Before the 1980’s PTSD was psychiatrically managed with different names such as depression, fear, sleeplessness, etc. However, after the Vietnam War it became obvious that Post Traumatic Stress Syndrome was a separate diagnosis and the group of symptoms were identified as one disease. Once PTSD was recognized as one disorder, the door was opened for new research, and a better understanding of symptoms and treatments.
By definition, the name PTSD was changed in the DSM-5 to Trauma-Stressor Related Disorders wherein the patient must exhibit a set of symptoms outlined by the CDC and American Medical Journals.
PTSD is more clearly defined as the result of a horrendous event involving death, serious injury — or the threat of either to the patient or someone else, causing intense feelings of fear and helplessness. Symptoms of PTSD include flashbacks; nightmares; avoidance of people, places, or thoughts connected to the trauma; and hyperarousal, including hyper vigilance, insomnia, and irritability.
By “specific” criteria I mean:
- At least one re-experiencing symptom
- At least 3 avoidance symptoms
- At least 2 negative alterations in mood and cognitive abilities
- At least 2 hyperarousal symptoms for a minimum of a month
In addition, there are the “Four F’s of PTSD:
- FIGHT – seeking safety, rages, bullying, narcississtic behavior
- FLIGHT -flees for safety, stays busy all the time, overreacts, perfectionism
- FREEZE – shot down, brain fog, disassociate
- FAWN – attach for safety, co-dependency, people pleasing, repression of self
There is a great deal of information on the Internet now about PTSD, some of which is very detailed. However, for those claiming PTSD as a primary diagnosis for a private disability claim, it will be difficult to support a PTSD claim unless therapists and psychologists are aware of the criteria and can document those symptoms that specifically relate to their patients. Without documentation of specific diagnostic criteria, a claim for PTSD is hard to support. A mere mention of “PTSD” on an update or application form is insufficient evidence to support paying a benefit.
The next problem is that PTSD is considered a behavioral disease and insurance companies will require actual psychotherapy notes as “proof of claim.” The exact nature of the catastrophic trauma causing the PTSD will be known to the insurer. Like other hard to support diagnoses to support, like fibromyalgia, lupus, etc., PTSD must be fully documented as to the symptoms listed by the CDC and others before it is accepted as a disabling disability.
