How VA Rates PTSD: DC 9411 Stressors and Impairment

PTSD is evaluated under 38 CFR 4.130, Diagnostic Code 9411. Like all psychiatric diagnoses, ratings are assigned at 0%, 10%, 30%, 50%, 70%, or 100% based on the veteran's documented level of occupational and social impairment rather than the specific trauma history.

A 10% rating reflects mild symptoms controlled by continuous medication; 30% describes occasional work impairment and depressed mood; 50% reflects reduced reliability and productivity due to flattened affect or panic attacks; 70% requires deficiencies in most areas such as work, family relations, judgment, and mood (including suicidal ideation); and 100% reflects total occupational and social impairment.

Under 38 CFR 3.304(f), stressor evidence rules include (f)(1), an in-service PTSD diagnosis, where lay testimony alone may establish the stressor if the other conditions in that provision are met; (f)(2), combat; (f)(3), fear of hostile military or terrorist activity; and (f)(4), prisoner-of-war status. For (f)(5), in-service personal assault, including military sexual trauma (MST), corroboration may come from sources other than service records, including evidence of behavior changes. VA may not deny such a personal-assault claim without first advising the claimant of those alternative sources. VA decides service connection.

Under the pyramiding rule (38 CFR 4.14), a veteran cannot receive separate ratings for PTSD, depression, and generalized anxiety. The VA combines all psychiatric symptoms into a single overall evaluation under 38 CFR 4.130 reflecting the veteran's total psychological impairment.

Under 38 CFR 3.304(f), PTSD service connection calls for a diagnosis in accordance with 38 CFR 4.125(a), a medical link to an in-service stressor, and credible supporting evidence that the stressor occurred, subject to the exceptions in (f)(1)-(5). A completed Initial PTSD DBQ or buddy statements are not required by these provisions. This is general education; VA decides service connection.