A PTSD VA claim needs three things: a current PTSD diagnosis, a traumatic event (called a stressor) that happened during service, and a medical link between the two. If VA grants service connection, it rates PTSD from 0% to 100% based on how much your symptoms limit your work and social life, not on the diagnosis alone.
This guide explains the rating levels in plain words and which pieces of evidence tend to matter most.
Key takeaways
- VA looks for a diagnosis, credible evidence that the stressor happened, and a medical link between your symptoms and that event.
- Ratings come in steps of 0, 10, 30, 50, 70 and 100 percent. The symptom lists VA uses are examples, and the rating depends on how much your symptoms affect work and relationships.
- In some situations, such as combat, your own statement can establish the stressor. For military sexual trauma, VA accepts many kinds of evidence.
- VA Form 21-0781, or the optional mental health questions in the online application, lets you describe the event in your own words.
- If you are in crisis, call 988 and press 1 for the Veterans Crisis Line. You do not have to wait for a claim decision.
What does a PTSD VA claim need to succeed?
Under 38 CFR 3.304(f), a PTSD claim generally needs three pieces:
- Medical evidence diagnosing PTSD that follows the DSM-5, the manual mental health providers use.
- Medical evidence linking your current symptoms to an in-service stressor.
- Credible supporting evidence that the stressor occurred.
VA's PTSD compensation page says qualifying events include combat, sexual assault or harassment, certain personal assaults, and other events such as car accidents or witnessing a natural disaster.
The National Center for PTSD explains that PTSD involves four types of symptoms: reliving the event, avoiding reminders, negative thoughts and feelings, and feeling on edge. It says a diagnosis needs each type, and that only a mental health provider can diagnose PTSD.
How does the PTSD rating work?
VA rates PTSD with the General Rating Formula for Mental Disorders in 38 CFR 4.130 (diagnostic code 9411). The table below is a plain-words summary, not the legal text.
| Rating | What VA looks for | Examples VA lists |
|---|---|---|
| 0% | A diagnosis, but symptoms do not interfere with work or social life and do not need continuous medication. | None listed. |
| 10% | Mild or short-lived symptoms that lower work efficiency only during significant stress, or symptoms kept in check by continuous medication. | None listed. |
| 30% | An occasional drop in work efficiency, with some periods of trouble doing tasks, but generally functioning satisfactorily. | Depressed mood, anxiety, suspiciousness, panic attacks weekly or less, chronic sleep problems, mild memory loss. |
| 50% | Reduced reliability and productivity. | Flattened emotions, panic attacks more than once a week, trouble following complex commands, memory problems, poor judgment, changes in mood and motivation, trouble building work and social relationships. |
| 70% | Problems in most areas, such as work, school, family relations, judgment, thinking or mood. | Suicidal thoughts, obsessive rituals that disrupt routines, near-constant panic or depression, poor impulse control, neglecting appearance and hygiene, inability to keep effective relationships. |
| 100% | Total occupational and social impairment. | Severe problems with thinking or communication, persistent delusions or hallucinations, ongoing danger of hurting self or others, trouble with basic daily self-care, disorientation, memory loss for close relatives or your own name. |
The regulation introduces its symptom lists with the words "such symptoms as," so they work as examples, not a checklist. VA also has to consider how often your symptoms happen, how severe they are and how long they last, and it should rate based on all the evidence about work and social impairment, not only the examiner's view on exam day (38 CFR 4.126).
One more note. VA proposed changes to the way it rates mental disorders in February 2022 (87 FR 8498). As of this writing, the criteria above are the ones in the eCFR, so check ecfr.gov for the current text before you rely on any chart.
If the 70% row feels close to home, or you are having thoughts of suicide, please do not wait for a claim. Call 988 and press 1, text 838255, or chat online. The Veterans Crisis Line is free, confidential and open 24/7.
What evidence matters most for a PTSD VA claim?
- A diagnosis and treatment records. Notes from a VA or private mental health provider that show your diagnosis and how your symptoms have changed over time.
- Proof of the stressor. Service records, unit or personnel records, or other documents that fit your account. Give VA details such as where the event happened, roughly when and what unit you were in, because VA uses your statement to help find records.
- A medical link. A provider's opinion connecting your current symptoms to the in-service event. Our guide to the VA nexus letter explains what a strong one covers.
- Your own statement. Use VA Form 21-0781 or the online questions to describe what happened and how it affects you now.
- Statements from others. People who served with you or who see the changes in you can describe what they saw. VA Form 21-10210 is made for this.
- Evidence of daily impact. Notes about missed work, strained relationships, sleep problems or other limits. These help VA see how PTSD affects your life.
When can your own statement establish the stressor?
For some situations, 38 CFR 3.304(f) lets your own testimony establish the stressor, as long as it fits the circumstances of your service and nothing clear and convincing points the other way. These are:
- You engaged in combat with the enemy, and the stressor relates to that combat.
- You were a prisoner of war, and the stressor relates to that experience.
- PTSD was diagnosed during service, and the stressor relates to your service.
- Your stressor involved fear of hostile military or terrorist activity, such as an IED, incoming mortar fire or sniper fire. In this case a VA or VA-contracted psychiatrist or psychologist must confirm that the stressor supports a PTSD diagnosis and that your symptoms relate to it.
For personal assault, including military sexual trauma, the rules allow evidence from many sources: law enforcement, rape crisis or counseling centers, hospitals, and statements from family, roommates, fellow service members or clergy. Changes in behavior can count too, such as a request for a transfer, a drop in work performance, substance use, or unexplained anxiety or depression. Before denying that kind of claim, VA must tell you about these evidence options and give you a chance to send them.
What should you expect at the PTSD claim exam?
VA may schedule a claim exam to learn more about your PTSD. VA says the exam is not treatment. You can ask for a male or female provider for mental health exams. Talk about how often symptoms happen and how they affect sleep, work and relationships. It is fine to say that some topics are hard to discuss. For a full walk-through, read our VA C&P exam tips.
What if your claim is denied or the rating seems low?
A decision is not always the end. VA offers three review paths: a Supplemental Claim with new and relevant evidence, a Higher-Level Review, or a Board Appeal. If your symptoms have gotten worse since the decision, you can also file a claim for increase with current medical evidence. If you want help gathering your paperwork first, SustainBL's VA claims support can help you get organized.
Frequently asked questions
Can I file a PTSD VA claim if I was not in combat?
Yes. VA lists sexual assault, harassment, other personal assaults, car accidents and witnessing a natural disaster among qualifying events, as well as combat. Without combat, you will usually need other evidence that the event happened, such as records, statements or changes in behavior after the event.
What is VA Form 21-0781?
It is the Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s). VA's form page calls it optional. If you apply online for a new mental health condition, you can answer the optional mental health questions in the application instead.
Do I need a diagnosis before I file?
A diagnosis is one of the things VA looks for. You can bring one from a VA or private provider, and VA may also schedule a claim exam if it needs more information. The exam is for your claim, not for treatment.
Can my PTSD rating change over time?
It can. VA may schedule a review exam to see whether a condition has changed. If your symptoms get worse, you can file a claim for increase with current medical evidence of the change.
Do I need a disability rating to get VA mental health care?
Disability compensation and health care are separate. VA says to apply for VA health care to use its PTSD services, which include talk therapy and medicine. If you are in crisis, call 988 and press 1 at any time.
Start the free VA claim questionnaire
Not sure what evidence you already have? Answer a few simple questions and see what your next steps could look like. Start the free VA claim questionnaire whenever you are ready.
This article is general information, not legal, medical or financial advice. SustainBL is not a law firm and does not guarantee any VA decision.
