◢ Mental health • 38 CFR § 4.130, DC 9411
PTSD (Post-Traumatic Stress Disorder)
PTSD is rated under the General Rating Formula for Mental Disorders. The rating is driven by occupational and social impairment — how much your symptoms interfere with work and relationships, not the symptom list itself. Most veterans rated for PTSD land at 50% or 70%; the 100% rating is reserved for total impairment.
Rating tiers under 38 CFR § 4.130, DC 9411
The VA rates ptsd (post-traumatic stress disorder) at these schedular tiers. Most veterans land at the middle tiers — extreme tiers require correspondingly extreme documentation.
Diagnosed but symptoms do not interfere with work or social functioning and do not require medication.
Mild symptoms that decrease work efficiency only during periods of significant stress, or symptoms controlled by continuous medication.
Occupational and social impairment with occasional decrease in work efficiency. Includes depressed mood, anxiety, suspiciousness, panic attacks (weekly or less), chronic sleep impairment, mild memory loss.
Reduced reliability and productivity. Flattened affect, panic attacks more than once a week, difficulty understanding complex commands, impaired judgment, disturbances of motivation and mood, difficulty maintaining work and social relationships.
Deficiencies in most areas (work, school, family, judgment, thinking, mood). Suicidal ideation, obsessional rituals, near-continuous panic or depression, impaired impulse control, neglect of personal appearance, inability to establish effective relationships.
Total occupational and social impairment. Gross impairment in thought processes or communication, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting self or others, disorientation to time and place, memory loss for own name.
Evidence the C&P examiner needs
Build the record before the exam. Walk in with documentation, walk out with a stronger rating.
- 01
Stressor statement (VA Form 21-0781) describing the in-service traumatic event
- 02
Buddy statements from anyone who served with you or knew you before and after the event
- 03
Treatment records from VA mental health, Vet Centers, or private therapists
- 04
DBQ (Disability Benefits Questionnaire) for Mental Disorders, completed by a qualified provider
- 05
Lay statement from spouse or family describing daily-life impact
- 06
Documentation of work missed, jobs lost, or relationships ended
Secondary conditions to file alongside
These conditions frequently develop as a consequence of ptsd (post-traumatic stress disorder) and are often missed. Each can be filed as a secondary claim and add to your combined rating.
Sleep apnea (secondary to PTSD)
Strong nexus literature supports sleep apnea as secondary to PTSD. A 50%+ PTSD rating often supports a successful secondary claim.
Erectile dysfunction (secondary to mental health meds)
SSRIs prescribed for PTSD frequently cause erectile dysfunction, which is service-connected as secondary with no separate rating but adds Special Monthly Compensation (K).
GERD (secondary to PTSD)
Chronic stress and PTSD medications can cause gastroesophageal reflux disease, often rated 10-30%.
Hypertension (secondary to PTSD)
Mounting nexus evidence; the 2024 NAS report supports secondary connection in many cases.
Common mistakes that lower the rating
- 01
Filing without a documented stressor — combat veterans get a relaxed standard, but non-combat stressors require corroboration
- 02
Missing the C&P exam — the examiner's report carries enormous weight; if you cannot attend, reschedule before the exam date
- 03
Underreporting symptoms because you 'don't want to seem weak' — accurately describe your worst week, not your average week
Pro tip
The General Rating Formula for Mental Disorders rewards specifics. Replace 'I have trouble sleeping' with 'I sleep 3-4 hours nightly, wake from nightmares 4 nights per week, and have not slept through a night since 2018.' Concrete frequency and duration map directly to rating tier language.
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Source: 38 CFR Part 4 (VA Schedule for Rating Disabilities) and VA M21-1 Adjudication Procedures Manual. This guide explains the regulation; it is not legal advice and does not substitute for an accredited VA claims agent or VSO. Find a free VSO at va.gov/ogc/apps/accreditation.