 Good morning and thank you for tuning in. I'm Elizabeth DePompe with Disabled American Veterans and I'm joined by DAV Benefits Advocate Jackie Graham. Today, in recognition of Sexual Assault Awareness Month, we'll be talking about filing claims related to military sexual trauma. Military sexual trauma, or MST, refers to a service member's experience with sexual assault or sexual harassment during any point of his or her military service. This includes everything from lewd remarks to forced or coerced sexual encounters. An estimated one in three female veterans and one in 100 male veterans in the VA healthcare system report experiencing MST. Jackie is a DAV Associate National Service Officer based in Bay Pines, Florida, where she assists veterans with benefits claims, including claims related to MST. She is an Army veteran and former medic and has been a veteran's advocate since 2010, including five years in counting with DAV. Jackie, thank you so much for joining us today. Thank you. Can you start by giving us a sense of how often you're helping veterans with MST claims? It's difficult to provide an exact number as some PTSD claims, depression claims, anxiety claims are also MST claims, but not labeled as MST claims. Some of this is due to the stigma some people have about MST or even PTSD today. To be frank, there's some people who have a purple heart from combat in Vietnam that don't want to be rated for PTSD because of the stigma they feel that's there. As a reference for numbers though, I'd say personally I'm working on about three female cases and four male cases at this time. And every NSO across the nation probably works about four MST cases a month. But all in all in total though, there's really no possible way to give an exact number. Yeah, and I'm glad you mentioned to you kind of broke it down by male and female cases. Just another reminder that while statistically this this impacts female veterans more so than men, men are certainly impacted by this. And we also know those kind of numbers can be under reported. Absolutely. Can you describe the types of MST cases that come across your desk? Well, there's really no typical case because every case is individual to the person. It's kind of like a snowflake. They all look the same until you get up close and personal. And then each case is unique and different. What triggers one person may not be a trigger for the next person, even though they went through a similar event. For some people, it's the event itself is a trigger. And for others, it could be a smell or a sound like just the smell of a specific shampoo or cologne could be a trigger for somebody else. There's just not a typical case. It's very uniquely each person. Yeah. What are some of the common ways that you see MST affect veterans lives? From my experience, it destroys their lives. It's as if DAV is their last lifeline, their last hope, their last ray of light. There's times when I'm talking to a veteran and I feel as if I'm literally pulling them off of the ledge, like wrapping my arms around them and pulling them over to the DAV, you know, let us help you. Sometimes they're in such a dark space that they can't find that light. They can't find that little silver ray, you know, silver lining. And people with MST have trouble with relationships. They've trouble going to the grocery store. Some of them have trouble being a parent. It really destroys their life. Yeah, it absolutely affects or can affect every part of a veteran's life. And then especially if they've not been getting treatment or care for that, you know, for years, we know a lot of people are getting delayed care for various reasons. I'm sure that just compacts those issues even more. It does. Sometimes it's difficult for them to get care because they're not service connected yet and it's not recognized. And so it's hard for them to get in the care system. Right. So in your experience, what do you see when a veteran tries to handle their MST claim on their own? And how can DAV help? It doesn't work. It's an absolute nightmare. I tell my veterans it's my job to stress for them. So they don't have to. They provide all the information they can. We put it together and, you know, we help them sort through the best way to present it. DAV is their shield. We tell them what they need to do, what to expect, how to, we guide them through the process. And we're literally there for them every step of the way. Yeah, I know that's something when we, when you and I previously talked that you stressed a lot. Like that's, that's why you're here. That's why benefits advocates are here. You all can help kind of carry that burden, especially through, you know, this, this claims process. Can you, I'm sorry, when someone comes to you with an MST claim, how do you approach it? And how is it maybe different or not different from other claims? I treat every claim as if it was my own claim. When you sit, when I sit down with you, I think what would I want you to do for me on my claim? What's the action I take for you? So I handle all claims with compassion and attention to detail. And my goal is to get you, you know, validated and to be recognized for what you've been through. So can you walk through to some of the steps involved in filing an MST claim? Absolutely. When a veteran first comes to us, if we don't have representation, we need them to complete a VA form 21-22, which grants us representation. We can see their file. We can access their information. There's some things we can find for them and some things we can't. We encourage them to do the VA form 21-0966, which is an intent to file. It protects their data claims. So if we submit the intent to file on March 3rd and it takes us six months to get all their paperwork together, their effective date would be March 3rd, the date of the intent to file. So it protects their data claim. So I encourage veterans to do that one. The VA form 21-526Z is the formal application. That's where we fill out all the information the VA needs and list the contentions that we're filing for. And then for MST or PTSD, we file the VA form 21-0781A. This is the form. It's called a statement of support of claim for service connection for PTSD secondary to personal assault. This form is used. The veteran needs to list as much information as they can remember as far as date, time, event, everything. And the VA uses that to verify and validate that the incident happened or as much as they can verify and validate. Because MST is one of those that's very difficult to say it definitely happened. Here's the paperwork because so much, so often it's not reported. The other thing is securing any lay statements or any other evidence that we might need. If they spoke with their chaplain or they spoke with family member wrote a letter, things like that could help the VA too. And I want to talk a little bit more about markers in a second. But I know I've heard from some veterans who experienced MSTs, the claims process can be re-traumatizing. And, you know, when you're talking about needing to open up and to, you know, share that experience all over again. Just any kind of words of encouragement or advice to folks who just heard you and thought, oh gosh, I don't want to go through re-sharing that. Well, I can go back to the DAVs with you every step of the way. Where your shield. We're going to walk you through it. We're going to help prepare you. If you talk about it with us, it'll be easier for you to talk about it with the compensation examiner. Or, you know, a lot of times I'll tell my veterans, okay, send me an email and tell me what happened. Let me help you put what needs to be on the 0781A form. Let me put it together for you so it makes sense to the VA. Because sometimes when you're talking about an emotional event, you're talking from the heart versus getting the factual information out there that the VA needs. And so if the veteran emails me and says, here's my story, here's what happened. And I can go through and pick out what needs to go where on that form and literally put it together for them. They still have to sign it, but I can put it together for them. You know, so you talked about, especially with sexual assault cases, it can be hard to have those kind of documents and hard evidence. Tell us what markers are and why those are important in MST cases. Markers are things that the VA looks for. So if you have an MST case and you don't have all the lined up documents of you reported it to the authorities at the time, there's no documentation. The VA will look in your record for markers. They look for things such as episodes of depression or panic attacks, anxiety without identifiable reasons. They'll look for visits to a medical or clinic or dispensary without a specific diagnosis or ailment. They'll look for an increased interest of pregnancy tests or tests of STDs including HIV around the incident. They look for decreased or increased use of prescription medication, increased use of over-the-counter medication, alcohol or drug abuse, obsessive behavior such as overeating or under eating. So there's more markers out there, but these are the things the VA looks for. So you say this incident happened at this time frame. They look in your record to see is there any markers that they can hang their hat on to say maybe this is a result of that incident. And it's a way to help the veteran by having markers to look for. Yeah, because again, we know that so many people who experience MST don't report it and they might not want to file a claim because they feel like they don't have documents or a paper trail. And so I think it's important for folks to know that there is a lot more to it and a lot more that VA looks for. So don't be deterred if you don't have a piece of paper. Absolutely. What else can you tell us about what veterans should be prepared for when they go to file an MST claim? They need to be prepared to tell their story because they have to sit down with an examiner. Once we get the claim submitted, they're going to have to sit down with an examiner, someone they've never met, someone they don't have a trust fund with. They're going to have to sit down with them and they're going to have to tell their story. And you know examiners are just like people. You get some really great examiners and then you get some examiners that you just wonder why they're doing what they're doing to be honest. But the veteran needs to remember when you go to that exam, you have to put everything on the table, you know, and recounting the event could cause triggers for the veteran. And I recommend that they have a support person on standby. Have someone go with you to the appointment. So when you come out of that appointment, you may feel drained or you may feel exhausted that you just went through this all over again. Have that support system there for you. Have that person to just lean on when you're there. You know, the other thing is that the veteran has to be prepared for pushback because they're putting their story out there. They're opening themselves up and they have to for the exam, but they may feel the examiner doesn't believe them. They may feel the VA doesn't believe them, but you need to be prepared for the pushback that may just be your perception. But you need to remember above all else that the DAV is there for you and you're not alone. Even if the VA denies the claim, there's still avenues that the DAV and the veteran can take to achieve service connection. No, doesn't mean it's done. Yeah, I'm glad you said that that's important to know. I think that's great advice to have your support system kind of at the ready, whether that's a person with you or just someone you know you can call immediately after. And then just being kind of mentally prepared knowing that it's going to be tough. It's okay that it's tough. It's normal and that there are, you know, again, their support. There's DAV and your own personal support system out there for you. Why do this? What is the benefit of getting service connection related to MST? For most people, I think it's the validation. It's being recognized for what they went through and acknowledging that it happened. You know, this alone can change the life of a veteran. You know, they can hold their head higher. And you know, for some, it's the monetary compensation changes their life because all these years they've been dealing with this event. It's never been validated, never been recognized. And they're unable to make ends meet because they can't hold a job. Their entire life has been affected by it. And the validation and recognition, I think, helps some of them hold their head high and the monetary value helps some of them for the first time in their life. Take care of themselves. Yeah. And what would you say to someone who's still feeling hesitant about filing a claim? Well, you served your country. You earned a DD 214. You signed your name on the check willing to pay the debt with your life if you were asked to. Just because that check wasn't cash doesn't mean you haven't earned this. Counseling is hard and you have to have counseling with an MST claim. And even though counseling is hard, it's rewarding at the same time. You have to find the counselor that is your puzzle piece, the one that fits you. And once you find that puzzle piece, the connection in counseling is helpful. And I'll tell people that counseling is like telling your kid to clean the bedroom, but you're the kid. So you tell your kid to go clean the bedroom and they say it's done. And you walk in there and something seems amiss, something seems off. So you look under their bed and you just roll your eyes and you look in the closet and you're like, oh my God. So you make their bed, you vacuum their floor and you go underneath the bed and you pull all that mess out and put it on top of the bed. You go in their closet and you pull everything out of their closet and you put it on the bed. And this is where counseling is hard because now you're facing all this stuff that you've put away and hidden and tucked in corners. But then you pick up one item because everything has a home, everything has a place, whether it's in the trash can, whether it's in the Goodwill box or on a shelf. You pick up each item and you find a home for that item. And once you find its home, you put it there and you pick up another item and you keep going item after item and eventually, eventually you can see the bedspread again. And this is when counseling starts to become rewarding and the overwhelming feeling starts to dissipate because now you're seeing the end. You're seeing, okay, things have a home. I can deal with this. I can work with this. And you never forget the event. You never do. But you learn to live with it and you learn to manage it. So counseling, I tell people all the time, counseling is hard in the beginning. It's worse than you can ever imagine in the beginning, but eventually you get to that happy place where, okay, I can do this. Yeah. And now not only are you doing it, you don't have things hidden in the background. You've dealt with everything. And it does make it easier. Yeah, I love that analogy. I can say anecdotally, some of the veterans I've spoken to who experienced MST and, I mean, they credit counseling and good counselors, including through the VA for really saving their lives and just making such a huge difference. So thank you for talking about that. Jackie, thank you so much for being here and talking about this. Thank you for your service and your continued service today and helping veterans with their claims. To those watching, please visit benefitsquestions.org to locate a DAV benefits advocate near you. For more information and resources, you can also visit dav.org slash military dash sexual dash trauma. If you need immediate confidential crisis support, call the Veterans Crisis Line now by dialing 988 then press one, or you can visit veteranscrisisline.net. You can call, text, or chat online with caring qualified VA responders, many of whom are veterans or family members of veterans themselves. Lastly, we encourage folks to support DAV backed legislation related to MST to help us improve services and access to care. You can find all DAV supported legislation by visiting the DAV Commanders Action Network at davcan.org. The Commanders Action Network keeps you updated on legislation affecting veterans and their families and allows you to directly contact your representatives in Congress to advocate for issues important to you. Jackie, thank you again. Thank you all for tuning in and have a good afternoon.