From: "Bruce K. Melson" <>


There is a section in M21 that states that a stressor letter should not be requested with award of certian medals i.e. Purple Heart, CIB, CAR and Valor Medals. But experience has shown that it is best to submit one (letter). If the incident that is the stressor is connected to a medal like the Purple Heart or Valor Medals, that would be the vertification.

We have used the following when submitting PTSD claims that was published several years back by NVLSP.


ATTACHMENT TO PTSD CLAIM                                          


SECTION I                                                        


I served in Southeast Asia from the month of         19   , to the month        19   .  I served with the following             



I had the following duties during this time:                      



The military experiences I found most terrifying, life-threatening, or stressful include the following:                

 ___armed combat or enemy action                                     

 ___bombed or shelled or tripped booby-trap                          

 ___shipwrecked or in airplane or vehicle accident                   


 ___grave registration duty                                          

 ___other action that threatened my life                             


 ___ treating or dealing with casualties                             


 I have attached a detailed description of the stressful event(s) and have attached portions of military records or other evidence that are objective proof of or support the existence of the         

 stressful event.



 SECTION II                                                         


 A. Since the event described above, I have re-experienced the event in nightmares, flashbacks and just over and over again in my mind.                                                           


 ___Nightmares have occurred___times each month over the past ___   


 ___I have thought about the event___times each month over the      

 past ___ year(s).                                                  

 ___Flashbacks have occurred___times each month over the past       



 B.  I felt numb after the event, or had difficulty "feeling".      


 C.  I have much less interest in my family, friends and activities such as                                                    


 that used to be important to me.  I feel close to almost no one anymore.


D. The following problems were not present before the event described above but are now:                                          


 ___I'm jumpy or hyper-alert or startle easily                       


 ___My sleep is disturbed; I can't get to sleep or stay asleep; I    

 wake up too early; or I have nightmares.                            


 ___I feel guilty that I survived when others did not; and guilty about what I had to do or didn't do to survive.


 ___I have trouble concentrating on things or remembering things.  


 ___I avoid activities that remind me of the event or of Vietnam.  


 ___Certain activities that resemble the event and remind me of it 

 make me more nervous or anxious.                                  


 ___I have trouble concentrating on things or remembering things.    


 ___I avoid activities that remind me of the event or of Vietnam.    


 ___Certain activities that resemble the event and remind me of it   

 make me more nervous or anxious.                                    



 ___I avoid getting close to anyone in my family, or on my job, or 

 among friends.                                                     


 ___I have no interest or little interest in getting close to      

 anyone in my family, or on my job, or among my friends.  It just  

 doesn't seem worth it to get close.                               


  ___I have self-medicated on alcohol or other substances to try   

 to block out Vietnam-related feelings, thoughts, nightmares, or   

 to get to sleep.                                                  


 ___I am very concerned with the possibility of losing control of  

 my temper or having other strong feelings.                         








 SECTION III                                                            


 A. I request service-connected benefits and believe I have been and continue to be unable to function in social settings like I used to or to work to my fullest capacity because of Stress            

 Disorder and that it had its origin in my active duty service. I also request increased compensation based on unemployability if the service-connected rating is less than 100%.  The following  information explains my social and employment history since I was discharged(see attached letters and documents):                        


B. I have received psychiatric or psychological treatment for my nervous condition or treatment for alcohol or drug abuse or counseling for my problems identified above:                         


 ___in the military in _____ while stationed at _______________        

 ___within one year following discharge from the service at_____      

 ___more than one year following discharge from the service at___     


 SECTION IV                                                            


 A.  I knew the following people in Vietnam and they might be able to verify some of my experiences:______________________________      


 B. I knew the following people before and after going to Vietnam. They could verify how I was different after returning:              

Willie G. Dougherty
Operations Director
The National Veterans Organization of America, Inc.
Visit NVO Website at
Veterans Voice of Austin