How VA Rates Mental Health Conditions
Veterans can receive VA disability compensation for both physical and mental health conditions caused by military service. The Department of Veterans Affairs rates mental health conditions differently than physical ailments, and not all psychiatric disorders qualify for service-connected disability compensation. Here, we will discuss which mental health conditions can qualify a veteran for VA disability compensation, how veterans prove these claims, and how VA goes about rating these conditions.
Eligible Mental Health Conditions
Any diagnosed mental health condition that can be attributed to a veteran’s military service is ratable by the Department of Veterans Affairs. Such disabilities can include:
- Anxiety disorders, such as Post-Traumatic Stress Disorder (PTSD);
- Psychotic disorders, such as Schizophrenia;
- Cognitive disorders;
- Eating disorders, such as anorexia or bulimia;
- Mood disorders;
- Residual effects of Traumatic Brain Injuries (TBI); and
- And more.
While many psychiatric conditions are eligible for VA disability compensation, others are not. VA does not consider some psychiatric conditions to be related to military service due to the nature of the disorder:
- Personality Disorders. These types of conditions are marked by lifelong behavioral patterns that do not change, therefore, military service can not cause a personality disorder.
- Substance Use Disorder. VA does not directly grant service connection for substance use disorder. Veterans can, however, be service connected on a secondary basis for disabilities that arise from substance use due to a service-connected condition. For example, a veteran who uses alcohol to cope with symptoms of PTSD and later develops cirrhosis of the liver may be entitled to disability compensation for the liver condition as secondary to PTSD.
- Impulse Control Disorder.
- Cognitive Delays and Developmental Disabilities.
Evidence Needed to Establish Service Connection for Mental Health VA Claims
One of the first pieces of evidence VA looks for when determining a veteran’s eligibility for service connection are in-service treatment records. If psychiatric symptoms emerged while a veteran was in the military and he or she sought treatment with a mental health counselor, it should be documented in service records.
Sometimes VA will ask that veterans detail a stressor, or a traumatic event that occurred during service and later manifested as a mental health condition, such as Post-Traumatic Stress Disorder. In some situations, there is no official note of the traumatic event in a veteran’s records. In this case, veterans are able to provide a lay statement from themselves or a fellow servicemember. If VA determines the veteran’s statement is credible, it may concede validity of the event and grant service connection for PTSD.
In cases of personal assault or military sexual trauma, regulations allow VA to look at other forms of evidence to corroborate that the event occurred. This is because assaults of this nature tend to go underreported. Personality changes, such as comparing the veteran’s behavior before and after service or a decline in performance while still in the service, can be considered. Lay evidence from those the veteran confided in about the event may also be used to verify the incident for VA compensation purposes.
How Does VA Rate Mental Health Conditions?
Aside from eating disorders, VA rates all mental health conditions using the same diagnostic criteria. Mental health conditions are rated at 0%, 10%, 30%, 50%, 70%, or 100% using VA’s General Rating Formula for Mental Disorders. These ratings are based on the level of social and occupational impairment a condition presents. For example, a veteran experiencing mild symptoms, or whose symptoms are well controlled by continuous medication, may receive a disability rating of 10%. Veterans with more severe symptoms—such as an intermittent inability to perform the activities of daily living or suicidal ideation—may receive a 100% disability rating.
Veterans are not required to meet all, or even any, of the criteria in a rating level to qualify for that rating. Since mental health conditions can manifest differently per individual, VA’s rating formula for mental health conditions is not binding. Symptoms listed in each level of the rating formula are simply examples to demonstrate the types and levels of impairment commonly found at that assigned percentage rating.
Previously, VA rated veterans’ mental health conditions using a Global Assessment of Functioning (GAF) Score. As of August 2014, VA officially adopted the Diagnostic and Statistical Manual (DSM-5). The DSM-5 does not feature GAF scores, therefore they are not used by VA when adjudicating claims for mental health conditions.
Veterans with Multiple Disabilities
Since all mental health conditions are evaluated using the same criteria, veterans with multiple mental health conditions will likely be assigned one combined rating. Similarly, veterans do not need to submit a separate claim for each mental health condition, although they are free to do so if they wish.
Veterans can only be rated for a symptom’s functional limitations once. For example, veterans experiencing fatigue as a result of their Sleep Apnea and PTSD will only be rated for fatigue under the diagnostic code for one condition. To have the same symptom considered under more than one diagnostic code is called Pyramiding, which VA regulation strictly prohibits.
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