Veterans seeking to file disability claims related to military sexual trauma are “more likely” to be denied by the Department of Veterans Affairs than those whose claims are for combat injuries, according to a new report mandated by Congress.
That conclusion emerged in a major review of VA protocols around disability claims related to military sexual trauma, or MST. The report found that the “major challenge” veterans face at the VA when filing a claim for military sexual trauma is the “incompatibility” of those claims with “many components” of VA processes originally developed for assessing bodily injuries or behavioral diagnoses from combat.
The conclusions come from a congressionally-ordered report, released June 3, by the National Academies of Sciences, Engineering, and Medicine.
The report also found that, long before veterans reach the VA, the military’s hierarchical structure and internal culture dissuade survivors from reporting military sexual trauma. Once out of active duty, veterans find that the VA’s evidence threshold creates a standard “that many veterans are unable to meet.”
The report cited research from 2024 which compared MST and combat claims between October 2017 and May 2022. They found that the majority of MST claims were submitted by white women Army veterans. Those claims faced higher odds of being denied than combat claims (27.6% versus 18.2%). The disparity between MST claim and combat claim denials was even greater for male veterans, and greater still for Black veterans.
The report’s authors also referenced an American Civil Liberties Union report that reviewed VA PTSD claims that can specify MST or other combat injuries. Between 2008 and 2012, the VA granted claims for PTSD related to MST “at a significantly lower rate” than other PTSD claims, with MST claims lagging behind by 16 and 30% every year.
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“I suspect it does relate not so much to the rules of wisdom of medicine, but frankly to cultural suppositions and the difficulty obtaining a history,” said Dr. Harold Kudler, a 40-year VA psychiatrist and senior policy lead for VA mental health, who worked on the report.
Kudler said the legal definition of military sexual trauma was established by Congress following the 1991 Tailhook Scandal, an annual convention of Navy and Marine Corps officers which revealed a military culture plagued by an acceptance of sexual harassment and assault. A number of leaders retired early or resigned in the wake of the scandal, and it led to the Defense Department’s zero tolerance policies around sexual assault.
Veteran testimony as evidence
In 2002, the VA established its formal standards for evaluating MST claims. The June report is the latest revision aimed at improving the process, and concluded that the VA remains poorly suited to assess the complexities of MST.
“Most of these disability questionnaires are to look for a health condition, like do you have arthritis in your legs? Do you have major depression? We’re diagnosing a disorder, and most of the evidence for that is, look, ‘Here’s the X-ray,’ ‘Here’s the psychological testing,” Kudler said. “But military sexual trauma is not a physical or mental condition. It is an event with many possible physical and/or mental health conditions which may stem from it and so it’s a special challenge.”
One of their major recommendations, Kudler said, is allowing veterans’ own testimony to support their MST claim. Kudler said this would establish a “basic principle of fairness” and not create a “bureaucratic technicality” which basically prohibits a claim from being evaluated.
In 2010, the VA changed the rules for PTSD claims by reducing the evidence threshold and allowing personal testimony. Veterans can submit MST claims related to PTSD or another bodily injury like pelvic pain or migraines. For the latter, veterans must still present additional evidence like an official Department of Defense sexual assault report or complaint, medical records, or police reports related to the trauma.
The committee found those requirements created a “higher burden of proof” for MST claims compared to combat claims.
“We’re saying we don’t have to wait for this document to appear. Even in civilian cases, people more often than not don’t report sexual abuse, sexual harassment, sexual battery, rape. People are embarrassed. People don’t want to go to court and talk about this experience. It’s often the worst experience of their lives, even more so in the military,” Kudler said. “Why are we basing this entire process on them having done that?”
