CLAIM RECON | CONDITIONS
PTSD VA Disability Rating
DC 9411 | 38 C.F.R. § 4.130 | M21-1, Part IV.ii.4.B | General Rating Formula for Mental Disorders
NOT AFFILIATED WITH THE VA|Educational tools only - not legal advice▼
Understanding PTSD Ratings
Post-Traumatic Stress Disorder (PTSD) is rated under Diagnostic Code (DC) 9411 using the General Rating Formula for Mental Disorders at 38 C.F.R. § 4.130. Ratings are assigned at 0%, 10%, 30%, 50%, 70%, or 100% based on the level of occupational and social impairment — not the specific symptoms listed.
Per M21-1, Part IV.ii.4.B, the Rating Veterans Service Representative (RVSR) evaluates the overall level of disability by considering the frequency, severity, and duration of symptoms, and their impact on occupational and social functioning. The symptom lists at each rating level are examples, not requirements — a veteran does not need to exhibit every listed symptom to qualify for a given rating. See Mauerhan v. Principi, 16 Vet. App. 436 (2002).
Key principle: The VA must evaluate the veteran's overall disability picture. A veteran who exhibits some symptoms of a 70% rating and some of a 50% rating should be rated at the level that most closely approximates the overall impairment. Per 38 C.F.R. § 4.7, when there is a question as to which rating should be applied, the higher rating is assigned if the disability picture more nearly approximates the criteria for that rating.
PTSD Rating Criteria (DC 9411)
0%$0.00/mo
A mental condition has been formally diagnosed, but symptoms are not severe enough to interfere with occupational and social functioning or to require continuous medication.
10%$175.03/mo
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.
30%$552.47/mo
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss.
50%$1,131.68/mo
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect, circumstantial/circumlocutory/stereotyped speech, panic attacks more than once a week, difficulty understanding complex commands, impairment of short- and long-term memory, impaired judgment, impaired abstract thinking, disturbances of motivation and mood, difficulty establishing and maintaining effective work and social relationships.
70%$1,808.45/mo
Occupational and social impairment with deficiencies in most areas such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation, obsessional rituals, speech intermittently illogical/obscure/irrelevant, near-continuous panic or depression affecting ability to function independently, impaired impulse control, spatial disorientation, neglect of personal appearance and hygiene, difficulty in adapting to stressful circumstances, inability to establish and maintain effective relationships.
100%$3,938.58/mo
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting self or others, intermittent inability to perform activities of daily living, disorientation to time or place, memory loss for names of close relatives/own occupation/own name.
38 C.F.R. § 4.130, DC 9411 | General Rating Formula for Mental Disorders | 2026 rates (2.8% COLA)
INSIDE THE RATING DECISION
How Raters Evaluate PTSD and Mental Health
30% Threshold
Raters document: 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. Key symptoms at this level: anxiety, chronic sleep impairment, depressed mood.
50% Threshold
Raters look for: occupational and social impairment with reduced reliability and productivity. Required symptoms include flattened affect, panic attacks more than once a week, difficulty understanding complex commands, impaired short- and long-term memory, impaired judgment, disturbances of motivation and mood, difficulty establishing and maintaining effective work and social relationships.
70% Threshold
At 70%, raters list specific symptoms: anxiety, chronic sleep impairment, difficulty adapting to a worklike setting, difficulty adapting to stressful circumstances, difficulty establishing and maintaining effective work and social relationships, disturbances of motivation and mood, flattened affect, forgetting to complete tasks, impairment of short- and long-term memory, retention of only highly learned material.
Why 100% Gets Denied
Raters write: a higher evaluation of 100 percent is not warranted unless the evidence shows total occupational and social impairment due to such symptoms as gross impairment in thought processes or communication, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting self or others, intermittent inability to perform activities of daily living, disorientation to time or place, memory loss for names of close relatives, own occupation, or own name.
What This Means
Per Vazquez-Claudio v. Shinseki (2013), you must show both the symptoms AND the resulting occupational/social impairment. Per Bankhead v. Shulkin (2017), the rater must consider what your condition looks like WITHOUT medication. If SSRIs control your symptoms but you would be severely impaired without them, that must be documented.
PTSD C&P Exam: What the Examiner Evaluates
Per M21-1, Part IV.ii.4.B and the PTSD DBQ (Disability Benefits Questionnaire), the C&P examiner assesses:
Occupational impairment: Can you hold a job? Have you been fired or quit due to PTSD symptoms? Do you have conflicts with coworkers/supervisors?
Social impairment: Do you isolate? How are your family relationships? Do you avoid crowds or public places?
Symptom frequency/severity: How often do you have nightmares, flashbacks, panic attacks, hypervigilance? How bad are they on your worst days?
Functional impact: Can you manage daily activities? Personal hygiene? Finances? Driving?
Suicidal ideation: Active vs. passive. History of attempts. Current plan or intent.
Behavioral observations: Appearance, speech, mood, affect, thought process, orientation, judgment, insight.
Secondary Conditions Linked to PTSD
Under 38 C.F.R. § 3.310 | Per M21-1, Part IV.ii.1.C
Typical ratings: 0%, 30%, 50%
Published studies link PTSD to sleep-disordered breathing. Weight gain from psychotropic medications is an additional pathway.
Bruxism / TMJDC 9905MODERATE
Typical ratings: 10%, 20%
Stress-induced jaw clenching causes TMJ dysfunction. Dental records documenting nightguard prescription support nexus.
GERD / Acid RefluxDC 7346MODERATE
Typical ratings: 10%, 30%
Stress-induced acid production and psychotropic medication side effects cause gastrointestinal symptoms.
HypertensionDC 7101MODERATE
Typical ratings: 10%, 20%
Chronic stress response elevates blood pressure. Multiple studies support PTSD-hypertension nexus.
Typical ratings: 10%, 30%, 50%
Stress and sleep disruption trigger chronic headaches. VA records documenting frequency and prostrating attacks.
Erectile Dysfunction + SMC-KDC 7522STRONG
Typical ratings: 0% + $139.87/mo
SSRI medications (sertraline, paroxetine, fluoxetine) have documented sexual side effects. Medication records establish nexus.
IBS / Functional GIDC 7319MODERATE
Typical ratings: 10%, 30%
Gut-brain axis dysfunction from chronic stress. Published research supports PTSD-IBS nexus.
Chronic FatigueDC 6354WEAK-MOD
Typical ratings: 10%, 20%, 40%
Sleep disruption and hyperarousal cause chronic fatigue. Requires clear distinction from sleep apnea symptoms.
Regulatory Authority for PTSD Ratings
38 C.F.R. § 4.130, DC 9411 — General Rating Formula for Mental Disorders (PTSD rating criteria)
38 C.F.R. § 4.125 — Diagnosis of mental disorders (DSM-5 criteria required)
38 C.F.R. § 3.304(f) — Service connection for PTSD (stressor verification)
38 U.S.C. § 1154(b) — Combat veteran presumption for stressor events
38 C.F.R. § 4.7 — Higher evaluation when disability approximates next level
M21-1, Part IV.ii.4.B — Examining and rating mental disorders
M21-1, Part IV.ii.1.F — Combat-related claims (§ 1154(b) implementation)
Mauerhan v. Principi (2002) — Symptom lists are examples, not requirements
Vazquez-Claudio v. Shinseki (2013) — Must show symptoms AND occupational/social impairment level
Bankhead v. Shulkin (2017) — Must consider condition severity without medication
Public Law 117-168 (PACT Act) — Expanded presumptive conditions for toxic exposure
Understand how the VA rates your PTSD