VA Disability Claims Process Can Worsen Symptoms Associated With Military Sexual Trauma

Interviews with a small sample of veterans seeking disability compensation for military sexual trauma (MST) reveal the US Department of Veterans Affairs (VA) claims process may retraumatize victims by invalidating their experiences and forcing them to relive their assaults, according to a new report.

For some victims, “retraumatization and invalidation contributed to perceptions of VA-enacted institutional betrayal, which impacted their trust in and likelihood of using VA health care,” report Aliya R. Webermann, PhD, of VA Connecticut Healthcare System and Yale School of Medicine, et al in the Journal of Trauma & Dissociation.

One participant recalled that having to write about her trauma “was a big trigger. It was hard. When I was typing it, in the back of my mind, that’s all I could remember. It’s like going through this whole thing all over again.” Another described writing her statement as “brutal.”

Clinical psychologist Anne P. DePrince, PhD, a professor at the University of Denver not involved in the research, said in an interview with Federal Practitioner that the findings “add to a growing number of studies showing that institutional policies can be more than just red tape.

“Policies and procedures, and how those are implemented by staff, can have real consequences for survivors of intimate abuse, adding to the psychological burden they bear.”

The Burden of Military Sexual Trauma

According to a 2016 meta-analysis, 15.7% of US service members and veterans have experienced MST when measured as combined sexual assault and harassment. Viewed separately, assault was reported by 13.9%, including 23.6% of women and 1.9% of men, while harassment was reported by 31.2%, including 52.5% of women and 8.9% of men. The VA defines MST as “sexual assault or threatening sexual harassment experienced during military service.” MST has been linked to posttraumatic stress disorder (PTSD), substance misuse, suicidality, and other adverse outcomes, the new study notes.

Veterans are eligible for service-connected disability compensation for any condition, such as PTSD precipitated by MST, the study authors write, but patients must provide evidence of the trauma and show that the MST caused their disability.

A 2024 analysis found that MST-related PTSD claims for disability were more likely to be denied than combat-related PTSD claims (27.6% vs 18.2%, respectively).

‘I Had to Relive All of That Again’

The researchers recruited 15 victims of MST for interviews in 2024 (73% women, 60% White, 60% Army, mean age 52.6 years). Most served prior to 9/11 and lived in a single state.

In the conversations, which addressed the MST-related claims process, participants described being forced to repeat their stories. “When it was time for me to sit down and write, I had to relive all of that again. It was kind of rough,” one participant said.

Four veterans said being asked to recall their traumas was especially difficult when they were already doing so as part of treatment: “Through therapy, I gotta keep telling the same thing over and over, and it gets old . . . isn’t once enough?” said one veteran, while a male veteran said the experience was “like a knife going into your gut all the time.”

Victims Told They Don’t Fit the Mold

Veterans also described stress during the process.

“It would make me shut down,” said one participant about trying to appeal an initial 10% disability rating. “I used to drink a lot. It took a toll not just on me, but on my relationship.”

Two of the 15 veterans were denied disability, and they described reading their files as traumatic.

“When I read what they put, sometimes I feel as if I’m being assaulted all over again,” one said.

Additionally, some veterans “described being confronted when their lives did not follow a simple pattern of behavior before and after their MST,” the authors write.

One female veteran said: “They were like, ‘But you continued to perform so well and do well in class and still be able to be a military rock star.’ People deal with trauma in different ways. I don’t have to do a 180 and s— the bed to show this is impacting me.”

In other comments, veterans spoke about racial divides—the 2024 analysis found Black veterans were more likely to be denied MST-related disability claims than White veterans—“the living hell” of denied claims, and perceptions of the VA as “an institutional adversary that was distrustful and untrustworthy.”

DePrince said the study highlights the importance of preparing trauma survivors for what they will experience in the claims process.

“My team has learned from survivors across multiple studies just how important clear and accurate information is when trying to navigate legal, health, and social service systems,” she said. “Unfortunately, many survivors find it hard to get clear and accurate information about these processes, which adds to the stress of trying to access much-needed care and resources after trauma.”

Clinical psychologist Sheela Raja, PhD, an associate professor at the University of Illinois Chicago who studies how trauma affects survivors, agreed with DePrince in an interview with Federal Practitioner.

“When survivors know what’s coming, they can prepare, and that alone can make a huge difference,” said Raja, who was familiar with the study findings.

Raja, who has written books about trauma and PTSD, called research such as this “essential.” These reports bring “survivors’ voices forward and help us understand not just their experiences, but the symptoms and stress that can come from navigating systems that weren’t designed with trauma in mind.”

The VA funded the study. The authors have no disclosures. DePrince is associate editor of the Journal of Trauma and Dissociation, where the study appeared, but she was not involved in the review of the paper. Raja has no disclosures.