Mental health · 38 CFR 4.130
Mental Health Conditions and VA Disability
Mental health is the largest area of VA disability claims, and one of the hardest to prove on paper. PTSD, depression, and anxiety are the most common. The VA rates nearly all of them with one set of rules, the General Rating Formula in 38 CFR 4.130.
Patriot Path writes the medical piece of these claims. Our licensed psychologists and physicians write nexus letters and independent medical opinions that connect your condition to your service. One flat fee of $1,500, and the first consultation is free.
Reviewed by the Patriot Path Medical Team
Licensed psychologists (PhD) and physicians • Last updated: June 2026
Conditions in this system
These are the mental health conditions veterans claim most. PTSD has a full guide now, with a rating estimator and the service-connection pathways. The rest are on the way.
- PTSD
The most claimed mental health condition. Special stressor rules apply.
DC 9411
- Depression
Major depressive disorder. Often tied to chronic pain or another service condition.
DC 9434
- Anxiety
Generalized anxiety disorder and related conditions.
DC 9400
- Bipolar disorder
Mood swings between deep lows and high, manic periods.
DC 9432
- Adjustment disorderGuide in progress
A strong, lasting reaction to a stressful change or event.
DC 9440
- Panic disorder
Repeated panic attacks, sometimes with agoraphobia.
DC 9412
How the VA rates mental health conditions
Nearly every mental health condition is rated with the same yardstick: the General Rating Formula in 38 CFR 4.130. The rating is 0, 10, 30, 50, 70, or 100 percent.
What moves the number is how much the condition affects your work and your relationships, called occupational and social impairment. The symptoms in the rules are examples, not a checklist. You do not have to match every one to earn a rating level.
One thing surprises a lot of veterans: if you have more than one mental health diagnosis, the VA gives you a single combined rating for all of them, not a separate rating for each.
Connecting a mental health condition to service
- Direct. The condition started in or was caused by service. PTSD has its own stressor rules (38 CFR 3.304(f)) for combat, fear of hostile activity, and military sexual trauma.
- Secondary. Another service-connected condition caused or worsened it (38 CFR 3.310). Depression from chronic pain, tinnitus, or sleep apnea is common. Because the VA combines all mental health conditions into one rating, a mental health condition is not rated as secondary to another one.
- Aggravation. Service made a condition you already had meaningfully worse.
For most claims the VA needs a current diagnosis, an in-service cause, and a medical opinion linking them (38 CFR 3.303). That opinion has to clear the “at least as likely as not” standard, a 50% or better chance. That standard is the benefit-of-the-doubt rule under 38 U.S.C. 5107(b), carried out in 38 CFR 3.102. A nexus letter is that linking opinion.
Frequently asked questions
How does the VA rate mental health conditions?
Almost every mental health condition uses one set of rules, the General Rating Formula in 38 CFR 4.130. The VA assigns 0, 10, 30, 50, 70, or 100 percent based on how much the condition affects your work and your relationships, not on a checklist of symptoms.
Can I get separate ratings for PTSD and depression?
Usually not. When you have more than one mental health diagnosis, the VA gives a single combined rating under 4.130 for all of them together, rather than stacking them.
What makes a PTSD claim different?
PTSD has special service-connection rules (38 CFR 3.304(f)) about proving the in-service stressor. Combat, fear of hostile activity, and military sexual trauma each have their own evidence standards. See the PTSD guide for details.
Can a mental health condition be secondary to another condition?
Yes, when the cause is a service-connected condition in another body system, such as chronic pain, tinnitus, or sleep apnea. Note that the VA combines multiple mental health diagnoses into one rating, so a mental health condition is not rated as secondary to another mental health condition.
Do I need a nexus letter for a mental health claim?
Often, yes. If your stressor is not automatically accepted, or the condition was diagnosed after service or claimed as secondary, a nexus letter is usually what links it to your service and decides the claim.
Carrying something from service?
You do not have to explain it twice. The first consultation is free, and we will tell you straight whether a nexus letter can strengthen your claim.
Sources & regulatory references
- VA disability compensation (VA.gov) https://www.va.gov/disability/
- 38 CFR 4.130, Schedule of ratings, mental disorders (eCFR) https://www.ecfr.gov/current/title-38/section-4.130
- 38 CFR 3.304, Direct service connection (PTSD stressor rules) (eCFR) https://www.ecfr.gov/current/title-38/section-3.304
- 38 CFR 3.310, Secondary service connection (eCFR) https://www.ecfr.gov/current/title-38/section-3.310
- 38 U.S.C. 5107, Benefit of the doubt (Cornell LII) https://www.law.cornell.edu/uscode/text/38/5107