Service connection for posttraumatic stress disorder following military sexual trauma: Impacts of military rank and branch on claim award denial.

OBJECTIVE

Military sexual trauma (MST) is a pervasive issue among U.S. service members that often leads to posttraumatic stress disorder (PTSD). After separation, Veterans may file service connection claims with the U.S. Department of Veterans Affairs (VA) for MST-related PTSD to access compensation and health care. Claims are reviewed, assessed by clinicians through forensic interviews, and rated to determine eligibility. Veteran claimants have described this process as emotionally burdensome, while VA staff have described the evaluation process as subjective and influenced by individual discretion. Decision-makers have varying levels of familiarity with military culture and sexual trauma, and implicit bias may shape perceptions about claimants and their credibility. Accordingly, this study examined the impact of military rank and branch on likelihood of MST-related PTSD claim award denial.

METHOD: A logistic regression using a national cohort of 18,951 Veterans who filed initial MST-related PTSD claims between October 2017 and May 2022 modeled the probability of MST-related service connection denial by military rank and branch. Veteran demographics, mental health status, and the season the claim was submitted were accounted for.

RESULTS

Junior enlisted Veterans have higher odds of denial than noncommissioned officers/petty officers (OR = 1.49), as well as warrant officers/commissioned officers (OR = 2.50). Army Veterans have 1.32 times higher odds of denial than Air Force Veterans, and Marine Corps Veterans have 1.18 times higher odds of denial than Army Veterans.

CONCLUSIONS

Military-related factors may influence how VA staff develop, evaluate, and rate PTSD service connection claims, with potential implications on whether Veterans disclose MST, file claims, or seek VA care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).