VA Disability Rating Criteria for Post-Traumatic Stress Disorder (PTSD)
The Department of Veterans Affairs rates Post-Traumatic Stress Disorder (PTSD) under 38 CFR Book C (Diagnostic Code 9411). Compensation ratings are determined by the severity of functional impairment and objective medical evidence.
Title 38 CFR Statutory Rating Schedule
Source: eCFR Part 4| Rating | Required Diagnostic Symptoms & Severity |
|---|---|
| 100% | 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; disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. |
| 70% | 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; spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances; inability to establish and maintain effective relationships. |
| 50% | 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; impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. |
| 30% | 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). |
| 10% | Occupational and social impairment due to mild or transient symptoms which decrease work efficiency only during periods of significant stress, or symptoms controlled by continuous medication. |
| 0% | Formally diagnosed but symptoms not severe enough to interfere with occupational/social functioning or require continuous medication. |
Statutory Secondary Service Connections for Post-Traumatic Stress Disorder (PTSD)
PTSD-related hyperarousal, nocturnal panic attacks, REM sleep fragmentation, and psychotropic medication-induced weight gain contribute directly to or aggravate OSA. Multiple BVA precedent decisions grant this link.
Chronic autonomic sympathetic overdrive and SSRI/SNRI antidepressant medications increase gastric acid secretion and relax the lower esophageal sphincter, causing secondary acid reflux.
The gut-brain axis connects PTSD-induced chronic stress response to visceral hypersensitivity and altered gastrointestinal motility.
Chronic stress, muscle tension, REM sleep deprivation, and altered serotonin pathways from PTSD trigger severe vascular migraine attacks.
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