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.
How the VA rates it
PTSD uses the General Rating Formula for Mental Disorders (38 CFR 4.130), which rates all mental health conditions on one scale of occupational and social impairment: 0, 10, 30, 50, 70, or 100 percent. The rating turns on how your symptoms affect work, school, and relationships, not on the diagnosis itself. The symptom lists in the regulation are examples, not checklists - VA looks at your overall level of functioning.
Rating criteria by percentage
Rated up to 100%Total occupational and social impairment. Marked by 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 at this level can include suicidal ideation, near-continuous panic or depression, impaired impulse control, neglect of personal hygiene, and inability to establish and maintain effective relationships.
Reduced reliability and productivity at work and socially. Typical symptoms include panic attacks more than once a week, flattened affect, impaired judgment and abstract thinking, disturbances of motivation and mood, and difficulty maintaining relationships.
Occasional decrease in work efficiency with intermittent periods of inability to perform occupational tasks, though generally functioning satisfactorily. Typical symptoms include depressed mood, anxiety, suspiciousness, panic attacks weekly or less often, 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 — Sleep apnea is one of the most commonly claimed secondaries to PTSD, through the weight gain and sleep disruption associated with PTSD and its medications.
- GERD — Chronic stress and psychiatric medications (SSRIs, NSAIDs for co-occurring pain) can cause or aggravate acid reflux.
- Migraines — Chronic hyperarousal, sleep deprivation, and tension from PTSD are recognized headache triggers.
- Erectile Dysfunction — Commonly claimed secondary to PTSD itself or to SSRI/SNRI medications used to treat it; often compensated through Special Monthly Compensation (SMC-k).
- Hypertension — A growing body of research links chronic PTSD hyperarousal to elevated blood pressure; frequently claimed with a nexus opinion.
- Irritable Bowel Syndrome — IBS is strongly associated with chronic stress disorders via the gut-brain axis.
Evidence that strengthens this claim
- Get a current PTSD diagnosis from a psychologist or psychiatrist that ties your symptoms to a specific in-service stressor - a diagnosis of 'anxiety' or 'depression' alone will not support a PTSD claim.
- Complete VA Form 21-0781 carefully: give the approximate date (a 60-day window is acceptable), unit, and location of each stressor event, and name witnesses if you can.
- Buddy statements from people who served with you, or who knew you before and after service, are powerful evidence of both the stressor and the change in your behavior.
- Keep a symptom log covering work impact (missed days, conflicts, lost jobs) and social impact - the rating is driven by occupational and social impairment, so document it concretely.
Filing notes
PTSD claims generally require VA Form 21-0781 (Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event) describing the stressor. Stressor-verification rules are relaxed for combat veterans and for stressors related to fear of hostile military or terrorist activity (38 CFR 3.304(f)); for military sexual trauma, VA accepts 'marker' evidence such as behavior changes, performance drops, or requests for transfer.
Rating rules to know
VA assigns a single mental health rating covering all service-connected psychiatric conditions rated under the general formula. If you have PTSD and depression, the symptoms are evaluated together as one rating - they are not rated separately and combined (38 CFR 4.14).
Related diagnostic codes
More mental health conditions
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.
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.