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MENTAL HEALTH SECTION
Current Section: Mental Health Conditions
Table of Contents

Mental Health Conditions

Mental Health Conditions

Overview of VA Mental Health Ratings

Mental health conditions are among the most common service-connected disabilities for veterans. The VA uses a unique approach to rating mental health conditions that differs from how physical conditions are rated. This section explains how mental health ratings work and provides detailed guidance for the most common mental health conditions.

The General Rating Formula for Mental Disorders

Unlike physical conditions, which have specific rating criteria for each diagnosis, most mental health conditions are rated using a single set of criteria called the "General Rating Formula for Mental Disorders" (38 CFR § 4.130). This formula evaluates how your mental health condition affects your:

  • Occupational functioning (ability to work)
  • Social functioning (ability to maintain relationships)
  • Overall quality of life
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Mental Health Rating Percentages

Mental health conditions are rated at 0%, 10%, 30%, 50%, 70%, or 100%. There are no 20%, 40%, 60%, 80%, or 90% ratings for mental health conditions under the General Rating Formula.

Pyramiding and Mental Health

The VA generally assigns only one rating for mental health conditions, even if you have multiple diagnoses (such as PTSD and depression). This is because many mental health symptoms overlap, and the VA prohibits "pyramiding" (rating the same symptoms twice under different diagnoses).

However, if you have distinct symptoms from different mental health conditions that don't overlap, you may be eligible for separate ratings.

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Focus on Symptoms, Not Diagnosis

When filing mental health claims, focus on documenting your symptoms and their impact on your life rather than fixating on a specific diagnosis. The VA rates based on the severity of symptoms, regardless of the exact diagnosis.

Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) is one of the most common service-connected mental health conditions. It develops after experiencing or witnessing a traumatic event and can significantly impact your daily functioning and quality of life.

Establishing Service Connection for PTSD

To establish service connection for PTSD, you need three elements:

  1. Current diagnosis of PTSD by a qualified mental health professional using DSM-5 criteria
  2. In-service stressor (traumatic event that occurred during service)
  3. Medical nexus (link between the stressor and your PTSD diagnosis)

Types of PTSD Stressors

The VA recognizes several categories of stressors, each with different evidence requirements:

Combat Stressors

For veterans who engaged in combat with the enemy, your testimony alone can establish the stressor if it's consistent with the circumstances of your service.

Evidence needed: DD-214 or other service records showing combat service, combat medals, or assignment to a combat zone.

Fear of Hostile Military or Terrorist Activity

For veterans who experienced fear of hostile military or terrorist activity, even without direct combat.

Evidence needed: Service records showing deployment to an area with hostile military or terrorist activity, and a VA psychologist or psychiatrist confirming the stressor is adequate to support a PTSD diagnosis.

Military Sexual Trauma (MST)

For veterans who experienced sexual assault or harassment during service.

Evidence needed: The VA recognizes that MST often goes unreported, so they accept various forms of "marker" evidence, including:

  • Records from law enforcement, rape crisis centers, or mental health counseling
  • Pregnancy tests or tests for sexually transmitted diseases
  • Statements from family, roommates, or fellow service members
  • Changes in behavior or performance after the incident
  • Requests for transfer to another assignment

Personal Assault (Non-Sexual)

For veterans who experienced physical assault during service.

Evidence needed: Similar to MST, the VA accepts various forms of marker evidence for personal assault.

Other In-Service Stressors

For stressors that don't fall into the above categories.

Evidence needed: Specific details about the stressor (date, location, unit assignment, names of witnesses) that the VA can verify through military records.

VA Rating Criteria for PTSD

PTSD is rated under Diagnostic Code 9411 using the General Rating Formula for Mental Disorders:

100%
Total occupational and social impairment
70%
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood
50%
Occupational and social impairment with reduced reliability and productivity
30%
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks
10%
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication
0%
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication

Building a Strong PTSD Claim

Evidence Checklist for PTSD Claims

Required Medical Evidence
Military Records
Supporting Statements
Additional Evidence (if applicable)
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PTSD Claim Tip

When describing your PTSD symptoms, be specific about their frequency, severity, and impact on your life. For example, instead of saying "I have nightmares," say "I experience combat-related nightmares 4-5 times per week that prevent me from getting more than 3-4 hours of sleep, leaving me exhausted and unable to concentrate at work the next day."

Case Study: Successful PTSD Claim

Veteran Profile

Marine Corps veteran with two deployments to Afghanistan (2010-2011 and 2012-2013). Served as a vehicle operator in areas with frequent IED attacks.

Stressor

The veteran's convoy was hit by an IED in 2012, resulting in casualties. The veteran was not physically injured but witnessed the deaths of two fellow Marines.

Symptoms & Presentation
  • Frequent nightmares about the incident (3-4 times per week)
  • Flashbacks triggered by loud noises or certain smells
  • Hypervigilance in public places
  • Avoidance of crowds and public transportation
  • Difficulty maintaining employment due to anger outbursts
  • Strained relationship with spouse and children
  • Self-medication with alcohol
Evidence Submitted
  • Diagnosis of PTSD from VA psychiatrist
  • Combat Action Ribbon on DD-214 (confirming combat exposure)
  • Unit records documenting the IED attack
  • Detailed personal statement describing the stressor and symptoms
  • Statement from spouse describing behavioral changes and relationship difficulties
  • Statement from former employer about anger issues at work
  • VA treatment records showing ongoing therapy and medication
Outcome

The veteran was initially awarded a 50% rating for PTSD. After providing additional evidence about the impact on employment and submitting a more detailed personal statement about suicidal thoughts and near-continuous depression, the rating was increased to 70%. The veteran later qualified for TDIU based on unemployability due to PTSD symptoms.

Key Takeaways
  1. Combat records significantly simplified the stressor verification process
  2. Detailed statements from family and employers provided crucial evidence about functional impairment
  3. Ongoing treatment demonstrated the chronic nature of the condition
  4. The veteran's willingness to disclose the full extent of symptoms (including suicidal thoughts) was essential for the increased rating
  5. TDIU provided 100% compensation rate despite the 70% rating

See Also

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