This guide covers how the VA actually rates ptsd / anxiety / depression under diagnostic code 9411 / 9400 / 9434 — the criteria the rater applies, the evidence that carries weight, and the related conditions veterans most often leave unclaimed. It's the same playbook our own case managers work from.
How the VA rates it
70% = deficiencies in MOST areas — incl. "difficulty in adapting to stressful circumstances (including work or a worklike setting)", impaired impulse control, suicidal ideation, inability to establish and maintain effective relationships · 50% = reduced reliability and productivity, panic attacks MORE than once a week, disturbances of motivation and mood · 30% = occasional decrease in work efficiency, panic weekly or less, chronic sleep impairment · 10% = symptoms controlled by continuous medication. THE SYMPTOM LISTS ARE EXAMPLES, NOT CHECKLISTS — the level of occupational and social impairment governs.
Honest ceiling: 70% for deficiencies in most areas — work, family, mood.
The evidence that wins
Service connection: Stressor — relaxed verification for combat / fear of hostile military activity.
Medical opinion (nexus): Needed unless clearly documented in service.
Secondary conditions veterans miss
Conditions that commonly develop because of this one can be service-connected on top of it:
- Sleep apnea secondary to MH — Well-supported literature pathway — needs sleep study + nexus
- GERD / IBS secondary to MH — Common; needs diagnosis + nexus
- Hypertension secondary to MH — Literature-supported
- ED secondary to MH or MH meds — Usually 0% BUT triggers SMC-K (~$136/mo) — pure missed money
- Bruxism / TMJ secondary to MH — Often overlooked
Filing it right the first time
Most denials on ptsd / anxiety / depression claims trace to the same failures: the evidence never addressed the actual rating criteria, the connection to service was asserted instead of supported, or the C&P exam went sideways because nobody prepared for it. A complete file — records, statements written to the criteria above, and honest exam preparation — is the difference.
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