February 25, 2005M21-1, Part III
Obtain any reports from the military police, shore patrol, provost marshal's office, or other military law enforcement. Development may include phone, fax, e-mail, or correspondence as long as documented in the file.
(5) Identifying possible sources of alternative evidence will require that you ask the veteran for information concerning the incident. This should be done as compassionately as possible in order to avoid further traumatization. The PTSD stressor development letter used by regional offices to solicit details concerning a combat stressful incident is inappropriate for this type of PTSD claim. Select the personal assault option from the PTSD Special Issue screen in MAP-D for this type of claim.
(6) Rating Veterans Service Representatives (RVSRs) must carefully evaluate all the available evidence. If the military record contains no documentation that a personal assault occurred, alternative evidence might still establish an in-service stressful incident. Behavior changes that occurred at the time of the incident may indicate the occurrence of an in-service stressor. Examples of behavior changes that might indicate a stressor are (but are not limited to):
Visits to a medical or counseling clinic or dispensary without a specific diagnosis or specific ailment;
Sudden requests that the veteran’s military occupational series or duty assignment be changed without other justification
Lay statements indicating increased use or abuse of leave without an apparent reason such as family obligations or family illness
Changes in performance and performance evaluations
Lay statements describing episodes of depression, panic attacks or anxiety but no identifiable reasons for the episodes;
Increased or decreased use of prescription medications;
Increased use of over-the-counter medications
Evidence of substance abuse such as alcohol or drugs
Increased disregard for military or civilian authority
Obsessive behavior such as overeating or undereating
Pregnancy tests around the time of the incident
Increased interest in tests for HIV or sexually transmitted diseases
Unexplained economic or social behavior changes
Treatment for physical injuries around the time of the claimed trauma but not reported as a result of the trauma, or
Breakup of a primary relationship.
(7) In personal assault claims, secondary evidence may need interpretation by a clinician, especially if it involves behavior changes. Evidence that documents such behavior changes may require interpretation in relationship to the medical diagnosis by a neuropsychiatric physician.