Military sexual trauma and PTSD: a claim map

The claim map

A claim map follows one veteran's route: what happened in service, the condition the law makes easier to prove for it, and the conditions that follow from it. Each box shows how the Board ruled at that step.

What happened in service

Military sexual trauma

Sexual assault, battery of a sexual nature, or sexual harassment during service

5,333 Board decisions that record military sexual trauma

event shown by other evidence38 CFR 3.304(f)(5)

Step 1 · event shown by other evidence

PTSD

42.2% granted

1,337 of 3,172 veterans · all PTSD claims 26.6%

secondary38 CFR 3.310(a)

Step 2 · claimed secondary to PTSD

45.6%granted when the same decision granted the PTSD

10.2%granted when it did not

Step 2 depends on step 1: a secondary claim needs a service-connected condition to attach to.

• Sleep apnea DC 6847

  31.6% · 18 of 57

  all veterans 33.1%

• Depression DC 9434

  69.0% · 20 of 29

  all veterans 63.2%

• Erectile dysfunction DC 7522

  37.0% · 10 of 27

  all veterans 33.7%

• Migraine / headaches DC 8100

  50.0% · 13 of 26

  all veterans 38.9%

• Hypertension DC 7101

  30.0% · 6 of 20

  all veterans 17.9%

Bar: share granted in Board decisions that record military sexual trauma (one count per veteran; a remand counts as not granted). Red mark: all veterans with the same claim. Step 2 counts claims decided in the same decision; conditions with at least 15 veterans.

How is military sexual trauma proven for a PTSD claim?

PTSD needs a diagnosis, credible supporting evidence that the in-service event happened, and medical evidence linking the symptoms to it (38 CFR 3.304(f)). When the claim is based on an in-service personal assault, evidence from outside the service records can corroborate the veteran's account: records from law enforcement, rape crisis centers, counseling centers, hospitals or physicians, pregnancy or sexually transmitted disease tests, and statements from family, roommates, fellow service members or clergy (38 CFR 3.304(f)(5)). In decisions that record military sexual trauma, the Board granted 42.2% of PTSD claims (1,337 of 3,172), against 26.6% for all veterans.

5,333 Board decisions from 2020 to 2025 record military sexual trauma. This page counts the PTSD claims in them, rated under DC 9411. Whether a decision records military sexual trauma was read by AI from the decision; the limits are below. The gap held every year: 38.2% against 22.3% in 2020 decisions, 47.7% against 30.9% in 2025.

What are markers in an MST claim?

Changes in behavior after the event that can show it happened, such as a request for a transfer, a drop in work performance, substance abuse, episodes of depression, panic attacks or anxiety with no clear cause, or unexplained economic or social changes (38 CFR 3.304(f)(5)). VA may ask a mental health professional whether the markers indicate that an assault occurred, and it must not deny the PTSD claim without first telling the veteran that this kind of evidence counts. VA's manual for raters applies the marker rule to PTSD only; for another diagnosis, such as depression, it asks for documentary evidence of the event (M21-1 VIII.iv.1.D).

PTSD and the other mental health conditions

Decisions that record MSTAll veterans

PTSD

42.2%

26.6%

Depression

51.0%

40.0%

Anxiety

28.6%

20.9%

Adjustment disorder

22.7%

23.3%

Schizophrenia

14.5%

12.8%

Share of decided claims granted; a remand counts as not granted. One count per veteran. Service-connection claims only, by rating code (PTSD DC 9411, depression 9434, anxiety 9400, adjustment disorder 9440, schizophrenia 9201).

In these decisions, PTSD was granted about 1.6 times as often as for all veterans. The other mental health conditions together were granted for 34.6% (399 of 1,152), about 1.3 times as often as for all veterans. Depression did well in both groups: 51.0% here (181 of 355), against 40.0% for all veterans.

The denials differ. For the other mental health conditions, the Board's note named the event, its corroboration or credibility in 38.1% of 168 denials, and the medical link in 57.7%. The Board does not always read the manual's PTSD-only line strictly: in A25110799 it granted an anxiety disorder on marker evidence in the service treatment records, finding nothing that bars that kind of evidence for a diagnosis other than PTSD.

Why are MST-related PTSD claims denied?

Most often over proof of the event. For 331 denials of PTSD in these decisions, the Board's note named the event, its corroboration or the veteran's credibility in 70.7% of them, the diagnosis in 46.8% and the medical link in 48.9%. Some veterans the Board found credible were still denied because no examiner diagnosed PTSD under the diagnostic criteria (38 CFR 4.125(a)).

The second step: conditions claimed secondary to PTSD

267 veterans in these decisions had a claim marked secondary to PTSD decided.

What conditions are claimed secondary to PTSD after an MST grant?

In the same decisions, sleep apnea was the most common: granted for 18 of 57 veterans (31.6%), against 33.1% for all veterans. Migraine was granted for 13 of 26 (50.0%), erectile dysfunction for 10 of 27 (37.0%) and depression for 20 of 29 (69.0%); the numbers are small.

Claimed secondary to PTSD	Decisions that record MST	All veterans
Sleep apnea	31.6% (18 of 57)	33.1%
Migraine or headaches	50.0% (13 of 26)	38.9%
Erectile dysfunction	37.0% (10 of 27)	33.7%
Hypertension	30.0% (6 of 20)	17.9%
Depression	69.0% (20 of 29)	63.2%
Acid reflux (GERD)	9.1% (1 of 11)	27.8%

The rules for proving the event do not reach the second step; the link between PTSD and another condition rests on a medical opinion.

Does the PTSD have to be granted first?

In practice, yes. When the same decision granted the PTSD, the conditions claimed secondary to it were granted 45.6% of the time (41 of 90). When it did not, 5 of 49 were granted.

Where the PTSD was not on appeal, usually because it was already service connected, 240 veterans had a secondary claim decided, and 33.8% were granted.

Read the decisions

Recent decisions, with the Board's reasoning as summarized by AI and checked against the decision text:

• A25109533, December 2025: PTSD granted; the VA examiner found the event corroborated by in-service markers, such as a request to move for mental health reasons and a psychiatric hospitalization, together with the post-service records and the assessment itself.
• A25108192, December 2025: PTSD granted on a private clinician's diagnosis; VA had already made a favorable finding on the event, supported by a law enforcement report, and the Board gave less weight to a VA opinion that did not address the existing diagnosis.
• A25110799, December 2025: an anxiety disorder granted on markers in the service treatment records, such as pregnancy and sexually transmitted disease tests. The regional office had denied it because, in its view, marker evidence counts only for PTSD.
• A25101843, November 2025: PTSD denied though the Board found the veteran's account of harassment credible; there was no formal diagnosis of PTSD under the diagnostic criteria.
• A25108547, December 2025: migraine granted secondary to service-connected PTSD; a VA treatment record noted the headaches began after the military sexual trauma.

What the data cannot tell you

Military sexual trauma is an AI-extracted finding for the whole decision: it means the decision discusses it, not that VA or the Board found the event proven. The gap at the first step shows what the decisions contained, not what caused the result. Many PTSD claims based on personal assault are decided by VA and never reach the Board. A veteran can have PTSD and another mental health condition claimed in the same decision, and each is counted. Service-connection claims only, read for each condition; rating appeals are left out. The second step counts only claims decided in the same decision. Denial notes are AI-extracted. These are historical outcomes, not predictions.

For representatives

• Gather evidence from outside the service records early: counseling, medical and police records, pregnancy or sexually transmitted disease tests, and statements from family, friends, fellow service members or clergy.
• Look for markers in the service and personnel records: transfer requests, a drop in work performance, substance use, or episodes of depression, panic or anxiety after the event, and ask for an examiner's opinion on what they show.
• Make sure the examiner addresses PTSD under the diagnostic criteria; a credible account is not enough without the diagnosis.
• If the diagnosis is depression or anxiety rather than PTSD, gather documentary evidence of the event as well; the manual's marker rule is written for PTSD.
• After the grant, screen for the conditions that follow: sleep apnea, migraine, erectile dysfunction and hypertension, each with its own medical opinion.