The Department of Veterans' Affairs (VA) rates all service-connected disabilities, including mental disabilities, according to the VA's Schedule of Rating Disabilities.
Once the VA has determined that your mental health condition is related to your military service, it will rate your condition based on how severe it is. The VA will look to your medical records to determine how severe your clinical symptoms are.
While the VA has different diagnostic codes for different mental illnesses, such as 9411 for PTSD and 9434 for depression, all mental health conditions are rated under the same criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published by the American Psychiatric Association. These criteria will be explained below.
In addition, the VA considers scores from a diagnostic tool called the Global Assessment of Functioning Scale (GAF) to determine the severity of your disability. GAF scores are designed to measure your ability to function at work, socially and emotionally, and range from 0-100. The higher your score, the better your ability to function. This means a lower score can help you get a higher rating from the VA. You will be assigned a GAF score as a part of your Compensation and Pension exam.
VA regulations provide for ratings of 0%, 10%, 30%, 50%, 70%, or 100% for psychiatric conditions. While VA ratings are generally available in 10% increments from 0 to 100, the ratings schedule provides that all mental illnesses will be rated as "chronic adjustment disorders" with only the percentages listed above. While a 0% rating doesn't provide any payments, it does allow eligibility for health care and other benefits.
100% rating: Completely unable to function socially or at work with symptoms such as severely inappropriate behavior, ongoing hallucinations or delusions, consistent threat of harming self or others, unable to remember basic information such as names of close relatives, severe confusion and disorientation, and/or inability to care for self.
70% rating: Unable to function in most social and work areas with symptoms such as obsessive behaviors, illogical speech, depression and panic so persistent that it interferes with ability to function, suicidal thinking, inability to control impulses (including becoming violent without provocation), neglecting self-care such as hygiene, inability to handle stress, and/or inability to maintain relationships.
50% rating: Some impairment in ability to function socially and at work with lack of reliability and productivity, due to symptoms such as trouble understanding, memory loss (forgetting to do things), poor judgment, mood disturbances, trouble with work and social relationships, and/or having one or more panic attacks weekly.
30% rating: Some trouble functioning socially and at work, occasionally inefficient with work or unable to perform work tasks, but generally able to care of self and speak normally. Symptoms can include depression, anxiety, chronic difficulty sleeping, mild memory loss, suspiciousness, and panic attacks (can be less than once a week).
10% rating: Mild symptoms creating work and social impairment when under significant stress, or mild symptoms managed successfully with continuous medication.
0% rating: Diagnosis of mental illness but symptoms are so mild that they don't require continuous medication, or, don't interfere with social and work functioning.
The VA has no set guidelines for mental health ratings based on specific diagnoses, but instead uses discretion and examines all of the medical evidence on your symptoms and functional limitations before deciding on a rating. This means it is extremely difficult to predict what rating you will receive. Typically, however, the VA provides very low ratings for mental health conditions. Here are some ways to get the highest rating your mental condition warrants.
When you go for your Compensation and Pension Exam with the VA psychiatrist, avoid exaggerating or trivializing your symptoms. Just be factual and tell the truth. Try not to give simple yes or no answers. Instead, explain your yes or no responses and describe your symptoms. You know more about your social and work impairments than anyone else. Your medical records will contain some details, but you are the expert on what your daily life is like with your mental illness.
When applying for benefits or for an increased rating, the more details you can provide to the VA about your day-to-day functioning with family, friends, social activities and work, the better. Write a statement about how your illness impacts your daily life. Describe what a typical day is like for you from start to finish and be sure to be very specific. "Often I don't get out of bed at all" or "I am afraid to leave the house." This will add to what the VA doctor said about you in your Compensation and Pension Exam report, and, can be used to explain some of those answers.
In your statement, also discuss how frequently you suffer your most severe symptoms, as this can help to increase your rating. If you have a high GAF, describing your limitations can counter that high score and lead to an improved rating.
Statements from your family and friends can also help. These statements should always include this sentence at the end: "This statement is true and correct to the best of the writer's knowledge and belief" and be signed and dated. Sometimes people close to you can provide very helpful information about your illness affects you and how decreased your functioning is.
If you are planning to apply for benefits, start keeping a record of your symptoms in your calendar. This can help you remember how frequently you have panic attacks, for example, and can also be submitted to support your claim.
Sometimes criminal records can be submitted to prove issues with anger or violence, but this should be done with caution. DUIs can be used to show self-medication through alcohol, and domestic violence arrests can be used to support veterans' statements about aggressive and violent outbursts, but you may want to speak to a veterans disability lawyer for advice on when to do this.
Performance evaluations from a veteran's job can be submitted to the VA to demonstrate decreased inefficiency, insubordination, trouble following directions, or other work-related difficulties.
When applying for an increased rating, it is advisable to have an attorney who can make sure you are not submitting information that will support your current low rating or that might even support a lower rating than what you have already received.
If you aren't entitled to a 100% rating under VA criteria because your symptoms are not severe enough, you still might be able to get payment at the 100% rate if you can't work a job that pays you enough to live above the poverty level. The VA calls this Total Disability based on Unemployability (TDUI). To obtain TDUI, you must show that you can't work as a result of your service-connected mental illness.
For more information on how VA rates disabilities, including how ratings for multiple disabilities are combined, see Nolo's article on VA disability ratings.