, to determine symptoms that were present, their frequency and/or level of severity."
Translation: "This veteran has real mental health issues, but they over-reported so badly I can't tell what's actually going on."
What the BVA Judge Said
The judge's reasoning was straightforward:
- No PTSD diagnosis during service - Just adjustment disorder
- No PTSD diagnosis after service - Just symptoms and screenings
- VA examiner said no PTSD - Based on DSM-5 criteria and suspected exaggeration
- Already service-connected for depression and anxiety - Same symptoms, different label
The key quote from the decision:
"As the appellant does not have a separate diagnosis of PTSD or evidence indicating PTSD symptoms separate than those of his already service-connected major depressive disorder, generalized anxiety disorder, and alcohol use disorder to include insomnia, entitlement to a separate grant of service connection for PTSD is not warranted."
The veteran got 50% for mental health conditions - just not labeled as PTSD.
The Pyramiding Issue (This Is Important)
Here's something most veterans don't understand: You can't get multiple ratings for the same symptoms.
The VA calls this "pyramiding" and it's prohibited by regulation (38 CFR § 4.14).
With mental health conditions, the VA rates based on social and occupational impairment - not the diagnosis label. So if you have:
- Depression causing sleep problems, difficulty concentrating, social isolation
- Anxiety causing sleep problems, difficulty concentrating, social isolation
- PTSD causing sleep problems, difficulty concentrating, social isolation
The VA sees all of that as ONE rating because the symptoms overlap completely.
The BVA cited Amberman v. Shinseki (2009), which says you can only get separate ratings for mental health conditions if the symptoms are completely different and don't overlap.
In this case: The veteran's PTSD symptoms (nightmares, hypervigilance, anxiety, depression) were the same as his already-rated depression and GAD symptoms.
Bottom line: He couldn't get 50% for depression PLUS another rating for PTSD because they cause the same impairment.
What Went Wrong (The Critical Mistakes)
Mistake #1: Over-Reporting at the C&P Exam
The military provider in May 2023 noted "excessively elevated" scales that were "likely exaggerated."
The VA psychologist in January 2024 went further: "extreme exaggeration or feigning of symptoms."
What probably happened: The veteran, desperate for benefits and struggling badly, over-reported his symptoms thinking it would help his claim.
What actually happened: The examiner couldn't trust anything he said, so they couldn't diagnose him with anything.
This is the kiss of death for a claim. When an examiner suspects malingering, they document it, and your claim is essentially over.
Mistake #2: No Formal PTSD Diagnosis Ever Established
Look at the timeline:
- May 2023: Adjustment disorder (specifically NOT PTSD)
- July 2023: PTSD on problem list but no diagnosis
- September 2023: Positive screening but no diagnosis
- January 2024: Examiner says no PTSD diagnosis
Having symptoms ≠ having a diagnosis
PTSD has specific diagnostic criteria in the DSM-5. You need:
- Exposure to actual or threatened death, serious injury, or sexual violence
- Intrusion symptoms (nightmares, flashbacks)
- Avoidance of trauma-related stimuli
- Negative alterations in cognition and mood
- Alterations in arousal and reactivity
- Symptoms for more than 1 month
- Clinically significant distress or impairment
If a mental health professional evaluates you and says "you don't meet criteria for PTSD," you don't have PTSD for VA purposes - even if you're really struggling.
Mistake #3: No Private Medical Opinion to Counter the VA
The veteran had:
- Military records saying adjustment disorder (not PTSD)
- VA examiner saying no PTSD diagnosis + suspected malingering
What he needed: A private psychologist to evaluate him and either:
- Provide a legitimate PTSD diagnosis, OR
- Explain why the symptoms are separate from his depression/anxiety
He didn't have either.
What You Can Learn From This Case
Lesson #1: Don't Exaggerate at C&P Exams (Seriously)
I know you're struggling. I know you think if you just explain how bad it really is, they'll understand.
But exaggerating destroys your credibility.
Examiners are trained to spot inconsistencies. They use validity scales. They compare what you say to your medical records.
When they suspect malingering, they write it in your exam report, and your claim is toast.
What to do instead:
- Be honest about your symptoms
- Give specific examples (not dramatic generalizations)
- Focus on frequency and severity ("I have nightmares 3-4 times per week")
- If you're having a good day at the exam, say so ("Today is actually a better day, normally I...")
Lesson #2: You Need an Actual Diagnosis, Not Just Symptoms
Saying "I have PTSD symptoms" is not the same as having a PTSD diagnosis.
For VA purposes, you need:
- A qualified mental health professional (psychologist, psychiatrist)
- Who evaluated you in person
- Who applied DSM-5 criteria
- Who concluded you meet the criteria for PTSD
A positive screening is not a diagnosis. Symptoms listed on a problem list is not a diagnosis. Your own belief that you have PTSD is not a diagnosis.
If you don't have a formal diagnosis:
- See a mental health provider (VA or private)
- Ask specifically: "Do I meet criteria for PTSD?"
- Get it documented in your medical records
- If private, get a detailed written opinion
Lesson #3: Understand Pyramiding Rules
If you already have service-connected mental health conditions, you might not need a separate PTSD diagnosis.
Ask yourself:
- Are my PTSD symptoms different from my depression/anxiety symptoms?
- Do they cause separate impairment?
- Or are they just different labels for the same problems?
If your PTSD nightmares, hypervigilance, and social isolation are the same as your anxiety-induced sleep problems and social withdrawal, you're already being rated for those symptoms.
Getting a PTSD label won't increase your rating if the symptoms overlap.
In this case: The veteran got 50% for his mental health conditions. That's a real rating with real benefits. The label doesn't change the money.
Lesson #4: When VA Says No, Get a Private Opinion
The veteran had:
- Military provider saying adjustment disorder
- VA examiner saying no PTSD + suspected exaggeration
That's game over unless you get a private opinion to counter it.
A private psychologist could have:
- Re-evaluated him properly
- Applied DSM-5 criteria independently
- Either confirmed PTSD or explained the diagnosis issue
- Addressed the malingering concern
Without that, he had no way to overcome the VA's negative findings.
Lesson #5: Focus on Getting Benefits, Not Getting a Specific Label
This veteran got 50% for major depressive disorder, GAD, and alcohol use disorder.
That's $1,075.16 per month (2025 rate) for a single veteran with no dependents. That's $12,901.92 per year.
He got the benefits. Just not the PTSD label.
I understand wanting the accurate diagnosis. I understand feeling like PTSD is the right label for what you experienced.
But from a practical standpoint: The VA pays you based on your level of impairment, not the diagnosis name.
50% for depression = same monthly payment as 50% for PTSD.
The Harsh Reality About This Case
This veteran was homeless. He was struggling badly. He asked the Board to advance his case on the docket due to financial hardship.
The Board said no. They said he didn't provide enough documentation of his financial hardship.
Then they denied his PTSD claim.
Man, that's brutal.
And here's the thing: He probably does have PTSD. His stressors in service were real. His symptoms are real. His struggles are real.
But "real symptoms" and "VA-compensable PTSD diagnosis" are two different things.
The system failed him by:
- Not getting him a proper diagnosis in service
- Having an examiner who couldn't differentiate real symptoms from exaggeration
- Leaving him to navigate this alone without proper mental health treatment
But the claim failed because:
- No formal diagnosis ever established
- Suspected malingering destroyed credibility
- No private evidence to counter VA's findings
- Symptoms overlapped with already service-connected conditions
What Should He Do Now?
If this veteran is reading this (or if you're in a similar situation), here's the path forward:
Option 1: File a Supplemental Claim with New Evidence
Get a private psychological evaluation that:
- Addresses the malingering concern directly
- Applies DSM-5 criteria properly
- Either confirms PTSD or explains why diagnosis is difficult
- Discusses how PTSD symptoms are separate from depression/GAD (if they are)
Then file a supplemental claim with that new evidence.
Option 2: Focus on Increasing Your Current Rating
He's rated 50% for depression + GAD + alcohol use disorder.
Is that rating accurate?
If his symptoms are worse than what 50% criteria describe, file for an increase on those conditions.
50% criteria: "occupational and social impairment with reduced reliability and productivity"
70% criteria: "occupational and social impairment with deficiencies in most areas"
100% criteria: "total occupational and social impairment"
If he's homeless and can't work, he might qualify for 70% or even 100% based on the same conditions already service-connected.
Option 3: Get Proper Treatment First
Before worrying about ratings and labels, get the mental health treatment you need.
If you're homeless, struggling, and your mental health is that bad:
- Contact the Veterans Crisis Line (988, press 1)
- Go to VA emergency room or nearest ER
- Connect with VA homeless services (SSVF, HUD-VASH)
- Get into consistent mental health treatment
Once you're stable and in treatment:
- You'll have better medical records
- Providers can properly diagnose you
- You'll have evidence of ongoing symptoms
- You'll be in better shape to pursue your claim
Your mental health is more important than your disability rating.
The Bottom Line
This case shows why having symptoms isn't enough - you need:
- A formal diagnosis from a qualified professional
- Credibility (don't exaggerate at C&P exams)
- Evidence that symptoms are separate from existing service-connected conditions
- Private medical opinions when VA says no
The veteran in this case got benefits (50% rating) but not the PTSD label specifically.
That might seem like a loss, but he's getting over $12K per year for his mental health conditions.
Sometimes getting benefits under a different diagnosis is still a win.
How Claim Raven Can Help
If you're worried about your C&P exam preparation:
- C&P Exam Prep tool walks you through what examiners look for and common mistakes to avoid
- Raven Eye can analyze your VA exam report to see if there are red flags like suspected malingering
- Secondary Condition Finder helps identify if you should be claiming other conditions instead of fighting for a specific label
Not a lawyer or VSO - just a veteran (68W, 100% P&T) building tools to help us navigate this process.
Want to see more BVA case breakdowns like this? Let me know what conditions you want analyzed.
Case Citation: Citation Nr: A25048755, Decision Date: June 3, 2025 Full Decision: Available on VA.gov (search citation number)
Disclaimer: This is educational analysis, not legal advice. Every case is different. If you need help with your claim, consider working with an accredited VSO or attorney.