Military Sexual Trauma (MST)

Military sexual trauma (MST) is not a standalone disability rating or diagnostic code. It is an in-service experience that may cause or aggravate a diagnosable mental or physical condition. VA compensates the resulting service-connected condition, such as PTSD, depression, anxiety, an eating disorder, or a physical residual.

For PTSD based on an in-service personal assault, 38 CFR § 3.304(f)(5) permits evidence from sources outside service records and evidence of behavior changes to corroborate the stressor. That rule matters because many experiences were not reported when they occurred.

TL;DR

• MST is an event or experience, not a ratable diagnosis by itself.
• VA rates the diagnosed condition caused or aggravated by MST under that condition's criteria.
• PTSD may be rated from 0 to 100 percent under the General Rating Formula for Mental Disorders.
• The personal-assault rule allows marker evidence and evidence from nonmilitary sources to corroborate a PTSD stressor.
• A lack of an official report does not automatically defeat an MST-related PTSD claim.
• VA may submit marker evidence to a qualified medical professional for an opinion about whether it indicates that a personal assault occurred.
• Compensation and health care are separate. VA provides free MST-related care without requiring a disability rating or documentation of the experience.
• A survivor can request a male or female C&P examiner, although availability may affect scheduling.

What VA Actually Rates

The claim should name the current disability, not list only “MST.” Common claimed conditions include PTSD, depressive disorders, anxiety disorders, eating disorders, sexual dysfunction, chronic pain, and other diagnosed mental or physical residuals.

PTSD is evaluated under DC 9411 in 38 CFR § 4.130. The percentages are 0, 10, 30, 50, 70, and 100, based on occupational and social impairment. The listed symptoms are examples, not a checklist. VA must assess their severity, frequency, duration, and effect on work and relationships.

Other diagnoses use their own rating rules. Depression and most anxiety disorders use the same mental-disorder formula. Eating disorders use a separate formula under DCs 9520 and 9521. Physical residuals use the appropriate body-system code. VA generally does not assign separate ratings for multiple mental-health diagnoses when the symptoms and impairment overlap because § 4.14 bars duplicate compensation.

The Personal-Assault Evidence Rule

Section 3.304(f)(5) applies to PTSD claims based on in-service personal assault. Evidence from sources other than service records may corroborate the account. The regulation identifies examples such as:

• law-enforcement or investigative records;
• rape-crisis, mental-health, hospital, or physician records;
• pregnancy or sexually transmitted infection testing;
• statements from family, roommates, fellow service members, or clergy; and
• evidence of behavior changes after the claimed assault.

Examples of possible behavior changes include a transfer request, deterioration in work performance, substance use, episodes of depression, panic, or anxiety without an identified cause, and unexplained economic or social changes. VA's current MST compensation page also identifies changes in eating or weight, relationship problems, sexual-function problems, and treatment around the time of the experience.

A marker is not required to announce its cause. Its value comes from timing, context, and the complete record. A transfer request may have several explanations, for example. A qualified opinion can explain why a pattern is or is not consistent with the reported trauma.

Before denying a personal-assault PTSD claim because supporting evidence is absent, VA must advise the claimant that alternative-source and behavior-change evidence may be submitted and allow an opportunity to provide it. VA may also send evidence to an appropriate medical or mental-health professional for an opinion on whether it indicates a personal assault occurred.

Building a Trauma-Informed Evidence Timeline

The record does not need graphic detail beyond what is necessary to identify the event and support the medical and legal elements. A useful timeline can focus on:

1. the approximate period and duty setting;
2. changes observed before and after the event;
3. people or organizations told at the time or later;
4. counseling, medical care, transfer requests, discipline, performance changes, pregnancy or STI testing, or other markers;
5. when current symptoms began and how they continued; and
6. the clinician's diagnosis and nexus opinion.

VA currently uses VA Form 21-0781 for a statement supporting a claimed mental-health disorder due to an in-service traumatic event. A claimant can also submit lay statements and relevant private records. The evidence should be organized without forcing the survivor to repeatedly retell unnecessary details.

The Nexus and Diagnosis

A PTSD compensation claim generally needs a diagnosis, credible supporting evidence of the stressor under the applicable rule, and medical evidence linking current symptoms to that stressor. For another mental or physical diagnosis, the evidence should establish the current disability and connect it to the in-service experience or show that the experience aggravated a preexisting condition.

An examiner should address the full record, including favorable markers. A conclusion based only on the absence of an official report misses the purpose of the personal-assault rule. At the same time, a marker list is not a substitute for the medical assessment of the current diagnosis and nexus.

Compensation Is Separate From MST-Related Care

VA's MST health-care page states that free treatment is available for mental and physical health conditions related to MST. A person does not need a service-connected rating, does not need to have reported the experience when it happened, and does not need documentation of the experience to receive this care. Eligibility for MST-related care can be broader than ordinary VA health-care eligibility.

Every VA medical facility has a VHA MST coordinator for care. VBA regional offices have MST outreach coordinators who can assist with the compensation process. These are different roles, so the veteran should contact the coordinator that matches the need.

During a C&P exam, VA says a claimant may request a male or female provider. The request should be made as early as possible. If the exam or preparation causes immediate distress, care and crisis support take priority over claim strategy. The Veterans Crisis Line is available by calling 988 and selecting 1, texting 838255, or using its confidential chat.

What the C&P Record Should Establish

The record should answer:

• What current mental or physical condition is diagnosed?
• Is the claim for PTSD, another condition, or both?
• What direct records, alternative-source evidence, or behavior changes support the in-service event?
• Did VA identify and address favorable markers rather than relying only on the absence of a report?
• Does the clinician link the current condition to the in-service experience?
• If a condition existed before service, did service aggravate it beyond natural progression?
• What occupational and social impairment results from the mental-health symptoms?
• Which manifestations overlap with other service-connected mental-health diagnoses?

Common Failure Modes

• Treating MST as its own diagnostic code or promising a standard “MST rating.”
• Requiring an official report despite the alternative-evidence rule.
• Listing possible markers without connecting them to dates and context.
• Ignoring favorable personnel, treatment, or lay evidence in the medical opinion.
• Treating compensation eligibility as a prerequisite for free MST-related care.
• Using an unsourced “average MST rating” as though it predicts an individual outcome.
• Forcing unnecessary graphic detail into a public guide or supporting statement.
• Seeking duplicate mental-health ratings for the same symptoms and impairment.

Bottom Line

An MST-related disability claim should identify the actual diagnosed condition, use the personal-assault evidence rule when PTSD is claimed, organize direct and marker evidence into a clear timeline, and obtain a medical opinion that addresses the complete record. A missing official report does not end the analysis, and free MST-related care does not depend on winning a compensation claim.

Legal and support sources: 38 CFR § 3.304, § 4.130, VA MST and disability compensation, VA MST-related health care, and VA Form 21-0781, checked August 14, 2026.