VA Disability Rating for Depression and Anxiety
How Do Veterans Establish VA Service Connection for Depression and Anxiety?
Generally speaking, there are three basic elements of service connection. First and foremost, veterans must have a current diagnosis of the condition (i.e., depression, anxiety). From there, veterans must show evidence of an in-service event, injury, or illness. Finally, veterans must provide a medical nexus linking the current, diagnosed condition to the in-service occurrence. Oftentimes a veteran is diagnosed with depression and anxiety, but they still need to establish that these conditions are related to something that happened during their time in service. Importantly, veterans do not need to establish a “stressor” (i.e., a traumatic event). Instead, evidence of an in-service stressor is only required when establishing service connection for post-traumatic stress disorder (PTSD). When it comes to claims for depression and anxiety, veterans may point to psychological symptoms that manifested during or shortly after service and continue into present day.
Common Ways Depression and Anxiety Can Be Related to Military Service
Importantly, in-service causes of depression and anxiety do not have to be due to a military activity. Rather, the cause merely needs to have happened during service. Oftentimes veterans are experiencing problems not directly related to the military that still affect their functioning during service. For example, if a veteran is deployed to another country and they are experiencing problems with their family at home, they might become depressed and anxious over their inability to be with their family while stationed abroad. Again, as long as the factors causing the veteran’s symptomatology, or the symptomatology itself, manifested during service, they are eligible for service connection.
Secondary Service Connection for Depression and Anxiety
Service connection for depression and anxiety may also be established on a secondary basis. In this case, an already service-connected condition aggravates or causes the veteran’s depression and/or anxiety. For example, if the veteran is service-connected for a very debilitating back condition, it is possible that they will develop depression due to the chronic pain and limitations on activities of daily living. When filing for secondary service connection, providing a nexus opinion is especially important. The nexus between the veteran’s primary service-connected condition and their secondary condition must be clearly established in order to be granted secondary service connection for the latter.
Do Veterans Have to File Separate VA Claims for Depression and Anxiety?
Importantly, VA recognizes that veterans are not qualified psychological experts. Therefore, it is unreasonable to expect veterans to be certain of their exact mental health diagnosis. Veterans can only attest to their symptomatology and how it affects them on a daily basis. Clemons v. Shinseki (2009) held that a service connection claim for one psychiatric condition (e.g., PTSD) must be considered a claim for any psychiatric condition that may be reasonably raised by several factors (e.g., the veteran’s description of the claim and/or symptoms, evidence submitted by the veteran or obtained by VA). In other words, if there are other psychological diagnoses on record, VA is required to consider whether those diagnoses are related to a veteran’s service even if the veteran did not specifically file claims for those conditions. In short, veterans do not have to file separate VA claims for depression and anxiety.
How Does VA Diagnose or Evaluate a Veteran’s Depression and Anxiety for VA Disability Benefits?
From a diagnostic perspective, VA relies on the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) published by the American Psychiatric Association (APA) to rate all mental health conditions. Again, for PTSD there is criterion requiring a stressor ; however, depressive and anxiety disorders have separate diagnostic criteria. As long as the veteran’s particular symptoms meet the frequency, duration, and severity outlined for those conditions in the DSM-5, they should receive proper diagnoses. Once a diagnosis is reached, VA will apply the General Rating Formula for Mental Health Conditions found under 38 CFR § 4.130.
The possible disability ratings are: 0, 10, 30, 50, 70, and 100 percent. All mental health disability ratings are based on the severity of the condition and the resulting level of social and occupational impairment.
0% VA Rating for Depression and Anxiety
The 0 percent rating is reserved for a very mild presentation of psychopathology. If VA awards a 0 percent rating for depression or anxiety, it has determined that the veteran has a qualifying diagnosis, but the symptoms do not result in functional impairment or require medication. Importantly, a 0 percent disability rating is non-compensable, meaning the veteran will not receive monthly payments for that condition.
10% VA Rating for Depression and Anxiety
A 10 percent disability rating also represents a less severe form of depression or anxiety. The veteran may experience mild periods of high stress resulting in minor social and occupational impairment. However, the condition does not cause any major functional impairment and can be managed with medication.
30% VA Rating for Depression and Anxiety
The 30 percent rating criterion for depression and anxiety are also meant to represent mild symptomatology. In this case, “occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks” might mean that the veteran is starting to periodically miss work due to their lack of motivation associated with their mental health condition. However, their depression and/or anxiety does not fully prevent them from performing and succeeding in a work environment. Furthermore, they may occasionally isolate themselves as a result of their depressed mood and anxiety. Nonetheless, they are still able to maintain relationships with others. Overall, a 30 percent VA disability rating for depression and anxiety is assigned when a veteran presents with these symptoms in a mild manner, intermittently over time.
50% VA Rating for Depression and Anxiety
The 50 percent rating criterion involves an escalation in the frequency, duration, and severity of symptomatology. Furthermore, there are several additional symptoms included in this criterion that were not included in lower ratings. If veterans receive a 50 percent rating for depression and/or anxiety, it is likely that they are beginning to display more noticeable cognitive deficits such as difficulty following instructions or making decisions that depart from past behavior. Additionally, some of the mood-associated symptomatology may begin to manifest in physiological ways, such as a flattened affect. In other words, due to feelings of depression, veterans might speak in a monotonous tone and lack facial expressions. Overall, the level of occupational and social impairment also increases as part of the 50 percent rating. Here, the symptoms mentioned above cause a decrease in veterans’ ability to efficiently complete work-related tasks.
70% VA Rating for Depression and Anxiety
The 70 percent disability rating criterion for depression and anxiety is the most inclusive insofar as it represents a wide array of symptoms, including a progression of symptoms noted in the lower disability ratings. A veteran who receives a 70 percent rating for depression and/or anxiety may suffer from all of the symptoms included in the 50 percent rating, but at a higher frequency, duration, and severity. Here, the veteran is almost always in a state of panic or depression that affects their ability to interact with others. The veteran may also have trouble controlling their emotions in a way that leads to violent outbursts or conflicts with others. The level of social and occupational impairment may be evidenced by the veteran’s inability to hold down a job or complete classes for school.
100% VA Rating for Depression and Anxiety
The 100 percent rating is often difficult to obtain through VA because it requires a veteran’s symptoms to be so severe that they are totally impaired and unable to function in everyday life. While the symptoms listed in the 70 percent rating criterion involve a high level of impairment, the jump to 100 percent remains significant. There is often a substantial decline in cognitive and emotional functioning as compared to the rating criteria for lower percentages. Importantly, this decline results in total impairment when it comes to a veteran’s work life and personal life. An intermittent inability to perform activities of daily living can involve a veteran feeling too depressed to get out of bed, take a shower, or change clothes.
Self-injurious behaviors and suicide attempts are consistent with a 100 percent rating. In addition to thoughts and tendencies toward self-harm, a 100 percent rating for depression and/or anxiety also includes homicidal ideation in which a veteran may have thoughts of harming others. All of these symptoms and behaviors are consistent with the highest level of impairment reflected by the 100 percent rating criterion.
Do Veterans Get Separate VA Ratings for Mental Health Conditions?
VA’s General Rating Formula for Mental Health Conditions is meant to apply to a variety of psychiatric diagnoses. Veterans are not going to receive separate disability ratings for each mental health condition. Instead, they are going to receive a single disability rating under this formula that considers and accommodates all of their particular symptoms. For example, both depressed mood and anxiety are listed as symptoms in the rating criteria. Therefore, it is not a matter of getting separate ratings for each condition, but rather a matter of figuring out the severity of those symptoms and determining what the rating should be based on the level of social and occupational impairment that is present.
However, this is not to say that certain mental health conditions cannot be rated separately if deemed appropriate; for example, VA does have a separate set of criteria for eating disorders outside of the General Rating Formula. As such, there are certain circumstances where separate ratings may be involved, but they are few and far between. For the most part, mental health conditions are going to be rated together.
100% Individual Unemployability (TDIU)
In some cases, a veteran’s depression and anxiety are so severe that they are unable to secure and maintain substantially gainful employment. Here, veterans can apply for total disability based on individual unemployability (TDIU) benefits. Importantly, TDIU provides monthly compensation at the 100 percent level even if a veteran’s combined disability rating is less than 100 percent. In theory, a veteran may be underrated for depression and anxiety at 50 or 70 percent. However, if they can show that they are unable to work as a result of their depression and anxiety, they may be entitled to TDIU.
Evidence to Support Your VA Claim
Medical evidence is critical in claims for mental health conditions. Submitting private medical records or medical records from VA facilities is one way for veterans to demonstrate (1) the frequency, duration, and severity of their condition(s), and (2) how such symptomatology affects their daily functioning. In addition, veterans may submit lay evidence on their own behalf, or from friends and family members. Lay statements serve to outline in detail the onset and progression of the veteran’s condition. Individuals close to the veteran who can attest to how the veteran’s condition affects their daily life should consider drafting a lay statement for submission. Overall, having a statement that provides a clear, accurate picture of the veteran’s symptomatology and how it impairs their day to day life can be extremely helpful.
Are You a Veteran in Crisis or Know of One?
Please be advised, VA has implemented the Veteran Crisis Line equipped with specially trained responders ready to help veterans 24 hours a day, 7 days a week, 365 days a year. The Veterans Crisis Line connects service members and veterans in crisis, as well as their family members and friends, with qualified, caring VA responders through a confidential toll-free hotline, online chat, or text messaging service. Veterans can access the Crisis Line in any of the following ways:
- Dial 1-800-273-8255 and Press 1 to talk to someone
- Send a text message to 838255 to connect with a VA responder
- Start a confidential online chat session at VeteransCrisisLine.net/Chat
- Take a self-check quiz at VeteransCrisisLine.net/Quiz to learn whether stress and depression might be affecting you
- Find a VA facility near you
- Visit MilitaryCrisisLine.net if you are an active duty service member, guardsman, or reservist
If you or someone you know is currently experiencing a crisis, please seek assistance through the resources listed above.
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