How the VA Rates Mental Health Claims Under 38 CFR 4.130

The VA rates nearly every service-connected mental health condition on a single scale under 38 CFR 4.130, assigning a rating of 0, 10, 30, 50, 70, or 100 percent based on how much the condition interferes with your ability to work and maintain relationships. For 2026, that translates to monthly payments ranging from $180.42 at 10 percent to $3,938.58 at 100 percent for a single veteran with no dependents.¹ The diagnosis matters for establishing service connection, but once you’re connected, the rating turns on functional impairment, not on the label.

What the Rating Actually Measures

The legal standard is social and occupational impairment. Examiners assess how your condition affects your ability to hold a job, get along with coworkers, sustain family relationships, and handle everyday tasks. Objective evidence carries the most weight: job loss, disciplinary actions, hospitalizations, and documented social withdrawal. Your own account of symptoms matters, but the VA weighs it against your medical records and employment history.

Two principles shape how the criteria get applied. First, the benefit-of-the-doubt rule at 38 CFR 4.3 requires the VA to resolve close calls in your favor. When the evidence for and against a given rating is roughly equal, you win.² Second, the symptoms listed at each rating level are examples, not a checklist. The U.S. Court of Appeals for Veterans Claims held in Mauerhan v. Principi that the word “such as” in the regulation means the listed symptoms illustrate the type and severity that justify a rating; you don’t have to match them one for one.³ If your symptoms differ from the examples but produce the same level of impairment, you can still qualify at that level.

Which Conditions Are Covered

The General Rating Formula applies to diagnostic codes 9201 through 9440, covering the vast majority of psychiatric conditions: PTSD, major depressive disorder, generalized anxiety disorder, panic disorder, bipolar disorder, and schizophrenia among them.⁴ All of them are evaluated on the same functional-impairment scale.

Eating disorders are the exception. Anorexia nervosa (code 9520) and bulimia nervosa (9521) use a separate formula built around weight loss thresholds and incapacitating episodes.⁴ Any diagnosis used for rating must conform to the DSM-5; if the examiner’s diagnosis doesn’t meet DSM-5 criteria, the VA has to send the report back for correction.⁵

The Rating Levels and 2026 Payments

0 Percent (No Compensation)

The VA recognizes your diagnosis as service-connected, but your symptoms aren’t severe enough to interfere with work or social functioning or to require continuous medication.⁴ No monthly check, but the service connection preserves your right to file for an increase later and may qualify you for VA healthcare.

10 Percent — $180.42 per Month

Symptoms are mild or temporary and only reduce your work efficiency during periods of significant stress, or your symptoms are controlled by continuous medication.⁴

30 Percent — $552.47 per Month

You’re generally functioning satisfactorily with normal routine behavior and self-care, but you experience occasional dips in work efficiency and intermittent stretches when you can’t perform occupational tasks. Example symptoms include depressed mood, anxiety, suspiciousness, weekly or less frequent panic attacks, chronic sleep problems, and mild memory loss.⁴ The distinction from 10 percent is that the disruptions recur with some regularity rather than only under unusual stress. Starting at this level, you also become eligible for additional compensation for dependents.¹

50 Percent — $1,132.90 per Month

This level represents reduced reliability and productivity. Example symptoms include flat or blunted affect, speech that’s hard to follow, panic attacks more than once a week, trouble understanding complex instructions, impaired short- and long-term memory, poor judgment, and difficulty maintaining work and social relationships.⁴ Supervisors and coworkers notice the impact. Your output or attendance is visibly diminished.

70 Percent — $1,808.45 per Month

Deficiencies in most areas of life: work, family relationships, judgment, thinking, or mood. Example symptoms include suicidal ideation, obsessional rituals that disrupt daily routines, illogical or irrelevant speech, near-continuous panic or depression, impaired impulse control, spatial disorientation, neglect of personal hygiene, difficulty adapting to stressful situations, and inability to maintain effective relationships.⁴

The Federal Circuit held in Vazquez-Claudio v. Shinseki that a 70 percent rating requires both symptoms of the kind and severity listed (or equivalent) and evidence that those symptoms actually cause deficiencies in most areas. Having the symptoms alone isn’t enough; having the impairment alone isn’t enough.⁶ On suicidal ideation specifically, the Board of Veterans’ Appeals, citing Bankhead v. Shulkin, has held that both passive thoughts (wishing you were dead) and active planning qualify. You don’t need to be at high risk of self-harm to meet the criterion.⁷

100 Percent — $3,938.58 per Month

Total occupational and social impairment. Example symptoms include gross impairment in thinking or communication, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger to self or others, inability to perform activities of daily living, disorientation to time or place, and memory loss severe enough that you can’t remember the names of close relatives or your own occupation.⁴

Compensation received a 2.8 percent cost-of-living adjustment for 2026, and the rates above take effect December 1, 2025. All VA disability compensation is tax-free at the federal level.¹

The 2026 Medication Rule

Effective February 17, 2026, the VA published an interim final rule amending 38 CFR 4.10. Examiners now rate you based on your actual functional impairment at the time of the exam, including the effects of any medication you’re taking. They will not estimate what your disability would look like unmedicated.⁸

This is a real shift. Previously, some court decisions had pushed examiners to consider a veteran’s unmedicated baseline. Now, if medication effectively controls your symptoms, your rating reflects that controlled state. The rule applies to new claims and to any existing rating undergoing reevaluation. Veterans well-managed on medication may see lower ratings than they would have received under the prior approach, which makes it worth documenting breakthrough symptoms, side effects, and any limitations that persist despite treatment.

The Minimum 50 Percent Rule After a Traumatic In-Service Event

If a mental disorder developed during service as a result of a highly stressful event and was severe enough to cause your discharge, the VA must assign an initial rating of at least 50 percent. A follow-up examination is scheduled within six months of discharge to determine whether the rating should be adjusted.⁹

If You Have More Than One Mental Health Diagnosis

PTSD and depression, for example, will not get separate ratings. Under the anti-pyramiding rule at 38 CFR 4.14, the VA cannot rate the same symptoms twice under different diagnostic labels.¹⁰ The examiner evaluates all your psychiatric symptoms together and assigns one rating under whichever diagnostic code produces the highest evaluation. The focus is your total functional impairment.

Getting Paid at 100 Percent Without a 100 Percent Rating

If your rating is less than 100 percent but your condition still prevents you from holding a steady job, Total Disability Based on Individual Unemployability (TDIU) pays at the 100 percent rate. To qualify, you need at least one service-connected disability rated at 60 percent or higher, or two or more with a combined rating of 70 percent or more and at least one rated at 40 percent or more.¹¹ A single 70 percent mental health rating meets the threshold.

Beyond the percentage, you have to show you can’t maintain substantially gainful employment because of your service-connected disabilities. Odd jobs and marginal employment don’t count. You’ll file VA Form 21-8940 and VA Form 21-4192, and the VA will review your medical evidence alongside your work and education history.¹¹

The C&P Exam Is Where the Rating Gets Decided

The Compensation and Pension exam is not a treatment appointment. The examiner won’t prescribe medication or make referrals; their job is to gather information for the rating decision.¹² The exam may last 15 minutes or over an hour depending on the complexity of your claim.

The examiner works through the Disability Benefits Questionnaire, which requires selecting one of the standard impairment levels: no impairment, impairment only during significant stress, occasional decreased efficiency, reduced reliability and productivity, deficiencies in most areas, or total impairment.¹³ That selection drives the rating. If the examiner checks “occasional decrease in work efficiency,” you’re likely looking at 30 percent regardless of what else is in your file.

You can ask to have a caregiver or family member present, though the examiner may ask them to step out of the room.¹² Do not minimize your symptoms. Many veterans instinctively downplay their difficulties, and the examiner will take those statements at face value. Describe your typical bad days honestly, including how often they occur and what you can’t do when they hit.

When Your Compensation Starts and How Much Back Pay You Get

For a new claim, the effective date is the later of the date the VA receives your claim or the date your disability began.¹⁴ If you file within one year of leaving active duty, the effective date can go back to the day after separation. That window is worth thousands of dollars and is one of the most commonly missed deadlines in the VA system.

For a claim to increase an existing rating, the VA will date the increase back to the earliest point you can show the disability worsened, but only if you file within one year of that date. File later and the effective date is the day the VA receives your claim.¹⁴

If You Disagree With Your Rating

You have three options under the VA’s decision review system. A Supplemental Claim adds new and relevant evidence the VA didn’t have before. A Higher-Level Review has a more senior reviewer re-examine your existing file without new evidence. A Board appeal goes to a Veterans Law Judge and can include a hearing.¹⁵

Which lane fits depends on what went wrong. A Supplemental Claim makes sense when you have additional medical records, a stronger nexus letter, or buddy statements that fill gaps. A Higher-Level Review works when you believe the rater misapplied the regulation to evidence that was already in the file. The Board appeal is the most formal option. Filing promptly on any of the three preserves your effective date.

1
U.S. Department of Veterans Affairs. Veterans Disability Compensation Rates
2
eCFR. 38 CFR 4.3 – Resolution of Reasonable Doubt
3
U.S. Court of Appeals for Veterans Claims. Mauerhan v. Principi, No. 01-468
4
eCFR. 38 CFR 4.130 – Schedule of Ratings, Mental Disorders
5
eCFR. 38 CFR 4.125 – Diagnosis of Mental Disorders
6
Justia Law. Vazquez-Claudio v. Shinseki, No. 12-7114
7
U.S. Department of Veterans Affairs. Board of Veterans Appeals Decision 21001413
8
Federal Register. Evaluative Rating: Impact of Medication
9
eCFR. 38 CFR 4.129 – Mental Disorders Due to Traumatic Stress
10
eCFR. 38 CFR 4.14 – Avoidance of Pyramiding
11
U.S. Department of Veterans Affairs. Individual Unemployability if You Can’t Work
12
U.S. Department of Veterans Affairs. VA Claim Exam (C&P Exam)
13
U.S. Department of Veterans Affairs. Mental Disorders Disability Benefits Questionnaire
14
U.S. Department of Veterans Affairs. Disability Compensation Effective Dates
15
U.S. Department of Veterans Affairs. VA Decision Reviews and Appeals