PTSD VA Rating: Criteria & 2026 Pay

PTSD (diagnostic code 9411) is rated under the VA’s General Rating Formula for Mental Disorders in 38 CFR 4.130, the same formula used for depression, anxiety and other mental health conditions. The rating is based on your level of occupational and social impairment: how much your symptoms affect your ability to work and maintain relationships.

Two points matter more than most veterans realize:

• The symptom lists are examples, not checklists. The criteria say “due to such symptoms as.” You don’t need every listed symptom, and symptoms not on the list still count. What matters is the overall level of impairment, including how often symptoms happen, how severe they are and how long they last.
• All your mental health conditions get one rating. If you’re diagnosed with PTSD and depression, the VA assigns a single rating based on your combined symptoms rather than separate ratings for each.

Under 38 CFR 3.304(f), a PTSD claim generally needs three things:

• A current PTSD diagnosis that meets DSM-5 criteria.
• Evidence that the in-service stressor happened.
• A medical link between the stressor and your symptoms.

Special rules that make the stressor easier to prove

• Combat veterans: your own statement can establish a combat-related stressor if it’s consistent with the circumstances of your service.
• Fear of hostile military or terrorist activity: your statement can be enough if a VA or VA-contracted psychologist or psychiatrist confirms the stressor is adequate to support the diagnosis and is consistent with your service.
• Military sexual trauma (MST): the VA can consider “markers” outside your service records, such as requests for transfer, changes in behavior or performance, statements from family or friends, and records from counselors or rape crisis centers.

PTSD can cause or worsen other conditions, and each can be rated separately when a medical opinion supports the connection:

• Sleep apnea, sometimes through weight gain from medications or reduced activity
• Hypertension and some heart conditions
• GERD and IBS
• Erectile dysfunction, often related to PTSD medications, which can also qualify for SMC-K
• Migraines
• Alcohol or substance use disorders that develop as a result of PTSD

Secondary claims succeed or fail on the medical opinion, so it should explain how PTSD causes or aggravates the condition, not just state that it does.

• Describe your worst days, not your best. Many veterans minimize symptoms out of habit. Be accurate about frequency and severity.
• Talk about work and relationships. Missed work, conflicts with supervisors, isolation, and strained family relationships are what the rating formula measures.
• Bring a written summary of your symptoms, stressors and treatment so nothing gets left out under stress.
• Get a statement from someone close to you. A spouse, family member or friend can describe changes you may not notice yourself.

In South Dakota, PTSD exams are often done at the Sioux Falls VA Medical Center, through the Black Hills VA, by a contracted examiner, or by telehealth.