38 CFR Part 4 — 38 CFR § 4.130

Persistent depressive disorder (dysthymia) — VA Diagnostic Code 9433

Mental health

Diagnostic code

9433

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38 CFR § 4.130 lists Diagnostic Code 9433 as “Persistent depressive disorder (dysthymia).” The name has no percentage beside it. Note 2 says ratings under diagnostic codes 9201 to 9440 will be evaluated using the General Rating Formula for Mental Disorders. DC 9433 is inside that span.

Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was up to date as of 2026-10-01 and last amended on 2026-08-27. The § 4.130 source note prints 79 FR 45100, Aug. 4, 2014.

The rating criteria at each level

General Rating Formula for Mental Disorders — diagnostic codes 9201 to 9440, including DC 9433

Rating %: 100

Criteria (verbatim). 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.

Rating %: 70

Criteria (verbatim). 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.

Rating %: 50

Criteria (verbatim). 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.

Rating %: 30

Criteria (verbatim). 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).

Rating %: 10

Criteria (verbatim). 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.

Rating %: 0

Criteria (verbatim). 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.

Rating %	Criteria (verbatim)
100	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.
70	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.
50	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.
30	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).
10	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.
0	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.

The formula uses the words “such symptoms as” and “such as.” Those words are part of the printed lines.

Note 2, printed under the eating-disorder table: Ratings under diagnostic codes 9201 to 9440 will be evaluated using the General Rating Formula for Mental Disorders. Ratings under diagnostic codes 9520 and 9521 will be evaluated using the General Rating Formula for Eating Disorders.

DC 9433 does not print its own 100, 70, 50, 30, 10, or 0 line. The lines above are the formula Note 2 names.

The opening of § 4.130 says the nomenclature employed in this portion of the rating schedule is based upon the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and it points to § 4.125 for availability information. It says rating agencies must be thoroughly familiar with this manual to properly implement the directives in § 4.125 through § 4.129 and to apply the general rating formula for mental disorders in § 4.130. 38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just.

DC 9434 is major depressive disorder. The public page is the depression guide. DC 9435 is unspecified depressive disorder. DC 9440 is chronic adjustment disorder. DC 9411 is posttraumatic stress disorder. The public page is the PTSD guide. Note 2 puts 9201 to 9440, including those codes and DC 9433, on this formula.

The eating-disorder table caption is “Rating Formula for Eating Disorders.” Note 2 calls that formula the “General Rating Formula for Eating Disorders.” DC 9433 is not 9520 or 9521.

Source: 38 CFR § 4.130, Diagnostic Code 9433 and the General Rating Formula for Mental Disorders, eCFR full-text XML for 2026-10-01.

What the words mean in your records

No percentage on the name

The schedule lists “9433 Persistent depressive disorder (dysthymia)” and then the formula. The percentage lines belong to the formula, which Note 2 assigns to diagnostic codes 9201 to 9440.

Dysthymia in the title

The parenthetical on DC 9433 is “dysthymia,” lowercase. DC 9435 is “Unspecified depressive disorder.” DC 9434 is “Major depressive disorder.” The schedule prints three names.

Such symptoms as

The 100, 70, 50, and 30 percent lines use “such symptoms as” or “such as.” The 10 percent line is mild or transient symptoms during periods of significant stress, or symptoms controlled by continuous medication. The 0 percent line is a formally diagnosed mental condition whose symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.

Evidence that speaks to each level

The formula level

What the rater needs to see. The occupational and social impairment the formula describes, including the symptoms the line lists after “such symptoms as” or “such as.”

Where that usually lives. The mental-health examination and the treatment records that describe work and social function.

The diagnosis name

What the rater needs to see. Whether the diagnosis in the record is persistent depressive disorder (dysthymia), or another name the schedule lists under a different code.

Where that usually lives. The diagnosis in the examination report, read against the § 4.130 list.

Level	What the rater needs to see	Where that usually lives
The formula level	The occupational and social impairment the formula describes, including the symptoms the line lists after “such symptoms as” or “such as.”	The mental-health examination and the treatment records that describe work and social function.
The diagnosis name	Whether the diagnosis in the record is persistent depressive disorder (dysthymia), or another name the schedule lists under a different code.	The diagnosis in the examination report, read against the § 4.130 list.

VA’s public DBQ list, checked October 5, 2026, names “Mental Disorders” under Psychological. It also names “PTSD Review” as a separate form. The mental-disorders file is Mental Disorders.

The exam form

DC 9433 uses the general formula. This page does not say the form replaces that formula. The PTSD form is the separate list entry.

Related codes and how they interact

Unspecified depressive disorder is a different listed name.

DC 9435 is unspecified depressive disorder. Note 2 puts it on this same formula. The schedule does not print one name for both codes.

Secondary conditions and presumptions

The 2026-10-01 text of 38 CFR § 3.309(c)(1) lists “Dysthymic disorder (or depressive neurosis).” That row has no diagnostic code. It does not say “Persistent depressive disorder (dysthymia).” Section 3.309(c)(1) also lists “Psychosis.” and “Any of the anxiety states.” Those rows have no diagnostic code. 38 CFR § 3.309(a) lists “Psychoses.” That row has no diagnostic code. This page does not assign DC 9433 to those names.

Short answers

What is the VA rating for persistent depressive disorder?

Diagnostic Code 9433 in 38 CFR § 4.130 is evaluated under the General Rating Formula for Mental Disorders. The lines are 100, 70, 50, 30, 10, and 0 percent. Education only. VA decides on the evidence.

Which note assigns the formula?

Note 2 says ratings under diagnostic codes 9201 to 9440 will be evaluated using the General Rating Formula for Mental Disorders. DC 9433 is in that span. The same note sends 9520 and 9521 to the eating-disorder formula.

FAQ

What percentages apply to DC 9433?

Note 2 says ratings under diagnostic codes 9201 to 9440 use the General Rating Formula for Mental Disorders. The formula lines are 100, 70, 50, 30, 10, and 0, based on occupational and social impairment. DC 9433 does not print a separate percentage. Education only.

Is persistent depressive disorder the same code as major depression?

No. DC 9434 is major depressive disorder. DC 9433 is persistent depressive disorder (dysthymia). DC 9435 is unspecified depressive disorder. Note 2 puts all three on the same formula.

Does the prisoner-of-war list assign this code?

Section 3.309(c)(1) says “Dysthymic disorder (or depressive neurosis).” It does not say “Persistent depressive disorder (dysthymia),” and that row has no diagnostic code.

Next steps

Read the decision for DC 9433 or another code in 9201 to 9440, and the formula level it names.
The free worksheet is a place to write the code, the findings, and the records you already have. It does not file a claim or protect a filing date. An accredited representative is at find a VSO.
Other mental-disorder codes are on the mental-health diagnostic-code index. The category page is mental health conditions.

Education only. Not legal or medical advice. My Claim Packet is not a VA-accredited representative and does not file claims. VA decides every claim on its own evidence.

Other codes in this body system

Nearby catalog entries in Mental health, ordered by diagnostic code number. All Mental health codes

Also: DC code lookup (tools) lists the same index in a compact layout.

Source: 38 CFR Part 4, Diagnostic Code 9433 • va.gov

How to give a complete Persistent Depressive Disorder C&P answer

Context matters

Short answers can leave out frequency, duration, treatment, and functional effects. The examples below show what information may still need to be explained. They are not scripts.

Example incomplete answer
“It's been like this so long it's just normal for me.”
Context to add, if true
Chronic doesn't mean mild. Persistent depressive disorder by definition is 2+ years — describe how much it has eroded baseline functioning, not just current state.
Example incomplete answer
“I'm not as bad as someone with major depression.”
Context to add, if true
Don't compare. Dysthymia uses the same General Rating Formula as MDD — your tier is set by impairment, not diagnostic label.

Answer in your own words. Describe what is true, including better periods and flare-ups, without minimizing or exaggerating. No phrase guarantees a rating or claim outcome.

⚠️ Important Disclaimer

This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.