Service-Related PTSD: What the Armed Forces Compensation Scheme Requires from Expert Evidence

The Armed Forces Compensation Scheme (AFCS) is a no-fault scheme for injury and illness caused by service on or after 6 April 2005, set out in the Armed Forces and Reserve Forces (Compensation Scheme) Order 2011 (SI 2011/517). Injury caused by service before that date falls under the War Pensions Scheme instead. In a claim for service-related PTSD, AFCS PTSD expert evidence has to answer the questions the Order asks: who made the diagnosis, how far the disorder limits the claimant’s functioning, how long that has lasted or will last, and whether service was the predominant cause. An armed forces compensation PTSD report written to those questions is most useful at reconsideration and on appeal.

Who must diagnose the mental disorder

Since 6 April 2026, the note to Table 3 of Schedule 3 to the Order has required mental disorders to be diagnosed by a registered mental health professional (doctor, psychologist or nurse) working as part of a multidisciplinary mental health team overseen by a named consultant clinical lead. The change was made by the Armed Forces and Reserve Forces (Compensation Scheme) (Amendment) Order 2026 (SI 2026/272). Before that date the note required diagnosis by a clinical psychologist or psychiatrist at consultant grade.

Older guidance and reports may still describe the consultant-grade rule. Where a decision predates the change, check which version of the note the decision-maker applied. The note governs who makes the diagnosis; an independent report is most useful on the matters the tariff then turns on.

How Table 3 grades mental disorders

Table 3 does not name conditions. Its descriptors grade any diagnosed mental disorder by the functional limitation or restriction it causes and how long that lasts:

• permanent mental disorder causing very severe, severe or moderate functional limitation or restriction (levels 4, 6 and 8);
• mental disorder causing functional limitation or restriction which has continued, or is expected to continue, for 5 years (level 10);
• mental disorder causing functional limitation or restriction at 2 years, 26 weeks or 6 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 5 years, 2 years or 26 weeks respectively (levels 12, 13 and 14).

The notes to the table define the permanent levels by reference to work. Moderate limitation means the claimant cannot do work suited to their experience, qualifications and skills at onset but can work regularly in a less demanding job. Severe limitation means that, over time, they can work only in less demanding jobs. The very severe level applies where, in the opinion of the senior treating consultant psychiatrist, residual impairment after adequate best-practice treatment, including specialist tertiary interventions, is incompatible with any paid employment until state pension age.

Three provisions of article 5 also shape the evidence:

• functional limitation is assessed by comparison with a healthy person of the same age and sex (art. 5(6)), and the Table 3 note directs attention to psychological, social and occupational functioning;
• “permanent” means the injury has reached a steady or stable state at maximum medical improvement after appropriate clinical management of adequate duration (art. 5(7));
• for Table 3, duration runs from the date the claimant first sought medical advice for the disorder, not from the traumatic event (art. 5(5)).

A diagnosis alone therefore rarely settles the award. The level depends on evidence of function, the treatment received and the likely course.

Causation, burden and standard of proof

Benefit is payable for an injury caused wholly or partly by service; where service is only a partial cause, it must be the predominant cause (art. 8). The burden of proving any issue is on the claimant (art. 60(1)), and the standard is the balance of probabilities (art. 61). There is one exception: where a contemporary official record of a material fact is missing and other reliable evidence can establish that fact, there is a presumption in the claimant’s favour, which the Secretary of State may rebut (art. 60(2) and (3)).

PTSD claims often involve stressors outside service as well as within it, such as earlier trauma, bereavement, relationship breakdown or difficulties after discharge. The predominant cause test requires the expert to weigh those factors and give reasons, rather than record only the claimant’s account of the service events.

Reconsideration and appeal

A claimant can ask the Secretary of State to reconsider a decision. The application must be in writing, state its grounds and be made within one year of notice of the decision (art. 53). If an appeal is lodged without a reconsideration request, the decision must be reconsidered first.

In England and Wales, appeals go to the First-tier Tribunal (War Pensions and Armed Forces Compensation Chamber); Scotland and Northern Ireland have separate tribunals. An appeal should normally be made within one year of the decision letter. A panel normally comprises a judge, a medical member and a service member. The Chamber’s user guide asks for further medical evidence to be sent to the tribunal and Veterans UK as soon as possible, and no later than four weeks after the tribunal acknowledges the appeal.

AFCS PTSD expert evidence on appeal

An independent psychiatric report prepared for reconsideration or appeal can address the points on which the decision turned:

• Diagnosis: whether the presentation meets ICD-11 or DSM-5-TR criteria for PTSD, and whether another or additional disorder is present, such as depression, an alcohol use disorder or complex PTSD.
• Functional limitation: the claimant’s psychological, social and occupational functioning, described with reasons and related to the wording of the descriptors, including the work-based tests for the permanent levels.
• Treatment and permanence: whether the claimant has had appropriate clinical management of adequate duration, judged against NICE guideline NG116, and whether maximum medical improvement has been reached.
• Duration and prognosis: when medical advice was first sought, the course since then, and the prospects of substantial recovery within the periods the descriptors use.
• Causation: the contribution of service and non-service factors, with reasons that engage with the predominant cause test.

The Order does not prescribe any psychometric or symptom validity test. As in any medico-legal report, the expert should comment on whether the account is consistent with the records and the examination.

Give the expert the decision letter and its reasons, the full service medical record, GP and NHS records, treating-team letters and the claimant’s statement, and frame the questions around the descriptors rather than PTSD in general. The tribunal does not apply CPR Part 35, but a report that sets out the expert’s qualifications, the material relied on, any range of opinion and a statement of independence is easier for the panel to weigh.

We provide Armed Forces Compensation Scheme PTSD reports for reconsiderations and tribunal appeals, and service-related PTSD assessments for serving personnel and veterans.