Mental Health
PTSD, Depression, Anxiety Disorders, MST-Related PTSD, Bipolar Disorder, Adjustment Disorder & Chronic Insomnia
Mental health is the largest claim category in the VA system, and the most misunderstood. The rating does not follow the diagnosis. It follows how the condition affects work, relationships, and daily functioning, which means the evidence of impairment matters as much as the diagnosis itself. Our licensed psychiatrists and psychologists, serving veterans in all 50 states, prepare nexus letters and independent medical opinions for stressor-based PTSD claims, MST claims built on markers, depression and anxiety secondary to physical conditions, and the physical conditions that develop downstream of PTSD. Every opinion rests on an established diagnosis, a written medical mechanism, and reasoning grounded in your records and the medical literature.
About Mental Health Claims
One rating formula governs every mental health condition. PTSD, depression, anxiety, bipolar disorder, and the rest are all rated at 0%, 10%, 30%, 50%, 70%, or 100% under the General Rating Formula for Mental Disorders, and the formula measures one thing: occupational and social impairment. Two veterans with identical diagnoses can hold very different ratings. What separates them is the evidence of function. Missed workdays, strained relationships, memory problems, panic in public places, the jobs that did not last. If the file does not show it, the rating does not reflect it.
Connection to service runs in both directions here, and that is what makes this system the hub of so many claims. A stressor connects PTSD to service directly, with relaxed verification rules for combat and fear of hostile activity, and marker-based evidence rules for military sexual trauma. Physical conditions connect mental health secondarily, with depression secondary to chronic pain among the most common claims the VA sees. And service-connected mental health conditions anchor physical secondaries of their own: sleep apnea, GERD and IBS, hypertension, and migraines all have documented pathways out of PTSD.
The recurring evidence problem is the exam itself. A C&P evaluation is a short snapshot, and many veterans present composed for thirty minutes while their daily reality looks very different. Strong claims solve this with evidence the snapshot cannot see: treatment records over time, statements from the people who live and work with you, and documentation of impairment across settings rather than a single morning.
Mental Health Conditions
Click any condition to view its dedicated page with DC codes, rating criteria, secondary connections, and specialist guidance.
We are currently updating our list of specific conditions in this category. Contact us for a free consultation about your specific claim.
Common Mental Health Service-Connection Pathways
Mental health connects to service, and to other conditions, in both directions. These are the relationships we document most often, in plain medical terms.
The direct pathway. Combat and fear of hostile activity carry relaxed verification rules. Non-combat stressors need supporting evidence, and the opinion connects the verified event to the current diagnosis.
Service-connected pain that limits work, sleep, and activity is a recognized cause of depression. One of the most common and most supportable secondary claims in the system.
Constant ringing disrupts sleep, concentration, and quiet. Because tinnitus is the most commonly service-connected condition, this pathway is open to many veterans, but it needs its mechanism written out.
A single condition rated 70% meets the schedular threshold for TDIU. When symptoms prevent substantially gainful employment, TDIU pays at the 100% rate.
The VA recognizes that most military sexual trauma was never officially reported, so these claims do not depend on a report that may not exist. They can be supported instead by what the VA calls markers: changes in performance evaluations, a request for transfer, health visits around the time of the event, or a statement from someone you confided in. A careful and private record review often finds support a veteran did not know was there.
Why Mental Health Claims Can Be Challenging
Understanding these challenges in advance is the first step toward building a clearer medical record — and knowing where additional evidence may help.
The Rating Follows Function, Not Diagnosis
A PTSD diagnosis alone supports 0%. The rating comes from documented impairment at work and at home. Files heavy on diagnosis and light on function get rated low.
The Thirty-Minute Snapshot
Veterans trained to hold composure present well at a short C&P exam. The record has to show the days the examiner never sees, through treatment notes, lay statements, and work history.
Stressor Verification
Combat stressors have relaxed rules. Non-combat stressors need evidence, and MST claims need markers. Knowing which standard applies to your claim changes what you gather.
One Combined Rating
The VA rates all mental health conditions together, not separately. Every diagnosis still matters, because each contributes symptoms to the combined picture and each can anchor its own physical secondaries.
Secondaries Run Both Directions
Depression flows from pain. Sleep apnea flows from PTSD. Files routinely capture one direction and miss the other, leaving ratable conditions unclaimed.
The Need for Detailed Rationale
A conclusion alone carries little weight. The reasoning earns the credibility. The medical why, backed by literature and the record.
Medical Evidence Services for Mental Health Claims
Clinician-led services support mental health claims at different stages. Each one focuses on the evidence: an established diagnosis, a written mechanism, and function documented in rating terms.
Independent Medical Opinion / Nexus Letter
A clinician's written opinion on whether a condition is at least as likely as not connected to service, with the supporting medical rationale.
When you need to establish or strengthen the causal link — particularly for secondary claims or a claim that was previously denied.
Connects verified stressors to current diagnoses. Writes the depression secondary to chronic pain mechanism in full. Builds marker-based support for MST claims. Documents the physical conditions downstream of PTSD, with every supported theory in one letter.
Disability Benefits Questionnaire (DBQ)
Standardized disability questionnaires completed by licensed clinicians to evaluate the severity of your conditions according to VA rating criteria.
When you are filing for an initial rating, an increase, or need to document current functional impairment for a C&P exam.
Documents occupational and social impairment in the language of the General Rating Formula, across settings and over time, so the rating reflects your daily reality rather than one composed morning.
Claim Readiness Review
A pre-filing review of your medical records to identify what is already documented and what evidence may be missing.
Before filing or refiling, when you want a clear, honest picture of where a claim stands medically.
Checks whether the diagnosis is properly established, whether stressor or marker evidence exists, whether functional impairment is documented anywhere, and whether secondary pathways in either direction were ever explored. Before you file, not after the denial.
Veterans Usually Pair Mental Health With These Systems
Mental health pairs most often with pulmonology (PTSD driving sleep apnea), gastroenterology (anxiety driving GERD and IBS), cardiology (PTSD driving hypertension), and neurology (migraines and TBI overlap).
Frequently Asked Questions
Yes, when three elements line up. A current PTSD diagnosis from a qualified clinician. A verified in-service stressor. And a medical opinion linking the two. The stressor rules are more flexible than many veterans think. Combat and fear of hostile military or terrorist activity carry relaxed verification standards, and military sexual trauma has its own evidence rules built around markers rather than official reports.
Every mental health condition is rated under one General Rating Formula at 0%, 10%, 30%, 50%, 70%, or 100%. The rating does not follow the diagnosis. It follows occupational and social impairment: how the condition affects work, relationships, memory, judgment, and daily functioning. Two veterans with the same diagnosis can carry very different ratings, and the evidence of functional impairment is what separates them.
The 70% level describes deficiencies in most areas: work, school, family relations, judgment, thinking, or mood, with symptoms like suicidal ideation, near-continuous panic or depression affecting independent functioning, impaired impulse control, or neglect of personal appearance. It matters beyond the monthly amount, because a single condition rated 70% opens the schedular door to TDIU. Documentation that captures how symptoms actually play out at work and at home is usually what separates the two levels.
Yes, and it is one of the most common and most medically supportable secondary claims in the VA system. Living with service-connected pain that limits work, sleep, and activity is a recognized cause of depression. The opinion documents that relationship in your specific case: the pain condition, the functional losses it caused, and the timeline of the depressive symptoms that followed.
It can contribute, and the literature supports the relationship. Constant ringing disrupts sleep, concentration, and quiet, and for some veterans it becomes a daily stressor that feeds anxiety and depressive symptoms. Because tinnitus is the most commonly service-connected condition, this pathway is available to many veterans, but it is dismissed when the opinion asserts the link in one sentence instead of explaining it.
Yes. Service-connected PTSD is the starting point for several well-documented secondary claims: sleep apnea through sleep fragmentation and medication-related weight gain, GERD and IBS through the gut-brain axis and chronic stress physiology, hypertension through sustained sympathetic activation, and migraines through stress-induced neurovascular changes. Because the claimed condition in these cases is physical, the opinion comes from a physician in the matching specialty, and you will find those claims on our Pulmonology, Cardiology, and Gastroenterology pages. The clinicians here document the psychiatric condition that anchors the chain.
No. The VA assigns one combined rating for all mental health conditions together, because their symptoms overlap and the rating formula measures total occupational and social impairment. This is not a reason to leave a diagnosis unclaimed. Documenting every condition ensures the full symptom picture counts toward that single rating, and each service-connected mental health condition can still anchor its own physical secondaries.
The stressor is the in-service event the PTSD traces back to. Verification depends on the type. Combat stressors and fear of hostile military or terrorist activity can often be established through service records and a clinician's confirmation rather than incident-level proof. Non-combat stressors need supporting evidence, which can include unit records, buddy statements, and contemporaneous documentation. The medical opinion then connects the verified stressor to the current diagnosis.
Yes. The VA recognizes that most MST is never officially reported, so these claims can be supported by markers instead: a drop in performance evaluations, requests for transfer, disciplinary changes, substance use that began after the event, medical visits for related complaints, or statements from people you confided in at the time. A careful record review often surfaces markers a veteran did not realize counted as evidence.
This is the most common complaint in mental health claims, and it has a structural cause. A C&P exam is a short snapshot, and many veterans present composed for thirty minutes while their daily reality looks very different. The fix is evidence that covers time the exam cannot see: treatment records, statements from family and coworkers who observe daily functioning, work and attendance records, and an independent evaluation that documents impairment across settings rather than a single morning.
Yes, and mental health is one of the most common foundations for TDIU. When a service-connected psychiatric condition prevents substantially gainful employment, TDIU pays at the 100% rate even if the schedular rating is lower. The medical documentation must connect specific symptoms to specific work capacities: concentration, reliability, interacting with supervisors and the public, and adapting to workplace stress.
You need a mental health clinician, and that is all we use for this system. Both cost the same with us, so the choice comes down to the question your claim turns on. A licensed psychologist is the stronger author when the fight is about the diagnosis and its severity: structured evaluations, PTSD and MST assessments, and functional documentation in rating-formula language. A psychiatrist is the stronger author when the fight is medical: symptoms the VA blamed on a medical cause, layered diagnoses where ownership of symptoms is disputed, or rebutting a physician C&P examiner. We match the author to the question, and we explain the reasoning before you commit.
A current diagnosis from a qualified clinician. Evidence of the in-service stressor or the link to another service-connected condition. And functional evidence, which is the part most files are missing: treatment records over time, lay statements from people who see you daily, work history showing missed days or lost jobs, and documentation of how symptoms affect relationships and routine. The rating formula measures function, so the file has to show function.
No. A nexus letter is claim evidence, not ongoing treatment, so distance does not matter. The clinician reviews your records, conducts any needed evaluation by secure telehealth, and signs an opinion that carries the same weight with the VA whether it was written across town or across the country. What the VA weighs is the author's credentials and reasoning.
All 50. Our psychiatrists and psychologists work with veterans nationwide through secure telehealth and records review, whether you are in California, Texas, Florida, New York, or anywhere else. Rural veterans and those far from a VA facility use the same process as everyone else, with nothing lost to distance.
It is the medical-evidentiary standard used in nexus opinions. It means the probability of a connection is at least 50 percent, as likely as not. A clinician uses it to state, in medical terms, whether a condition is reasonably connected to service. It is a medical opinion, not a legal determination.
A discovery call is a no-obligation conversation about your conditions, your history, and your goals. We talk through the pathways that might fit, whether that is a stressor-based PTSD claim, a depression secondary to chronic pain theory, or physical conditions downstream of PTSD, and explain whether additional medical evidence would help. There is no pressure to proceed. If a letter would not add value to your claim, we will tell you.