PTSD VA Rating: How the 38 CFR § 4.130 Criteria Actually Work (0% to 100%)

VA rates PTSD by the occupational and social impairment shown across the evidence of record. The percentage assigned can affect monthly compensation, but no single symptom or exam answer guarantees a tier. A separate benefit called TDIU may apply when service-connected disabilities prevent substantially gainful employment.

This article breaks down the exact criteria the rater uses — the General Rating Formula for Mental Disorders at 38 CFR § 4.130 — tier by tier, in plain English, with the evidence VA considers when evaluating the full disability picture.

How the General Rating Formula works (DC 9411)

PTSD is rated under Diagnostic Code 9411, but the criteria are shared by nearly every mental-health condition — depression, anxiety, panic disorder — through the General Rating Formula at § 4.130. Two structural rules matter before we get to the tiers:

• The symptom lists are examples, not checklists. The formula says “due to such symptoms as” — and the Federal Circuit in Mauerhan v. Principi held that the listed symptoms are illustrative. The Veterans Court in Vazquez-Claudio added that what controls is the level of impairment the symptoms cause.
• VA compares the disability picture with both evaluations. Under 38 CFR § 4.7, VA assigns the higher evaluation only when the disability picture more nearly approximates that evaluation's criteria; otherwise, VA assigns the lower evaluation.

The six tiers, translated

Here is each tier of § 4.130, what the regulation says, and what it looks like in real life — with the 2026 monthly rate for a single veteran with no dependents.

• 0% — diagnosed, not impairing. A formal diagnosis exists but symptoms are not severe enough to interfere with work or social functioning or to require continuous medication. No payment, but service connection is established — which preserves the effective-date trail for a future increase.
• 10% ($180.42/mo) — mild, intermittent. Occupational and social impairment due to mild or transient symptoms that decrease work efficiency only during periods of significant stress, or symptoms controlled by continuous medication.
• 30% ($552.47/mo) — occasional decrease in efficiency. Intermittent periods of inability to perform occupational tasks, with symptoms like depressed mood, anxiety, suspiciousness, weekly (or less frequent) panic attacks, chronic sleep impairment, and mild memory loss. You generally function, with bad stretches.
• 50% ($1,132.90/mo) — reduced reliability and productivity. Symptoms like flattened affect, panic attacks more than once a week, difficulty understanding complex commands, impaired judgment, impaired abstract thinking, disturbances of motivation and mood, and difficulty establishing and maintaining effective work and social relationships.
• 70% ($1,808.45/mo) — deficiencies in most areas. Work, school, family relations, judgment, thinking, or mood. Example symptoms: suicidal ideation; obsessional rituals; intermittently illogical speech; near-continuous panic or depression affecting the ability to function independently; impaired impulse control; spatial disorientation; neglect of personal appearance and hygiene; difficulty adapting to stressful circumstances (including work); inability to establish and maintain effective relationships.
• 100% ($3,938.58/mo) — total occupational and social impairment. 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.

The most under-reported symptom that changes the tier

Suicidal ideation is a 70%-tier example symptom. Passive thoughts — “sometimes I think everyone would be better off without me” — count. The Veterans Court in Bankhead v. Shulkin held that suicidal ideation alone can support the 70% tier; it does not require a plan, an attempt, or hospitalization. Veterans minimize this at C&P exams for many reasons. Report it honestly, in plain words, including frequency, severity, and duration.

Evidence VA considers for a PTSD rating

1. A C&P exam may be one part of the record. Under 38 CFR § 4.126, VA considers the frequency, severity, and duration of symptoms, periods of remission, and the full record of occupational and social impairment. Describe the complete pattern accurately, including better and worse periods and how symptoms affect work and relationships. More detail is available in the C&P exam guide and the PTSD DBQ field guide.
2. Lay statements fill the record. A spouse's statement describing the nightmares, the isolation, the anger, the missed family events is competent evidence the rater must weigh. See buddy statements: evidence from people who know you.
3. Work records corroborate occupational impairment. Write-ups, accommodations, job changes, firings, and gaps in employment are exactly what “deficiencies in work” looks like on paper.
4. Treatment notes matter — but absence of treatment is not absence of disability. Consistent therapy notes help, but the VA cannot deny a tier solely because you toughed it out without treatment.

Conditions sometimes evaluated as secondary

A veteran may ask VA to evaluate another diagnosed condition as secondary conditions under 38 CFR § 3.310. Each theory needs condition-specific evidence showing that a service-connected disability caused or aggravated the other condition. The following are research starting points, not automatic links or ratings:

• Obstructive sleep apnea — requires its own diagnosis and medical evidence addressing the claimed connection or aggravation. Background: sleep apnea secondary to PTSD.
• GERD — any claimed connection or aggravation requires condition-specific evidence.
• Migraines — any separate evaluation depends on the migraine evidence and the applicable rating criteria.
• Hypertension — a diagnosis alone does not establish that PTSD caused or aggravated it.
• Erectile dysfunction — medication history may be relevant, but neither service connection nor special monthly compensation is automatic.

The Claim Coach secondaries track organizes questions and evidence to discuss with a VA-accredited representative.

Five documentation gaps that can leave an incomplete record

1. Describing only one moment. Explain the full pattern of symptoms, including frequency, severity, duration, remissions, and effects on work and relationships.
2. Hiding suicidal ideation. It is a 70%-tier symptom and the most under-reported one. Honesty here is not weakness; it is accuracy.
3. No collateral statements. The people who live with you see what you minimize. Lay evidence can describe observable changes and should remain accurate to what the writer saw.
4. Not reviewing the decision and evidence. If the decision does not reflect the record as you understand it, review the reasons and available options with an accredited representative. Educational background on review lanes is available in HLR vs Supplemental vs Board.
5. Assuming TDIU is automatic. A 70% PTSD rating meets the single-disability percentage threshold in § 4.16(a), but VA must separately determine whether service-connected disabilities prevent substantially gainful employment.

Quick answers

Educational content only. This is not legal, medical, or financial advice. Always consult an accredited VSO or VA-accredited attorney for claim-specific guidance. Data validated August 20, 2026. Primary authorities: 38 CFR § 4.130 (General Rating Formula for Mental Disorders, Diagnostic Code 9411), § 4.7 (higher of two evaluations), § 4.126 (evaluation of mental disorders), § 4.16 (TDIU), § 3.310 (secondary service connection). Case law: Mauerhan v. Principi, 16 Vet. App. 436 (2002); Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013); Bankhead v. Shulkin, 29 Vet. App. 10 (2017). 2026 rates are read from the site-wide effective-dated VA rate source. If you are in crisis, call or text 988 and press 1 for the Veterans Crisis Line.