These are conditions that affect your mood, thoughts, sleep, and how you get along at work and at home.

VA's code numbers for this: 9411, 9434, 9400, 9440, 9435, 9432, 9201-9440 (all use one formula)

Who does it: A VA doctor or a VA contract examiner. VA's exam page (updated Aug 15, 2025) names four contract companies: Loyal Source Government Services, OptumServe Health Services, Leidos QTC Health Services, and Veterans Evaluation Services (VES). (LHI is an older name; it is now part of OptumServe.) You can't pick which one. Answer every call or letter about scheduling.

• A psychologist or psychiatrist (or similar licensed mental health provider), VA or contract. The first PTSD exam must be done by a psychologist or psychiatrist.
• Many exams are in person; some are by video.
• Common questions: What do you do on a typical day? How do you sleep? Do you have nightmares? How is work? How are things with your spouse, kids, friends? Do you drink or use drugs? Have you had thoughts of hurting yourself or others? What treatment do you get?
• For a PTSD claim, they may ask about the event (the 'stressor'). You may share what you're able to.
• It often takes about 1 to 2 hours. Plan a quiet rest of your day.

The examiner fills out a form called a DBQ. You can read it ahead of time: Initial PTSD DBQ (not public; VA or contract psychologist/psychiatrist only). For other conditions and re-checks: Mental Disorders DBQ, or PTSD Review DBQ. (opens VA's site).

• 0%

  A doctor diagnosed it, but it doesn't really get in the way of work or home life, and you don't need daily medicine for it.

  VA's exact words

  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.

  Rule: 38 CFR 4.130, General Rating Formula for Mental Disorders (DC 9201-9440, incl. 9411 PTSD, 9434 major depressive disorder, 9400 generalized anxiety disorder)

• 10%

  Mostly you do fine. Symptoms show up only when life is very stressful (a death, a layoff). Or a daily medicine keeps it under control. For example only (everyone is different): a daily medicine keeps things steady at work and at home.

  VA's exact words

  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.

  Rule: 38 CFR 4.130, General Rating Formula for Mental Disorders (DC 9201-9440, incl. 9411 PTSD, 9434 major depressive disorder, 9400 generalized anxiety disorder)

• 30%

  Most days you get by. Your routine, self-care, and talking are normal. But some days you get less done or can't do your work. You may feel down or anxious, be on guard, sleep poorly, have a panic attack once a week or less, or forget names and recent things. For example only: bad days now and then mean calling in or leaving work early.

  VA's exact words

  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).

  Rule: 38 CFR 4.130, General Rating Formula for Mental Disorders (DC 9201-9440, incl. 9411 PTSD, 9434 major depressive disorder, 9400 generalized anxiety disorder)

• 50%

  You are less dependable and get less done at work, and relationships suffer. You may have panic attacks more than once a week, feel emotionally flat, forget tasks, have trouble with complicated instructions, make poor decisions, have low drive, and have a hard time making or keeping friends or work relationships. For example only: problems at work that others notice, and a hard time keeping up close relationships.

  VA's exact words

  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 (e.g., 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.

  Rule: 38 CFR 4.130, General Rating Formula for Mental Disorders (DC 9201-9440, incl. 9411 PTSD, 9434 major depressive disorder, 9400 generalized anxiety disorder)

• 70%

  Problems in most parts of life - work or school, family, judgment, thinking, or mood. Examples of symptoms: thoughts of suicide; panic or depression almost all the time; angry outbursts, sometimes violent; not keeping up with hygiene; not handling stress at work; not able to keep close relationships. For example only: problems in most parts of life (work, family, mood, judgment), like trouble keeping a job or being around people.

  VA's exact words

  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.

  Rule: 38 CFR 4.130, General Rating Formula for Mental Disorders (DC 9201-9440, incl. 9411 PTSD, 9434 major depressive disorder, 9400 generalized anxiety disorder)

• 100%

  You can't work and can't function with other people at all. Examples: seeing or hearing things that aren't there, being a constant danger to yourself or others, at times not able to take care of basic needs like bathing, not knowing the date or where you are, or forgetting close family names.

  VA's exact words

  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.

  Rule: 38 CFR 4.130, General Rating Formula for Mental Disorders (DC 9201-9440, incl. 9411 PTSD, 9434 major depressive disorder, 9400 generalized anxiety disorder)

What to write down: Good days and bad days, sleep, panic attacks, anger, missed work, skipped events, self-care slips. Also what a family member sees.

How: For 30 days, write 2-3 lines each night. Keep it simple. Ask your spouse or a close friend to write a short 'buddy statement' (VA Form 21-10210) about changes they have seen since service. If writing about hard memories upsets you, stop. You don't need details of what happened - just how you are doing now.

What to bring: Bring a photo ID, your list of medicines and doses, your home log, and any new private records you have not sent to VA yet. VA says you don't have to bring anything, but your notes help you remember. A spouse or caregiver may come along. VA says you can ask the examiner if they can stay in the room. The examiner may ask them to wait outside.

Tell the examiner

• Tell the whole truth. Don't add to it. Don't shrink it.
• Describe a normal day AND your worst days. Say how often the worst days happen.
• Answer the question you were asked. Skip the habit of saying 'I'm fine' or 'it's not that bad' when it is.
• It's OK to read from your log or notes. Hand the examiner a copy if they will take it.
• Don't act out symptoms or guess at numbers. If you don't know or can't remember, say so.
• If something hurts or makes you worse during the exam, say so right then.
• Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all your benefits (38 U.S.C. 6103). Honest, complete answers protect you.
• If talking about the past gets to be too much, you can ask for a short break.

• Showing up on a 'good day' face and saying 'I'm fine.' The examiner writes down what you say.

  Where this comes from: HTB practice note (secondary); see also 38 CFR 4.126(a): rating looks at frequency, severity, and duration over time

• Thinking you need every symptom on the list. The list is examples only.

  Where this comes from: Mauerhan v. Principi, 16 Vet. App. 436 (2002)

• Not giving enough detail. VA needs symptoms of similar severity, frequency, and duration to a level.

  Where this comes from: Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013)

• Rater treating suicidal thoughts as minor unless you were hospitalized. Thoughts alone can support 70%.

  Where this comes from: Bankhead v. Shulkin, 29 Vet. App. 10 (2017)

• Filing only for 'PTSD' when a doctor says it's depression or anxiety. VA must read the claim to cover any mental condition the records show.

  Where this comes from: Clemons v. Shinseki, 23 Vet. App. 1 (2009)

• Leaving out work problems. The rating is about work and social life.

  Where this comes from: 38 CFR 4.126(a); 4.130

1. On a bad day, what can't you do that you can do on a good day? How many bad days a week?
2. How are you sleeping? Nightmares?
3. How has work been - missed days, trouble with the boss or coworkers?
4. Have you pulled away from family or friends, or stopped doing things you used to enjoy?
5. Have you had any thoughts of hurting yourself? (If yes, call 988 and press 1 together, right now.)

• Proposed, not law yet

  VA proposed a new mental health formula. It would rate you on 5 areas: thinking (cognition); getting along with people; getting tasks done; getting around; and self-care. Each area gets a score 0-4. The lowest rating would be 10% (no more 0%). Level 4 in any area, or level 3 in two areas = 100%. Level 3 in one area, or level 2 in two areas = 70%. Level 2 in one area = 50%. Level 1 in two or more areas = 30%. The proposal also says medicine's help would be counted.

  Where it stands: Proposed Feb 15, 2022. Comments closed Apr 18, 2022. NOT final as of Oct 30, 2026. No final rule in the Federal Register; current 38 CFR 4.130 still applies. Treat online claims of a 'new PTSD rating' as rumor until VA publishes a final rule.

  87 FR 8498 (Feb 15, 2022), RIN 2900-AQ82

• Cancelled, not in force

  On Feb 17, 2026, VA put out a quick rule that would have rated you with the help your medicine gives you (38 CFR 4.10). VA cancelled it 10 days later. The old wording is back. Court case Jones v. Shinseki, 26 Vet. App. 56 (2012) still says: if the rating rule doesn't mention medicine, VA can't lower your rating because medicine helps.

  Where it stands: Rescinded effective Feb 27, 2026. Not in force.

  91 FR 7118 (Feb 17, 2026), interim final rule; 91 FR 9712 (Feb 27, 2026), rescission. RIN 2900-AS49

• eCFR 38 CFR 4.130 Schedule of ratings - mental disorders
• eCFR 38 CFR 4.126 Evaluation of disability from mental disorders
• Federal Register 87 FR 8498 proposed mental disorders rule
• Federal Register 91 FR 9712 rescission of medication rule
• Bankhead v. Shulkin (2017)
• Vazquez-Claudio v. Shinseki (2013)
• Mauerhan v. Principi (2002)
• Veterans Crisis Line
• VA public DBQ list, last updated Sept 15, 2025
• VA.gov - VA claim exam (C&P exam) page, last updated Aug 15, 2025

Checked against VA's rules on October 30, 2026.