How VA Rates Mental Disorders
Updated: August 11, 2025 • Current law under 38 CFR §4.130
The Gist: VA rates mental health conditions using the General Rating Formula in 38 CFR §4.130. Proposed changes from 2022 are not in effect and have no implementation date.
Heads up: VA proposed modernizing the mental health rating schedule in 2022 (domain‑based scoring). That proposal has not been finalized. This article explains the current law and, for awareness, summarizes the proposal.
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Current VA Mental Disorder Rating Criteria (38 CFR §4.130)
VA rates most mental health conditions (PTSD, depression, anxiety, etc.) using a single formula that looks at how your symptoms impact work and social functioning. The % levels below are plain‑English summaries of the regulation:
- 100% – Total occupational & social impairment (e.g., gross thought impairment, persistent danger to self/others, disorientation, inability to perform activities of daily living).
- 70% – Deficiencies in most areas (work, school, family, judgment, thinking, mood), with symptoms like near‑continuous panic/depression, impaired impulse control, neglect of hygiene, inability to maintain relationships.
- 50% – Reduced reliability & productivity (e.g., flattened affect, panic attacks more than weekly, impaired judgment/abstract thinking, disturbances of motivation and mood).
- 30% – Occasional decrease in work efficiency with intermittent inability to perform tasks; otherwise generally functioning satisfactorily (e.g., depressed mood, anxiety, weekly‑or‑less panic attacks, sleep impairment, mild memory loss).
- 10% – Mild/transient symptoms that decrease work efficiency only during significant stress or symptoms well‑controlled by continuous medication.
- 0% – Diagnosis, but symptoms aren’t severe enough to interfere with work/social functioning or require continuous meds.
Tip: The list of symptoms in §4.130 is not exhaustive. Raters should look at frequency, severity, and duration, and the overall functional impact — not just whether one specific symptom appears word‑for‑word.
Proposed 2025 Criteria (Not in Effect)
In 2022, VA proposed a more structured, domain‑based approach using five areas of functioning:
- Cognition (understanding, memory, concentration, decision‑making)
- Interpersonal interactions & relationships
- Task completion & life activities
- Navigating environments (getting around safely/effectively)
- Self‑care
The proposal assigns a level to each domain — none, mild, moderate, severe, or total — and then maps the overall pattern to a % rating:
- 100% – Level 4 (total) in ≥1 domain, or Level 3 (severe) in ≥2 domains
- 70% – Level 3 in 1 domain, or Level 2 (moderate) in ≥2 domains
- 50% – Level 2 in 1 domain
- 30% – Level 1 (mild) in ≥2 domains
- 10% – Minimum rating for any service‑connected mental disorder (i.e., no 0%)
Also proposed: combine eating disorders into the same general formula (no separate “eating disorders” table). Again — this is a proposal only.
Side‑by‑Side Comparison Table
| Rating | Current (38 CFR §4.130) | Proposed (2022 rulemaking) |
|---|---|---|
| 100% | Total occupational & social impairment (e.g., gross thought impairment, persistent danger to self/others, disorientation, inability to perform ADLs). | Level 4 (“total”) in ≥1 domain or Level 3 (“severe”) in ≥2 domains across the five domains. |
| 70% | Deficiencies in most areas (work, school, family, judgment, thinking, mood). | Level 3 (“severe”) in 1 domain or Level 2 (“moderate”) in ≥2 domains. |
| 50% | Reduced reliability & productivity. | Level 2 (“moderate”) in 1 domain. |
| 30% | Occasional decrease in work efficiency; generally functioning satisfactorily. | Level 1 (“mild”) in ≥2 domains. |
| 10% | Mild/transient; only under stress or controlled by meds. | Minimum rating for any SC mental disorder (no 0%). |
| 0% | Diagnosis with no significant functional impact/no continuous meds. | — (would be eliminated; floor becomes 10%). |
FAQ (Quick Answers)
- Are the new VA mental health rating rules in effect?
No. VA’s 2022 proposal hasn’t been finalized; current ratings follow 38 CFR §4.130. - Do the proposed changes affect my existing rating?
Not at this time. Until a final rule is published with an effective date, your rating is governed by the current schedule. - How do examiners decide the % under current rules?
By considering the frequency, severity, and duration of symptoms and their functional impact on work and social life — not any single symptom alone. - Can I seek an increase if my symptoms worsen?
Yes. File for an increase and support it with treatment notes, lay statements, and evidence of functional impact.
Practical Advice for Your Claim
- Prepare for the C&P exam the right way. Your examiner is looking for functional impact — how often symptoms show up, how severe they are, and what they stop you from doing. See: What the Examiner Wants You to Know.
- Don’t self‑edit. Be honest and specific. If panic attacks hit three times a week, say so. If you forget to shower or miss meds, say it. Details matter.
- Document change over time. If symptoms worsen, that’s grounds to seek an increase. Keep treatment notes, lay statements, and work records.
- Link symptoms to function. Translate “I’m anxious” into “I can’t attend meetings, I avoid crowds, I miss deadlines.” That’s how raters score impact.
- For PTSD claims: Make sure your diagnosis reflects DSM‑5 and that your evidence aligns with current criteria. See our guide: DSM‑5 PTSD & VA Ratings.
Resources & Internal Links
- 38 CFR §4.130 – General Rating Formula for Mental Disorders (current)
- VA Proposed Rule (Feb 15, 2022): Mental Disorders (domain‑based framework)
- C&P Exam: What the Examiner Wants You to Know
- DSM‑5 vs DSM‑IV for PTSD & Ratings
- VA Claims Process: What to Expect
- How to Write a VA Personal Statement
- How to Write a Buddy Letter
