My PTSD feels like it’s getting worse so why is the VA still keeping me at 30%?

If your PTSD rating is stuck at 30% despite your symptoms worsening, it almost always comes down to one thing: your medical records are not documenting the functional impact of your deterioration. The VA does not rate PTSD based on how severe your symptoms feel to you — they rate based on how clearly those symptoms are documented as impairing your ability to work, maintain relationships, and carry out daily responsibilities. How VA rating criteria work for PTSD (38 CFR § 4.130): - 30% — occasional decrease in work efficiency, difficulty with complex tasks - 50% — reduced reliability and productivity, panic attacks more than once per week, impaired judgment - 70% — deficiencies in most areas including work, family relations, judgement; near-continuous panic or depression - 100% — total occupational and social impairment To move to 50% or higher, your medical records need to show consistent evidence of impairment in occupational and social functioning — not just symptom descriptions, but real-world consequences. What actually moves the rating up: 1. Consistent, detailed documentation from your mental health provider describing functional impairment. 2. A Buddy Statement (lay statement under 38 CFR § 3.303) from a spouse or friend who can describe what they observe at home. 3. A formal PTSD Nexus Letter or IMO from an independent clinician who can write a clinical opinion establishing the severity in terms that map to VA criteria.