VA General Rating Formula for Mental Health Disorders Explained
Which VA Disabilities Are Rated Using This Formula?
Veterans can receive VA disability compensation for both physical and mental health conditions caused by military service. The Department of Veterans Affairs (VA) rates mental health conditions differently than physical ailments, and not all psychiatric disorders qualify for service-connected disability compensation. Eligible mental health conditions include the following:
- Anxiety disorders (e.g., panic disorder)
- Trauma and stress-related disorders (e.g., post-traumatic stress disorder)
- Psychotic disorders (e.g., schizophrenia)
- Cognitive disorders
- Eating disorders (e.g., anorexia or bulimia)
- Mood disorders (e.g., major depressive disorder)
- Residual effects of traumatic brain injuries (TBI)
Aside from eating disorders, VA rates all mental health conditions using the same diagnostic criteria. Mental health conditions are rated at percentages of 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 caused by the service-connected mental health condition.
What if You Have Multiple Mental Health Conditions?
It is important to note that oftentimes veterans have multiple diagnosed mental health conditions that may be attributed to service. However, VA does not rate each condition separately under its General Rating Formula. Instead, 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 who suffer from PTSD might also have a diagnosis of major depressive disorder. If VA has conceded that both of those conditions are attributed to the veteran’s service, the veteran is not going to receive a 50 percent rating for PTSD and a separate 30 percent rating for major depressive disorder. Rather, the veteran may receive a combined 70 percent rating under the diagnostic code for one condition.
To have the same symptom considered under more than one diagnostic code is called pyramiding, which VA regulations strictly prohibit.
Which Mental Health Conditions Do Not Qualify for VA Disability Benefits?
Again, 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, and therefore, military service cannot 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
Do Veterans Need to Meet All Criteria in VA’s Mental Health Rating Formula?
Importantly, veterans do not need to exhibit every single symptom listed in the rating criteria to receive that particular disability evaluation. 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 meant to demonstrate the types and levels of impairment commonly found at that assigned percentage rating.
For example, a veteran may be so anxious that they pick at their skin, causing physical harm to themselves. In this case, skin picking can be considered as both self-injurious behavior and an obsessive ritual that interferes with routine functioning, thereby warranting a 70 percent disability rating. Even though skin picking is not in and of itself a symptom that is listed in the rating criteria, it is similar to other symptoms that are listed.
100% VA Mental Health Ratings
VA’s rating criterion for a 100 percent mental health disability rating encompasses “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 (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.”
Generally speaking, this means that the veteran’s mental health condition is so severe that it affects all aspects of their functioning. At this point, they are unable to build and maintain interpersonal relationships and they are likely unable to work due to the severity of the condition.
As mentioned above, veterans who receive 100 percent disability ratings for mental health conditions struggle to perform activities of daily living, which includes medication management, dressing, bathing, cooking, and more.
70% VA Mental Health Ratings
A 70 percent disability rating for mental health conditions requires “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 which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); inability to establish and maintain effective relationships.”
A 70 percent disability rating is the second-highest possible rating and therefore, the symptomatology included in the criterion is slightly less severe than that of the 100 percent rating. In this case, the veteran will likely still have trouble developing and maintaining social relationships and may have serious difficulty securing and following substantially gainful employment.
Oftentimes, veterans with this rating are unemployed, working part-time, or frequently changing jobs. This challenge represents the fact that such veterans have difficulty adapting to stressful circumstances. One of the symptoms listed in the 70 percent rating criterion includes suicidal ideation.
It is important to note that veterans do not need to show that they have actually planned to commit suicide or that they have made previous suicide attempts. Rather, it is enough to show that the veteran has thoughts about suicide, death, etc.
How a 70% Rating Can Qualify Veterans for 100% TDIU
When considering the rating criteria for mental health conditions veterans should also be aware of their employment situation, as they may be entitled to a 100 percent rating due to total disability based on individual unemployability (TDIU).
Importantly, TDIU is awarded in cases where veterans are unable to work as a result of their service-connected conditions. Therefore, a veteran may be compensated at the highest level even if their condition does not warrant a 100 percent schedular disability rating.
50% VA Mental Health Rating
The rating criterion for a 50 percent mental health disability rating is as follows: “Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect, circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.”
Here, a veteran’s mental health condition may interfere with their ability to work or go to school; however, it does not stop them from engaging completely. Furthermore, their mental health condition affects their social relationships to a lesser degree than a veteran who might have a higher rating. Anxiety and panic attacks may still occur, but not as frequently as required for the 70 percent rating criterion.
30% VA Mental Health Ratings
For a 30 percent mental health disability rating, veterans must show “Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).”
Veterans with 30 percent disability ratings for mental health conditions still experience a decrease in work performance, but only occasionally. Generally, the veteran is functioning to a standard degree; however, there may be some days in which they are more affected than others.
10% VA Mental Health Ratings
A 10 percent disability rating for mental health conditions is contained even less severe symptomatology: “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.”
Symptoms may include mild depression or anxiety, mild or rare panic attacks, occasional difficulty sleeping, and more. Overall, the 10 percent rating criterion means that the veteran’s symptoms are very mild and do not consistently affect the veteran on a daily basis (only during times of high stress).
0% Non-compensable VA Ratings and Why They’re Still Important
Finally, a 0 percent disability rating (i.e., non-compensable rating) for mental health conditions is warranted when the following is true: “A mental health condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.”
Ultimately, it is still important to have VA recognize that the mental health condition is related to service. Even if the condition does not warrant a compensable at that point in time, it might become more severe in the future. In this case, veterans will not have to fight for service connection all over again. Instead, they will only need to file for an increased rating and provide evidence in support of the increased rating claim.
Types of Evidence for Mental Health VA Claims
Veterans should submit in-service treatment records if possible. That is, if psychiatric symptoms emerged while a veteran was in the military and they sought treatment with a mental health counselor, it should be documented in their service records. This information can serve as important evidence for service connection.
Veterans can also provide lay statements from either themselves or those individuals who know them well. The lay statement can outline the onset and progression of the veteran’s mental health condition, thereby demonstrating how the condition impairs their level of functioning.
Was Your VA Disability Claim Denied?
The experienced, accredited advocates at Chisholm Chisholm & Kilpatrick LTD have decades of experience successfully representing Veterans. For a free case evaluation, please contact us at 800-544-9144.
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