PTSD VA Rating Criteria
TL;DR. PTSD is rated under 38 CFR 4.130 Diagnostic Code 9411 using the General Rating Formula for Mental Disorders, which assigns 0, 10, 30, 50, 70, or 100 percent based on occupational and social impairment. The rater does not check off symptoms one by one. Instead, the rater identifies the bracket whose description best fits the veteran's overall functioning, then confirms that supporting symptoms exist. The most common rating misreads happen at the 50-to-70 and 70-to-100 transitions, where a single well-functioning C&P snapshot can pull a rating down a bracket even if the veteran's day-to-day reality is worse. Strong evidence packages address occupational impairment (work history, employer statements, lost-time documentation), social impairment (relationship documentation, family statements), and medication or treatment history. Once granted, PTSD ratings can become Permanent and Total (P&T) when the rater finds no expectation of improvement, and reach 20-year protection under 38 CFR 3.951(b).
How PTSD rating works mechanically
The General Rating Formula for Mental Disorders at 38 CFR 4.130 covers PTSD (DC 9411) along with the other mental disorders rated by the same formula (depression, anxiety, schizophrenia, etc.). The formula uses six percentage brackets and one descriptive paragraph for each bracket. The rater's job is to identify the bracket whose paragraph best describes the veteran's overall functioning.
The formula is famously NOT a symptom checklist. The Court of Appeals for Veterans Claims clarified in Mauerhan v. Principi, 16 Vet. App. 436 (2002) that the symptoms listed in each bracket are examples, not requirements. A veteran can be rated at a given bracket if his overall impairment matches that bracket, even if he does not have every listed symptom.
This cuts both ways. A veteran with one listed symptom from the 100 percent bracket (persistent delusions, for example) is NOT automatically 100 percent if his overall functioning is better than total impairment. And a veteran missing several listed symptoms from a bracket is NOT automatically denied that bracket if his overall functioning matches the description.
The six brackets explained
0 percent
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.
Translation: the veteran has the diagnosis, but does not have functional impairment. Rare for PTSD claims that reach a rating decision, because veterans with formally diagnosed PTSD almost always have functional impairment.
10 percent
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.
Key phrase: "controlled by continuous medication". A veteran whose PTSD symptoms are largely controlled by daily medication can be rated at 10 percent even if the underlying disorder is more severe than the symptom presentation suggests.
30 percent
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).
This is the "working but struggling" bracket. The veteran can hold a job and maintain relationships but has identifiable impairment that occasionally surfaces.
50 percent
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long term memory (such as retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.
This is the most common rating bracket for service-connected PTSD as of the most recent VA data. The marker phrase: "reduced reliability and productivity". The veteran can still work, but quality and consistency are notably reduced.
70 percent
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.
The bracket where TDIU eligibility typically becomes the strategic question (see TDIU explained). At 70 percent the schedular rating math under 38 CFR 4.16(a) supports TDIU when the veteran cannot maintain substantially gainful employment.
100 percent
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.
The 100 percent bracket does NOT require hospitalization. It does NOT require institutionalization. It requires total occupational and social impairment with supporting symptoms at the listed severity.
The two-axis framing the rater actually uses
Even though the formula reads like six bullet-point paragraphs, raters internally apply a two-axis framework:
- Occupational impairment. Can the veteran work? At what level? With what limitations? Documentation: employment history, employer statements, lost-time records, supervisor accommodations, performance evaluations.
- Social impairment. Can the veteran maintain relationships? Family functioning? Community connections? Documentation: spouse/family statements, relationship history, social isolation indicators.
Bracket assignment maps to these two axes:
- 10 percent: Minor work efficiency dip in stress, otherwise normal.
- 30 percent: Occasional work decreases, generally satisfactory.
- 50 percent: Reduced reliability and productivity. Effective work relationships difficult.
- 70 percent: Deficiencies in most areas. Inability to maintain effective relationships.
- 100 percent: Total impairment in both axes.
How ratings get downgraded — the four common errors
1. C&P snapshot vs. baseline divergence
The C&P examiner sees the veteran for one 30-90 minute appointment. If the veteran arrives on a relatively good day, dresses appropriately, makes eye contact, and gives organized answers, the examiner's notes may describe a 30 percent bracket even though the veteran's typical week looks like 50-70 percent. Mitigation: bring a "bad day" symptom log covering the prior 6-12 months. Bring a spouse or family member if allowed. Have a treating provider statement ready.
2. Work history misread
The rater may assume that continued employment indicates lower impairment. This conflates "maintaining a job" with "performing well at a job". A veteran working 30 hours a week at a part-time position he chose specifically because his PTSD prevents full-time work is still demonstrating impairment. Mitigation: include an employer statement or vocational expert evaluation specifically addressing accommodations, lost time, and performance reductions.
3. Medication compliance as functional improvement
The rater may interpret medication compliance as evidence the condition is "controlled". This is correct only for the 10 percent bracket; at 30 percent and above, controlled-by-medication is no longer the rating criterion. Mitigation: ensure progress notes document residual symptoms despite medication, and document side effects affecting functioning.
4. Treatment positivity bias
Therapy notes often emphasize progress and coping. Rater reads "patient reports improvement in mood" and interprets it as movement toward a lower bracket. Mitigation: ensure progress notes also document persistent symptoms, not just improvements. Ask the treating provider to write a dedicated impairment summary at the end of each year.
Evidence package by target rating
| Target rating | Required evidence categories |
|---|---|
| 30% | Diagnosis (DSM-5-TR via mental-health provider); current treatment notes showing weekly-or-less panic, sleep impairment, anxiety; brief work history showing occasional task interference. |
| 50% | Above plus: documentation of multiple-times-per-week panic; flattened affect or speech changes; supervisor or co-worker statement on reduced reliability; relationship strain documentation. |
| 70% | Above plus: suicidal ideation documentation (without minimizing — VA-friendly framing); inability to maintain effective relationships (divorce or estrangement records); near-continuous depression or panic; impaired impulse control episodes; documented job losses or significant accommodations. |
| 100% | Above plus: total occupational impairment (unemployed AND unemployable, per TDIU if not schedular 100); total social impairment (no relationships, no community function); evidence of severe symptom set (persistent delusions, persistent danger, ADL impairment). |
Worked example
Marine Corps infantryman, 4 combat deployments, OIF 2004-2010. Service-connected PTSD at 30 percent since 2015.
Submits increased rating claim in 2025. C&P exam describes well-groomed appearance, organized speech, denies suicidal ideation. Examiner notes "able to maintain relationships with family" because veteran lives with spouse and two children. Initial rating decision: continued at 30 percent.
Veteran files Higher-Level Review citing the snapshot issue. Submits: spouse statement describing daily emotional withdrawal, three panic attacks per week, three job losses in five years, prescribed sertraline + prazosin + trazodone (multi-drug regimen indicates moderate-to-severe PTSD), VA mental health treating provider statement specifying flattened affect, impaired short-term memory, difficulty maintaining work relationships.
HLR senior rater grants 70 percent retroactive to 2025 claim date. Reasoning: the 30 percent description (generally functioning satisfactorily) does not match the documented multi-drug regimen, three job losses, weekly panic, and spouse-documented daily withdrawal. Pattern fits 70 percent (deficiencies in most areas, inability to maintain effective work relationships, near-continuous panic, impaired impulse control via panic-triggered withdrawal).
2026 monthly compensation increase: from $568.05 (30% with spouse + 2 dependents) to $1,847.18 (70% with same dependents). Annual increase: $15,349. Plus back pay from 2025 claim date.
Sources cited in this article
- 38 CFR 4.130 — Schedule of ratings for mental disorders
- 38 CFR 3.344 — Stabilization of disability evaluations
- 38 CFR 3.951 — Preservation of disability ratings
- Mauerhan v. Principi, 16 Vet. App. 436 (2002) (symptom list is not a checklist).
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), American Psychiatric Association.
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