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Our military veterans have made many personal sacrifices on behalf of their country. As a result, they may face different health issues, including mental health disorders, both on active duty and even years after service. Veterans are much more likely to suffer a mental health disorder than civilians. This is due to the enormous demands of military life, such as deployments, combat, and constant relocations. Many veterans also find the adjustment back to civilian life very challenging. Studies show that veterans make up nearly one-fourth of suicides in the U.S. In fact, the veteran suicide rate is 1.5 times higher than that of the general population. If you are a veteran in crisis, contact the Veterans Crisis Line at 988 for free, confidential 24/7, 365 days a year support.
The VA estimates that approximately one-third of all veterans are rated for at least one mental health disorder. It is important to note that while you may receive a diagnosis of more than one mental health disorder, the VA will consider the combined effects of these conditions and will only assign one disability rating. Thus, you cannot receive separate disability ratings for each one of your mental health conditions.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) is the American Psychiatric Association’s latest reference handbook for diagnosing psychiatric illnesses. It contains 20 disorder chapters and nearly 300 mental illnesses. This newest version contains revised criteria for more than 70 disorders. The VA uses this handbook to diagnose, evaluate, and rate veterans’ mental disabilities. However, not all mental disorders listed in the DSM-5-TR are compensable by the VA. The eligible categories of mental disorders that are rated by the VA are listed in 38 CFR 4.130 and include, but is not limited to, schizophrenia, anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, bipolar disorder, major depressive disorder, chronic adjustment disorder, and eating disorders. You could get service-connected for any of these disabilities if your mental health condition began during or was caused or worsened by your military service.
VA Rating for Mental Health Conditions, such as Depression
Once the VA has service-connected you for a mental health disorder, VA regulations provide for ratings of 0%, 10%, 30%, 50%, 70%, and 100%. You can be service-connected for a mental health disorder and receive a 0% rating if your symptoms are mild enough that they do not require continuous medication or interfere with social and occupational functioning. Alternatively, you may receive a 100% disability rating if you have total occupational and social impairment resulting in an inability to function socially or at work. You do not have to exhibit every symptom listed in the rating criteria to qualify for that rating. Also, the listed symptoms are not all-inclusive; you may exhibit similar but different symptoms than those listed. A VA rating for a mental health disorder that remains the same for more than five years is considered to be a “stabilized” rating and, due to legal safeguards, is more difficult for the VA to decrease.
Even if you don’t receive a 100% disability rating, you can apply for total disability based on individual unemployability (TDIU) if your service-connected mental health disorder, either alone or in combination with other service-connected disabilities, renders you unable to secure and maintain competitive employment. With TDIU in place, the VA will award you disability compensation at the 100% rating level if you can show you cannot secure and maintain a steady job other than one that pays less than the current poverty level, as set by the U.S. Census Bureau, as a result of your service-connected mental and other service-connected disabilities.
Ways to Maximize Your VA Rating for Mental Health Disorders
Over half of all service members who experience mental health problems are hesitant to get help because they are concerned there is a stigma attached to seeing a mental health provider, or they are worried about losing their security clearance. These perceptions have evolved over time by increasing awareness, education, and training in today’s society and military services. Therefore, military members and veterans alike should not hesitate to get the help they need, not only for their well-being but also because the best evidence of a mental health disorder comes from your service or private medical records while you are in the military.
You should seek professional treatment for your mental health issues just as you would for your physical ailments. Be open with your mental health provider and the VA at your Compensation and Pension (C&P) exam. Do not minimize your condition and symptoms, but do not embellish them either. Explain the symptoms you suffer from and how they impact your daily life. Provide the VA with as many details as possible on how your symptoms negatively impact you. You can submit a personal statement detailing the symptoms of your condition and lay statements from your family, friends, and co-workers to help the VA comprehend the true impact of your condition. Suppose you have had issues at work; any written evaluations you can obtain from past or present employers detailing your work deficiencies will help as well.
Most Common Mental Health Disorders Rated by the VA
Amongst the most frequently diagnosed mental health disorders claimed by veterans is posttraumatic stress disorder (PTSD). It is also the third most commonly claimed VA disability overall. It is also the most frequent mental health issue that develops after military service. Studies show that military service is the most common cause of PTSD for men. Studies of Iraq and Afghanistan war veterans show that approximately 30 percent of all veterans have developed PTSD. Also, 20 percent of all women who deployed to these regions have been diagnosed with PTSD. The prevalence of military sexual trauma is another common cause of PTSD, especially for female veterans.
To prove service connection for PTSD, you must show (1) a current medical diagnosis of PTSD, (2) that the PTSD is the result of or was aggravated by an in-service stressor, and (3) a link between the current diagnosis and the stressor. Once your PTSD claim has been service-connected, the VA will assign a rating for your claim. VA ratings for PTSD depend on the frequency, severity, and duration of a veteran’s mental health symptoms over time. Commonly, the VA assigns a 70% rating for PTSD.
Major Depressive Disorder (MDD), also known as clinical depression, is another commonly claimed mental health disorder. MDD is just one of several types of depression. Some research studies show the rate of depression is five times higher in veterans than in civilians. When making a disability claim, it is vital that you thoroughly establish the impact your depression has on your life to receive the highest VA disability rating possible. To get service-connected for depression, you need to show that (1) you have a current diagnosis of depression, (2) evidence of an in-service event, disease, injury, or aggravation, and (3) a medical opinion that links your depression to the in-service event, injury, or illness. You do not need to verify the in-service stressor as you do for PTSD. On average, VA assigns a 30% rating for MDD.
Another frequently claimed mental health disorder is chronic adjustment disorder. It is common among military trainees recommended for separation due to mental health issues, as well as in previously deployed populations. It is probably the most commonly diagnosed mental health condition for service members. This disorder is similar to PTSD or depression in that you may develop a chronic adjustment disorder in response to traumatic or stressful events or life changes. Oftentimes, clinicians diagnose adjustment disorder or MDD secondary to the effects on one’s lifestyle caused by pain from service-connected medical disorders, such as a lower back or neck disorder. You would prove service connection for a chronic adjustment disorder in the same way you would establish a claim for MDD.
Mental Health Disorders the VA Will Not Rate
The VA does not consider the following mental health conditions to be related to military service and, therefore, does not grant service connection for these disorders: personality disorders, substance use disorder, all other abuse disorders or addictions (excluding anorexia or bulimia), impulse control disorder, and cognitive or developmental delays. These conditions and any symptoms they cause cannot be rated except as a secondary condition, meaning it is the direct result of another service-connected condition.
Secondary Service-Connection and Mental Health Disability
As discussed above, you cannot be service-connected for certain specified mental health disorders, such as substance use disorder. But you can be service-connected on a secondary basis if you already have a primary service-connected disability. For example, you have been service-connected for a back injury and start drinking heavily to deal with your symptoms, namely pain. Your prolonged alcohol use causes severe pancreatitis. You may receive a secondary service connection for pancreatitis due to alcoholism since the alcoholism developed as a result of your primary service-connected condition. As another example, you are service-connected for PTSD and start taking opioids to deal with your symptoms. Your opioid use causes anxiety. You may receive a secondary service connection for anxiety due to your opioid use since the opioid use developed as a result of your primary service-connected PTSD and, thereby, receive a higher disability rating for your combined symptoms. Note, however, that willful substance use, i.e., substance use that is not resultant from a service-connected disorder, is never compensable.
Proposed Changes to VA’s Mental Health Ratings
In 2022, the VA proposed substantial changes to its rating system for mental health disorders to reflect modern treatments and understandings of mental health. The VA believes the new criteria should lead to more generous veteran compensation than the current system. Current ratings are based on occupational and social impairment from 0% to 100%, wherein VA deems certain symptoms reflective of certain levels of social and occupational impairment. The VA is considering replacing these criteria with five others: cognition, interpersonal interactions and relationships, task completion and life activities, navigating environments, and self-care. Each will be assigned a rating from 0 to 4. The VA proposes to eliminate the 0% rating and increase the lowest rating for a mental health condition to 10%. Therefore, the VA rating for depression would start at 10%. Also, the requirement for total occupational impairment to receive a 100% rating would be eliminated, making it easier to attain a 100% rating.
Let an Attorney at Gang & Associates Help You with Your VA Mental Health Rating, Such as for Depression
Mental health disabilities can be much more complex than physical disability claims to prove. Common reasons the VA denies mental health claims include no formal diagnosis of your claimed condition, no evidence that your condition is connected to your service (for example, inability to show an in-service stressor event for PTSD), failure to show a nexus between your in-service event and your mental health condition (for example, inability to connect your PTSD to your in-service stressor).
If the VA has denied your claim for a mental health disorder or you received a lower rating than you think you deserve (for example, your VA rating for depression was 30%, and you believe you meet the necessary criteria for a 70% rating), contact us at your earliest convenience for a free consultation to discuss your options. We have helped thousands of veterans in their appeals to secure service connection, or a higher rating, for their mental disability claims, and we may very well be able to help you do the same. We have the years of experience necessary to fully comprehend these cases and successfully establish a service connection or get you a rating increase that is more commensurate with your condition. Remember, you have one year to appeal from the date of your decision letter.