VA Rating for PTSD, Depression and Anxiety

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All mental disorders share one rating formula keyed to occupational and social impairment — PTSD, major depressive disorder, generalized anxiety, adjustment disorder, panic disorder and more. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code 9411 / 9400 / 9434, explains what the C&P examiner measures, covers the presumptive and secondary routes to service connection, and lists the reasons these claims come back denied — and how each gets fixed.

How the VA rates ptsd, depression and anxiety in 2026 — the exact criteria

These are the criteria a VA rater applies, quoted from the rating schedule (§ 4.130). Your rating is the highest level whose wording your evidence meets — and evidence that never uses these words tends to be rated at the bottom.

General Rating Formula for Mental Disorders (DC 9201–9440, incl. 9411 PTSD, 9434 major depressive disorder, 9400 generalized anxiety)

There is no 20, 40, 60, 80 or 90 percent level. One combined mental-health rating covers all diagnosed mental disorders — PTSD, depression and anxiety are not stacked.

The listed symptoms are examples, not a checklist; the rating turns on the level of occupational and social impairment (Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013)).

For combat veterans, a claimed in-service stressor related to fear of hostile military or terrorist activity can be established by the veteran's own lay testimony once a VA psychiatrist or psychologist confirms it supports the diagnosis (38 CFR 3.304(f)(3)).

Honest ceiling: 70% for deficiencies in most areas — work, family, mood.

What the C&P examiner measures

A VA psychologist or psychiatrist runs a structured interview covering symptoms, work history, relationships, sleep, and function, and assigns the level of occupational and social impairment. Describe a typical week and your worst week honestly — how many days you missed, what you avoid, what your spouse has to cover for you. Minimizing ("I'm fine") is the most common way this exam goes wrong.

The questions that get at the rating criteria — answer them for yourself before the exam:

• Some guys park at the back of a lot so they can see everything, or they take the seat facing the door. Is that you?
• Do you ever check the locks more than once before bed?
• When somebody comes up behind you unexpected, what happens?
• How many times have you changed jobs in the last five years — and what ended each one?
• Anything you used to do that you've just stopped doing?

Service connection: presumptive, direct, or secondary

Psychoses shown within one year of separation are presumptive (38 CFR 3.309(a)). For PTSD, a combat veteran's own statement establishes an in-service stressor consistent with the circumstances of service (38 CFR 3.304(f)(2)); a stressor based on fear of hostile military or terrorist activity is established by lay testimony once a VA psychiatrist or psychologist confirms it (3.304(f)(3)); and military sexual trauma has relaxed evidentiary rules with markers such as behavior changes, requests for transfer or performance drops (3.304(f)(5)).

Every service-connection claim has three legs: a current diagnosis (the C&P exam can supply it), an in-service event, injury, exposure or an already-connected condition, and a link between the two — which the VA's own examiner addresses at the exam for direct and secondary claims, and which the law supplies for presumptive ones. You do not need a private opinion to file; you need one only if the VA denies for lack of nexus, and a supplemental claim within one year keeps your effective date.

Secondary conditions veterans miss

Conditions that commonly develop because of this one can be service-connected on top of it, each with its own rating:

• Sleep apnea secondary to MH — Well-supported literature pathway
• GERD / IBS secondary to MH — Common
• Hypertension secondary to MH — Literature-supported
• ED secondary to MH or MH meds — Usually 0% BUT triggers SMC-K — a flat monthly add-on most eligible veterans never claim
• Bruxism / TMJ secondary to MH — Often overlooked

Secondary-claim guides for this condition: Sleep Apnea secondary to PTSD →GERD secondary to PTSD or Anxiety →Hypertension secondary to PTSD →Depression secondary to Chronic Pain →Erectile Dysfunction secondary to PTSD or Its Medication →Insomnia secondary to Tinnitus →

What the medical literature says

Hoge C.W. et al., New England Journal of Medicine 351:13-22 (2004) — Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care
Landmark study: combat deployment significantly increases PTSD, anxiety and depression. Why it matters: Deployment-linked MH claims.

NASEM, Gulf War and Health, Vol. 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress (2008)
Deployment stress is associated with psychiatric disorders including PTSD, anxiety and depression — service need not involve combat. Why it matters: Non-combat and garrison stressor claims.

Why ptsd, depression and anxiety claims get denied — and the fix

• Rated 30 percent after the veteran said "I'm fine" — the exam reflects what you said, not what you live.
• Stressor "not verified" when the combat or fear-of-hostile-activity rules of 3.304(f) applied and needed no verification.
• Symptoms treated as a checklist rather than assessed for overall impairment.

A denial is a grade on the evidence packet, not a verdict on you. Filed as a supplemental claim within one year, the fix keeps your original effective date.

Filing it right the first time

1. Intent to File first. It locks your effective date for a year — back pay runs from that day, not from the day the package is ready.
2. File everything at once. Every condition with a real symptom and a plausible route — direct, presumptive, secondary, increase — goes in one claim. The VA's duty to assist schedules the exam and pulls your records; a condition held back "for more evidence" only starts its clock later.
3. Your statement in the criteria's words. A Statement in Support of Claim (VA Form 21-4138) that describes your worst days and your typical days using the language in the table above is the evidence the rater reads first.
4. Your records. VA records through Blue Button, decision letters and code sheet from VA.gov, and private records from each doctor's office or patient portal — or a signed 21-4142 so the VA pulls them.
5. Prepare for the exam. Know what the examiner measures (above) and answer honestly, including the bad days.

Frequently asked questions

Related guides: HypertensionSinusitis and RhinitisPlantar Fasciitis and Flat FeetAll conditionsDenied? The 3 lanesCombined-rating calculator

Rating criteria verified against eCFR (38 CFR Part 4) — last reviewed 2026-09-19. Regulations change; confirm anything decision-critical at ecfr.gov.