Depression VA Rating

Depression is rated under the same regulation as PTSD. Same six tiers, same symptom lists, same formula. A veteran with both diagnoses ends up with one rating, not two.

The reason isn't that depression is less disabling. 38 CFR § 4.130 rates every mental disorder except eating disorders under one General Rating Formula, and the pyramiding rule at § 4.14 keeps the same symptoms from being counted twice. This page walks through the formula word for word, how the depression diagnoses differ, the one-rating rule, the 50 to 70 percent line, how to prove service connection, what a depression nexus letter has to answer, the C&P exam, why claims get denied, TDIU, and the conditions claimed secondary to depression.

TL;DR

• Depression is rated under 38 CFR § 4.130, the General Rating Formula for Mental Disorders, at 0, 10, 30, 50, 70 and 100 percent, based on occupational and social impairment.
• Major depressive disorder (DC 9434), persistent depressive disorder (DC 9433), unspecified depressive disorder (DC 9435) and chronic adjustment disorder (DC 9440) all use that one formula.
• With PTSD, anxiety or another mental health diagnosis, VA assigns one rating for the combined impairment (38 CFR §§ 4.14 and 4.130).
• For a secondary claim, the nexus letter has to answer both causation and aggravation (El-Amin v. Shinseki) and explain why.
• After a service-connected TBI, depression that appears within 3 years of a moderate or severe TBI, or within 12 months of a mild one, is held to be caused by the TBI (38 CFR § 3.310(d)).
• VA proposed a new mental health rating formula in 2022. As of October 2026 it is still only a proposal, and § 4.130 is the rule VA applies.

Depression VA rating criteria under 38 CFR § 4.130

Depression has no rating table of its own. It is rated under the General Rating Formula for Mental Disorders in 38 CFR § 4.130, which reads as follows.

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: 100%

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: 70%

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: 50%

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): 30%

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: 10%

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: 0%

The symptoms at each tier follow the words "such as," so they are examples, not a checklist. The tier is set by the overall level of occupational and social impairment. Two other rules shape how VA reads it. Under 38 CFR § 4.126(a), VA has to weigh the frequency, severity and duration of symptoms, the length of remissions and all the evidence, "rather than solely on the examiner's assessment of the level of disability at the moment of the examination." Under § 4.126(b), social impairment counts but cannot be the only basis for the rating.

For severely impaired veterans, the step from 70 to 100 percent is the structural hurdle, for the same reason as PTSD. A veteran can clear "deficiencies in most areas" at 70 percent without clearing "total occupational and social impairment" at 100 percent. At the rates effective December 1, 2025 (the 2026 rates), a veteran with no dependents is paid $552.47 a month at 30 percent, $1,132.90 at 50 percent, $1,808.45 at 70 percent and $3,938.58 at 100 percent.

A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Across 12,973 decided Board rulings on depression from 2021 to 2026, 38.7% were granted, 33.6% denied and 27.7% remanded, so a grant is the most common outcome, and the grant rate runs 14.0 points above the Board-wide 24.7%. The data records the outcome of each ruling rather than the schedular rating tier, so it cannot show which tier depression claims most often receive. The Board section below shows how rating appeals compared with service connection appeals.

MDD, persistent depressive disorder and adjustment disorder

The rating schedule lists major depressive disorder under DC 9434, persistent depressive disorder (dysthymia) under DC 9433, unspecified depressive disorder under DC 9435 and chronic adjustment disorder under DC 9440. All of them are rated on the same formula, so the label does not set the percentage. It matters more for service connection.

Major depressive disorder. The most common depression diagnosis in these claims. It can come in episodes, so records should show how the depression affects work and relationships over time, not only during the worst stretch.

Persistent depressive disorder. DSM-5 merged dysthymia and chronic major depressive disorder into this diagnosis, defined by depressed mood for most of the day, on more days than not, for at least two years in adults (Patel and colleagues, StatPearls, 2024, PMID 31082096). Being persistent does not set the percentage by itself. Your records should explain how symptoms affect work, relationships, judgment, thinking, mood and daily functioning over time.

Adjustment disorder. The schedule lists only chronic adjustment disorder. Trouble often starts when service records show an adjustment disorder and a later diagnosis is major depressive disorder. Under 38 CFR § 4.125(b), when a mental disorder diagnosis changes, VA has to decide whether the new diagnosis is a progression of the old one, a correction of an error, or a new and separate condition, and it has to return the report to the examiner when the records do not make that clear. An opinion that explains why the later depression grew out of the in-service diagnosis answers that question directly.

If you have another diagnosis such as anxiety, PTSD or adjustment disorder, VA cannot pay twice for the same occupational and social impairment. A clear clinical history is more useful than treating each diagnostic label as a separate rating.

Sources: 38 CFR § 4.130, DC 9433 (opens in a new tab) and § 4.14, overlapping manifestations (opens in a new tab).

One rating for depression and PTSD

This is probably the most consequential thing to understand about depression ratings. 38 CFR § 4.14 says that "the evaluation of the same disability under various diagnoses is to be avoided," and Note 2 to § 4.130 puts every diagnostic code from 9201 to 9440 on the same General Rating Formula. Together, those rules are why a veteran with PTSD and major depression gets one mental health rating that reflects the impairment from both, not a PTSD rating plus a depression rating.

The examiner's form works the same way. The Mental Disorders DBQ asks for one level of occupational and social impairment "with regard to all mental diagnoses," and then asks whether the examiner can say which impairment comes from each disorder.

A few things follow.

• The depression diagnosis can still raise the rating. When depression adds impairment the PTSD picture did not capture, such as loss of interest, low motivation or trouble finishing tasks, the combined rating can move from 50 to 70 percent or from 70 to 100 percent.
• The rule cuts both ways. The same symptoms cannot be counted twice, but symptoms that are genuinely separate can each add to the picture.
• Physical conditions are different. The one-rating rule covers mental disorders. A physical condition caused by depression, such as sleep apnea, is rated on its own.

The 50 to 70 percent line for depression

As with PTSD, the biggest decision in many depression rating appeals is whether the case lands at 50 or 70 percent. The structural difference is whether deficiencies appear in "most areas" of life.

The cases that move from 50 to 70 percent usually do it on the strength of documented impact. The medical picture was already in the record. What was missing was specific evidence of how the depression affected work, family and social life. For depression, the 50 versus 70 line often turns on documentation of these points.

• Whether the depression affects work attendance, productivity or reliability over an extended period
• Whether family relationships have been measurably affected, such as separation, divorce or estrangement
• Whether you have had to cut hours, change jobs or leave work
• Whether social withdrawal is documented as significant rather than mild
• Whether judgment, motivation or the ability to plan and finish tasks is documented as impaired

They do not all have to be present. "Most areas" means most, not all. Statements from a spouse, coworker or friend about what has changed can fill in what clinic notes leave out; buddy letters and a personal statement are the usual way to add them.

How to prove service connection for depression

There is no presumption that covers depression on its own, so the claim is usually direct or secondary.

Depression that began in service

A direct claim needs a current diagnosis, evidence that the depression began in service or was caused by something that happened there, and a medical opinion that links them (38 CFR § 3.303). In-service onset can show up as mental health visits, antidepressant prescriptions, command-directed evaluations, or notes of low mood, by whatever label.

The harder cases are the ones where service records do not reflect what was happening. Many service members did not seek mental health care on active duty, and thin records are common. When the depression started in service but was not documented, the claim leans on statements from people who saw the change, the timing of the first diagnosis after service, and an opinion that addresses the gap.

Depression has no stressor verification rule. The stressor rules at 38 CFR § 3.304(f) are written for PTSD. For a combat veteran, § 3.304(d) accepts satisfactory lay evidence that a disease began in combat when it is consistent with the circumstances of that service.

Depression secondary to a service-connected condition

Under 38 CFR § 3.310, depression can be service connected when a service-connected condition caused it, or when your depression is aggravated by your service-connected condition, meaning it would be less severe but for that condition (M21-1 V.ii.2.D). VA rates only the part above the baseline, so the opinion should describe the baseline.

• Chronic pain. Depression is often claimed secondary to painful service-connected conditions such as a back or knee condition.
• Tinnitus. Depression claimed secondary to tinnitus is common in the Board's decisions, and the opinion has to explain how the tinnitus affects mood in your case.
• Traumatic brain injury. 38 CFR § 3.310(d) holds depression to be caused by a service-connected TBI when it appears within 3 years of a moderate or severe TBI, or within 12 months of a mild one, absent clear evidence to the contrary. Outside those limits, the claim is decided on the ordinary rules.
• PTSD. Depression secondary to PTSD can be granted, but because of the one-rating rule, it changes the mental health rating rather than adding a new one.

The Board section below compares secondary depression claims with direct ones.

Nexus letter for depression

A nexus letter is the medical opinion that links your depression to service or to a service-connected condition. The questions it has to answer depend on the theory, and a strong letter covers each of these points.

1. A diagnosis VA can accept. Under 38 CFR § 4.125(a), if a mental disorder diagnosis does not conform to DSM-5 or is not supported by the findings, VA returns the report to the examiner. The letter should name the diagnosis and the findings behind it.
2. The theory, stated plainly. For a direct claim, it should say when symptoms began, point to the in-service records or events, and explain any gap in treatment after service. For a secondary claim, it has to answer two separate questions: whether the service-connected condition caused the depression, at least as likely as not, and whether your depression is aggravated by your service-connected condition, meaning it would be less severe but for that condition. An opinion that answers only the first is inadequate (El-Amin v. Shinseki, 26 Vet. App. 136 (2013)).
3. The baseline, for aggravation. VA rates only the part above the baseline, so the letter should describe how severe the depression was before the aggravation, from the earliest records available.
4. Overlapping diagnoses. If you also have PTSD, anxiety or a TBI, the letter should say which symptoms come from the depression, or explain why they cannot be separated.
5. The records it relied on. The letter should list the service records, treatment records and statements the clinician reviewed.
6. The reasoning. The Court of Appeals for Veterans Claims has said that "most of the probative value of a medical opinion comes from its reasoning" (Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008)). The letter should explain why the clinician reached the conclusion and deal with the other causes in your file, such as life stressors after service.

Where depression opinions break down

In the Board decisions I've read, depression opinions most often fail for the same reasons: no rationale, a conclusion with no reasoning behind it, records the clinician never reviewed, an incomplete examination, or a specialty that does not fit the question. An opinion can also fail on its facts. When the Board finds that the depression did not actually begin when the opinion says it did, the opinion loses its weight even if it uses the right words. Raven Nexus organizes the records and questions to bring to your clinician; the clinician decides what the opinion can say.

The depression C&P exam and DBQ

VA examines depression on the Mental Disorders DBQ, titled Mental Disorders (Other Than PTSD and Eating Disorders). If you also have a PTSD diagnosis, the form says the Initial PTSD questionnaire is completed instead, by a VHA staff or contract examiner. The examiner is asked to list each mental disorder diagnosis, say whether the symptoms of each can be separated, pick one overall level of occupational and social impairment for all mental diagnoses, and say whether that impairment can be divided among the diagnoses. When a TBI is in the record, the form asks the same questions about the TBI.

The overall impairment level the examiner picks maps directly onto the rating tiers, which makes it the closest thing to a rating recommendation in the file. A form with 70 percent symptoms checked and a 50 percent impairment level selected is an inconsistency worth raising.

Depression is often under-rated at the exam for a few reasons.

• It can look calm in the room. A quiet, cooperative veteran with severe depression can come across as less impaired than the records show.
• The notes repeat. "Depressed mood, low energy, decreased interest" can appear for years with little variation, which hides how severity changed.
• Medication masks severity. The 10 percent tier covers "symptoms controlled by continuous medication," but at higher tiers the picture gets muddier.

That is why § 4.126(a) matters: the rating should rest on all the evidence, not just the exam. Bring statements and records that show what a bad week looks like. C&P exam prep walks through the form before the appointment.

Why VA denies depression claims

Most denials and low ratings come from a few gaps, each with a fix.

No diagnosis VA can accept. The record shows symptoms but no DSM-5 diagnosis supported by findings. The fix is a full evaluation by a psychologist or psychiatrist.

No evidence the depression began in service. The service records are thin. The fix is the in-service evidence you do have, statements from people who saw the change, and an opinion that addresses the gap.

A secondary opinion that addresses only causation. The fix is an opinion that answers both caused by and aggravated by, with a baseline (El-Amin).

An opinion built on a wrong fact. The onset date is off, or the clinician missed key records. The fix is an opinion that names the records reviewed and gets the timeline right.

An in-service adjustment disorder treated as resolved. VA reads the later depression as a new, unrelated condition. The fix is an opinion that explains whether the later diagnosis is a progression of the earlier one, the question 38 CFR § 4.125(b) requires VA to answer.

A rating set by one exam. The fix is the rest of the record: treatment notes over time and statements about work and home life, which § 4.126(a) requires VA to weigh.

The Board section below shows how the Board ruled on depression appeals and why it denied or remanded them.

TDIU with a depression rating

TDIU works the same way for depression as for PTSD. Under 38 CFR § 4.16(a), it pays at the 100 percent rate when service-connected conditions keep you from substantially gainful work, and the schedular threshold is one disability at 60 percent or more, or a combined 70 percent with one disability at 40 percent or more. A 70 percent depression rating clears the single-disability threshold on its own.

For a veteran with no dependents, that is $3,938.58 a month instead of $1,808.45 at 70 percent (2026 rates), a difference of $2,130.13 a month. The evidence that tends to succeed describes how depression interferes with sustained effort, concentration, getting along with others and showing up reliably. The TDIU guide covers the application and the proof.

Depression and secondary claims

Depression is also a cause. Under 38 CFR § 3.310, a condition that service-connected depression caused or made worse is service connected too, and a physical condition is rated on its own rather than folded into the mental health rating. In the Board's 2021 to 2026 rulings, sleep apnea was claimed secondary to depression far more often than any other condition, followed by migraines, hypertension, erectile dysfunction and GERD.

Secondary conditions to depression covers each one, which to file first and the Board's numbers for every pair, and sleep apnea secondary to depression covers the most common of them in full.

The rating math is why this matters. Under 38 CFR § 4.25, a veteran at 70 percent for depression who adds sleep apnea at 50 percent combines to 85, which rounds to 90 percent. For a veteran with no dependents, that is $2,362.30 a month instead of $1,808.45.

Questions veterans ask about depression

What is the VA rating for depression?

Depression is rated under the General Rating Formula for Mental Disorders at 0, 10, 30, 50, 70 or 100 percent. The tier depends on how much the depression impairs work and social functioning, not on the diagnosis label.

What is the VA rating for depression and anxiety?

One rating. VA evaluates all of your mental health diagnoses together under the same formula and does not rate the same impairment twice (38 CFR § 4.14), so depression and anxiety share one rating that reflects their combined effect.

What is the VA rating for persistent depressive disorder?

Persistent depressive disorder (dysthymia) is DC 9433 and uses the same formula, so it can be rated anywhere from 0 to 100 percent. The chronic course does not set the percentage; the documented impairment does.

Do I need a nexus letter for depression?

Usually, unless VA has already linked your depression to service. A nexus letter matters most when the VA exam finds no link, addresses only causation on a secondary claim, or relies on a wrong onset date.

Is depression a presumptive condition?

Not on its own. The closest rule is 38 CFR § 3.310(d): depression that appears within 3 years of a moderate or severe service-connected TBI, or within 12 months of a mild one, is held to be caused by the TBI.

Is VA changing how it rates depression?

VA proposed a new rating formula for mental disorders on February 15, 2022 ("Schedule for Rating Disabilities: Mental Disorders," 87 FR 8498, RIN 2900-AQ82). As of October 2026 it is still a proposal with no final rule, so VA and the Board rate depression under § 4.130.

Bottom Line

Depression is rated under 38 CFR § 4.130, the same General Rating Formula that governs PTSD, at six tiers set by overall occupational and social impairment. With PTSD or anxiety it shares one mental health rating, though it can raise that rating when it adds impairment. The diagnosis label matters most for service connection, especially when an in-service adjustment disorder became depression later. A depression nexus letter has to name a DSM-5 diagnosis, state the theory, answer both causation and aggravation on a secondary claim, and explain its reasoning. Physical conditions caused by depression, led by sleep apnea, are rated on their own. The 2022 proposal to replace the formula is still only a proposal.

Methodology and Limitations

• Data source: Rating criteria are quoted from 38 CFR § 4.130 as published on eCFR (current through October 2026), with 38 CFR §§ 4.14, 4.125 and 4.126. Service connection rules are from 38 CFR §§ 3.303, 3.304(d) and (f), and 3.310, including § 3.310(d) for TBI, with the aggravation standard from M21-1 V.ii.2.D. TDIU eligibility is from 38 CFR § 4.16 and combined ratings from § 4.25. Case law: El-Amin v. Shinseki, 26 Vet. App. 136 (2013), and Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The persistent depressive disorder definition is from Patel RK, Aslam SP, Rose GM, "Persistent Depressive Disorder," StatPearls (2024), PMID 31082096. The proposed rule is 87 FR 8498 (February 15, 2022), RIN 2900-AQ82; the Federal Register lists no final rule under that RIN as of October 2026. Exam content follows VA's Mental Disorders (Other Than PTSD and Eating Disorders) DBQ (version updated October 14, 2025). Compensation figures are VA disability pay rates effective December 1, 2025 (the 2026 rates) for a veteran with no dependents.
• Board snapshot: From 2021 to 2026, the Depression summary covers 12,973 decided Board rulings on depression: 38.7% granted (including partial grants and mixed outcomes), 33.6% denied, and 27.7% remanded. Dismissed, withdrawn and moot rulings are excluded. These are appealed claims, not your personal odds.
• Sample size: Board figures in this post come from Claim Raven's read of every Board decision from 2021 to 2026 that it holds: 511,036 decisions containing 1,378,030 rulings. Of 14,759 Board rulings on depression, 12,973 were decided (granted, denied or remanded); the rest were dismissed, withdrawn or closed another way. Board-wide, the grant rate on decided rulings is 24.7%. The direct and secondary figures count decided service connection rulings. The data captures the outcome of each ruling rather than schedular rating tiers, so this page makes no claim about which tier is most common.
• Classification approach: Tier text is quoted from § 4.130. Rating practice descriptions and the common reasons opinions fail are based on Claim Raven's review of Board decisions involving depression rating appeals and depression service connection claims.
• Limitations:
• The General Rating Formula uses representative symptom lists that are illustrative, not exhaustive. Rating decisions evaluate overall impairment, and individual cases vary.
• Compensation figures use the rates effective December 1, 2025 (the 2026 rates) for a veteran with no dependents. Family rates differ at 30% and above.
• TDIU eligibility described here covers the standard schedular path. Extraschedular TDIU under § 4.16(b) follows a different process.
• The single-rating rule reflects §§ 4.14 and 4.130. Application can vary where mental health conditions present with distinctly separate symptoms.
• Diagnostic distinctions between depressive disorders and adjustment disorder vary across clinicians.
• These observations reflect patterns from the regulatory text and Board decisions. They are not predictions of individual outcomes.