Major Depressive Disorder
Major depressive disorder involves persistent low mood, loss of interest, and changes in sleep, energy, and concentration. VA rates it on the degree of occupational and social impairment, and it is one of the most common conditions claimed secondary to chronic pain.
How the VA rates it
Depression uses the General Rating Formula for Mental Disorders (38 CFR 4.130): a single scale of 0, 10, 30, 50, 70, or 100 percent based on occupational and social impairment. What matters is how symptoms affect your work and relationships, not which depressive diagnosis you carry. It can be service connected directly or as secondary to another service-connected condition, such as chronic pain.
Rating criteria by percentage
Rated up to 100%Total occupational and social impairment, with symptoms such as gross impairment in thought or communication, persistent delusions or hallucinations, persistent danger of hurting self or others, or inability to perform activities of daily living.
Impairment with deficiencies in most areas (work, school, family relations, judgment, thinking, or mood). Symptoms can include suicidal ideation, near-continuous depression affecting independent functioning, impaired impulse control, and inability to maintain effective relationships.
Reduced reliability and productivity. Typical symptoms include flattened affect, impaired judgment and abstract thinking, disturbances of motivation and mood, and difficulty maintaining work and social relationships.
Occasional decrease in work efficiency with intermittent inability to perform occupational tasks, though generally functioning satisfactorily. Typical symptoms include depressed mood, anxiety, chronic sleep impairment, and mild memory loss.
Mild or transient symptoms that decrease work efficiency only during periods of significant stress, or symptoms controlled by continuous medication.
A formal diagnosis exists, but symptoms are not severe enough to interfere with occupational and social functioning or to require continuous medication.
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Sleep Apnea — Commonly claimed secondary to depression through medication-related weight gain and disrupted sleep architecture.
- Erectile Dysfunction — A frequent side effect of SSRI/SNRI antidepressants and of depression itself; typically compensated via SMC-k.
- GERD — Antidepressant medications and chronic stress can cause or worsen reflux.
- Migraines — Depression and migraines are strongly comorbid; each can aggravate the other.
This is often secondary to
If you already have one of these service-connected, it may support connecting this condition.
- Tinnitus — Depression is commonly claimed secondary to chronic tinnitus, which disrupts sleep and concentration.
- Lumbosacral Strain — Depression secondary to chronic back pain and the lifestyle limitations it causes is a well-established claim path.
- Degenerative Disc Disease — Chronic spine pain and loss of function commonly lead to secondary depression.
- Migraines — Frequent prostrating headaches and the unpredictability they impose are a recognized cause of secondary depression.
- Traumatic Brain Injury — Depression is a common residual of TBI and can be service connected secondary to it.
Evidence that strengthens this claim
- Get a current diagnosis from a mental health professional; ongoing treatment records (therapy notes, medication history) carry significant weight.
- If claiming secondary to a service-connected condition like chronic pain or tinnitus, get a medical nexus opinion explicitly linking the depression to that condition or its treatment.
- Document occupational impact: missed work, reduced hours, performance write-ups, or jobs lost. The rating formula is built on occupational and social impairment.
- Statements from a spouse, family member, or coworker describing withdrawal, irritability, or loss of interest help establish the social-impairment side of the rating.
Rating rules to know
VA assigns one combined mental health rating under the general formula. Depression claimed alongside PTSD or anxiety is evaluated as a single psychiatric disability picture, not stacked as separate ratings (38 CFR 4.14).
Related diagnostic codes
More mental health conditions
Post-Traumatic Stress Disorder (PTSD)
PTSD is a trauma-related condition marked by re-experiencing, avoidance, negative mood changes, and hyperarousal after an in-service traumatic event. VA rates it on how much it impairs your ability to work and maintain relationships, not on the severity of the trauma itself.
Rated up to 100%
Generalized Anxiety Disorder
Generalized anxiety disorder involves persistent, excessive worry that is hard to control, with physical symptoms like restlessness, muscle tension, and sleep problems. VA rates it on how much it impairs work and social functioning.
Rated up to 100%
Chronic Adjustment Disorder
Chronic adjustment disorder is an ongoing emotional or behavioral reaction to a stressor - often a service-connected disability, injury, or major life change - with symptoms of depression, anxiety, or both. VA rates it the same way as every other mental disorder: by occupational and social impairment.
Rated up to 100%
Panic Disorder and/or Agoraphobia
Panic disorder involves recurrent, unexpected panic attacks and persistent fear of future attacks; agoraphobia is avoidance of places where escape feels difficult. VA rates both under one diagnostic code based on occupational and social impairment.
Rated up to 100%
Bipolar Disorder
Bipolar disorder causes cycling episodes of mania or hypomania and depression. VA rates it under the general mental disorders formula based on occupational and social impairment across the full cycle of the illness, not just during episodes.
Rated up to 100%
Obsessive-Compulsive Disorder (OCD)
OCD involves intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that consume time and interfere with functioning. VA rates it on occupational and social impairment under the general mental disorders formula.
Rated up to 100%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.