If you’re struggling right now, help is available 24/7.
Call or text 988 and press 1 for the Veterans Crisis Line, or text 838255. You don’t need to be enrolled in VA health care and you don’t need a rating.
Veterans read the mental health rating criteria, count how many listed symptoms they have, and conclude they don’t qualify for a higher level. That is not how the rating works — and courts have said so plainly.
The symptom lists are examples. The rating is decided by how much your work and relationships are impaired.
One Formula for Every Condition
PTSD, major depression, generalized anxiety, bipolar disorder, panic disorder — all of them are evaluated under the same General Rating Formula for Mental Disorders.
That’s why VA typically assigns a single rating for mental health rather than stacking separate percentages for each diagnosis. The diagnosis affects service connection; the rating level is about function.
The Six Levels
| Rating | Level of occupational and social impairment | Example symptoms named in the criteria |
|---|---|---|
| 100% | Total occupational and social impairment | Gross impairment in thought or communication; persistent delusions or hallucinations; persistent danger of hurting self or others; disorientation to time or place; memory loss for own name or occupation |
| 70% | Deficiencies in most areas — work, school, family relations, judgment, thinking, or mood | Suicidal ideation; near-continuous panic or depression; impaired impulse control; neglect of hygiene; difficulty adapting to stressful circumstances; inability to establish and maintain effective relationships |
| 50% | Reduced reliability and productivity | Flattened affect; panic attacks more than once a week; impaired short- and long-term memory; impaired judgment; disturbances of motivation and mood |
| 30% | Occasional decrease in work efficiency, with intermittent inability to perform tasks | Depressed mood; anxiety; suspiciousness; panic attacks weekly or less; chronic sleep impairment; mild memory loss |
| 10% | Mild or transient symptoms that reduce work efficiency only under significant stress | Or symptoms controlled by continuous medication |
| 0% | Formally diagnosed, but symptoms don’t interfere with functioning or require continuous medication | — |
Look at the 10% row again. Symptoms controlled by continuous medication is itself a 10% criterion. Being stable on medication doesn’t mean 0% — the medication is doing work the rating is meant to recognize.
Why Counting Symptoms Is the Wrong Approach
The criteria say “due to such symptoms as,” and that phrasing does real legal work.
The Court of Appeals for Veterans Claims held in Mauerhan v. Principi that the lists are not exhaustive. A rater need not find all, most, or even some of the listed symptoms to assign a given level. Symptoms not on the list count too.
The Federal Circuit added in Vazquez-Claudio v. Shinseki that the analysis has to connect symptoms to the resulting level of occupational and social impairment. Symptoms are evidence; impairment is the standard.
The practical translation: don’t describe your condition as a checklist. Describe what it stops you from doing.
What “Occupational and Social Impairment” Means in Practice
Two people with identical diagnoses can rate very differently, because the question is function.
- Work: missed shifts, tasks handed to someone else, jobs you left, warnings, accommodations, an inability to take instruction or work with the public.
- Family: relationships that have narrowed or ended, arguments, withdrawal from your own household.
- Social: friendships that stopped, activities you gave up, avoidance of crowds, stores, or events.
- Judgment and thinking: decisions you no longer trust yourself to make, concentration that fails partway through a task.
- Mood: not the word “depressed,” but what the mood does to a normal week.
The 70% level uses the phrase “deficiencies in most areas.” Most, not all. A veteran functioning at work but whose family life and social world have collapsed can meet it.
Preparing for the Exam
Veterans consistently undersell themselves at a mental health evaluation, often out of habit rather than choice.
- Describe your worst weeks, not your best day. The examiner sees a snapshot; you know the range.
- Keep a symptom journal for a month beforehand — dates, what happened, what you couldn’t do.
- Bring lay statements. A spouse or co-worker sees things you’ve normalized. Our guide to writing a buddy letter raters credit explains how.
- Answer the work question fully. It feeds both the rating level and potential TDIU eligibility.
- Don’t minimize. “Fine” is a reflex, and it can cost two rating levels.
Our guide to what happens at a C&P exam covers the appointment itself. The full criteria are in 38 CFR 4.130.
Describing Impairment in Your Own Words
The gap between how veterans describe their symptoms and how the criteria are written costs real rating levels. Translating is straightforward once you see the pattern.
| What veterans usually say | What the criteria are asking about |
|---|---|
| “I’m fine, I just don’t sleep well.” | How many nights a week, for how long, and what it costs you the next day |
| “I keep to myself.” | Which relationships have ended, which activities you’ve given up, how long since you’ve seen a friend |
| “Work’s been rough.” | Shifts missed, tasks reassigned, warnings received, jobs left, accommodations you rely on |
| “I get irritable sometimes.” | Impaired impulse control — what actually happened, and who was there |
| “My memory isn’t what it was.” | Appointments missed, tasks left unfinished, instructions you had to have repeated |
Specific and concrete beats stoic every time. You aren’t complaining — you’re supplying the evidence the criteria are written to evaluate.
Treatment Doesn’t Cost You the Rating
A persistent fear keeps veterans out of care: that getting better on paper will reduce the rating and the payment.
Two things worth saying about that. First, the criteria expressly recognize symptoms controlled by medication as compensable. Second, untreated conditions get worse, and the record of ongoing treatment is what supports a rating over time — gaps in treatment get read as improvement.
Care is available regardless of rating. The Veterans Crisis Line is open to any veteran, enrolled or not, and our guide to the Be the One initiative covers how to start a conversation with someone you’re worried about.
Frequently Asked Questions
Do I need every symptom listed to get a rating level?
No. The lists are examples. Under Mauerhan v. Principi, a rater need not find all, most, or even some of the listed symptoms.
What decides the rating if not the symptoms?
The level of occupational and social impairment those symptoms cause.
Are PTSD and depression rated separately?
Generally no. All mental disorders are evaluated under the same formula, and VA typically assigns one rating.
Does being on medication mean 0%?
No. Symptoms controlled by continuous medication is a 10% criterion in the rating formula.
What does the 70% level require?
Occupational and social impairment with deficiencies in most areas — work, school, family relations, judgment, thinking, or mood.
Will getting treatment lower my rating?
Treatment builds the medical record your rating rests on, and the criteria recognize symptoms controlled by medication. Gaps in treatment are more often read as improvement.
Get It Reviewed Before You File
If your current rating doesn’t match how your weeks actually go, that’s worth a conversation. An accredited service officer reads these decisions constantly and knows what evidence moves them.
Our guide to free help from an accredited service officer explains how to reach one, or call Post 51 at (541) 451-1351.