Depression and Anxiety: How the VA Sets Your Rating

Claims can wait. If you are thinking about hurting yourself, reach the Veterans Crisis Line first: call 988 and press 1, text 838255, or start a chat at VeteransCrisisLine.net. Someone answers around the clock, it costs nothing, and you don't need a VA rating or VA health care enrollment to use it.

The VA has separate diagnostic codes for dozens of mental health conditions, but nearly all of them point to one place: the General Rating Formula for Mental Disorders in 38 CFR 4.130. The ones veterans claim most often include:

• Major depressive disorder (9434) and persistent depressive disorder, also called dysthymia (9433)
• Generalized anxiety disorder (9400), panic disorder or agoraphobia (9412) and other specified or unspecified anxiety (9410, 9413)
• Unspecified depressive disorder (9435) and bipolar disorder (9432)
• Chronic adjustment disorder (9440). A short-lived adjustment reaction that cleared up after a bad assignment is a different thing, and the code says chronic for a reason.

Two practical points follow. First, the diagnosis has to meet DSM-5 standards, so a note that says "stressed" or "down" in your chart is a starting clue rather than a diagnosis. Second, the VA gives one rating for all of your mental health conditions together. Rating depression and anxiety separately would count the same sleeplessness and the same missed workdays twice, which the rules forbid. The upside is that every symptom you report, whatever label it falls under, feeds that single rating.

It started while you were serving

Look for anything that shows the trouble began in uniform: sick call visits for sleep or stress, a referral to behavioral health, a counseling statement after your performance slipped, or mental health answers on your separation health assessment. A current diagnosis plus a medical opinion connecting it to that period can carry a direct claim, even if nobody used the word depression back then.

Another service-connected condition caused it

This is how many veterans end up rated. Constant back or knee pain, ringing ears that never stop, migraines, a lost career after an injury: any of these can wear a person down until depression or anxiety sets in. A secondary claim needs a medical opinion that explains how the service-connected condition led to the mental health condition. A sentence saying the two are "related" rarely persuades a rater.

A service-connected condition made it worse

If you had depression before a service-connected injury and the injury pushed it beyond where it would have gone on its own, the VA can rate the added portion. The rater compares your baseline with your current level, so records from before the worsening help.

It followed a brain injury

For veterans with a service-connected TBI, the VA presumes depression is part of the injury if it shows up within three years of a moderate or severe TBI, or within one year of a mild one. The TBI guide explains how severity is classified.

A diagnosis gets you in the door. The rating depends on impairment, and impairment shows up in the ordinary details of a week. Raters respond to specifics like these:

• Days of work missed, warnings received, hours cut, or a job you left because you couldn't keep up
• How often panic attacks happen, what they feel like and how long they last
• Friendships you've let go, events you skip, and how things are at home
• Basic routines slipping, such as showering, eating or paying bills
• Medications you take and the side effects you live with

Therapy notes written over months carry real weight because they show a pattern. A statement from your spouse or a coworker fills in what you may not notice yourself. Taking medication doesn't disqualify you. If your symptoms still interfere with work and relationships while you take it, describe exactly how.

A secondary mental health rating can change your total more than people expect. A veteran rated 20% for a back condition who adds depression at 30% combines to 40%, which pays $795.84 a month at 2026 rates for a veteran alone. The VA disability calculator runs your own numbers.

The mental health exam ends with a choice that shapes the whole rating. On the VA's questionnaire for mental disorders, the examiner picks the one statement that best describes your level of occupational and social impairment, and those statements use the same wording as the levels in the rating formula above. The symptoms the examiner marks, and the history you give, are what back up that choice.

• Bring specifics. Missed shifts, write-ups, a job you left, a marriage under strain, days you didn't leave the house. Concrete events land better than "it's been hard."
• Describe a typical bad week. If symptoms come and go, say how often they hit and how long they last.
• Get the report afterward. You can request your exam results with VA Form 20-10206 and see which impairment level was chosen and why.