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Conditions PTSD

PTSD VA Rating

Written and reviewed by Landon · Updated October 6, 2026

About 1.76 million veterans are service-connected for PTSD, and many are rated at 70 percent because the 100 percent tier requires total occupational and social impairment.

Board of Veterans' Appeals: 37.6% granted across 41,911 decided Board rulings on PTSD, 2021 to 2026. What this number means

Ask Raven about PTSD

Answers grounded in VA rules and Board decisions. Free to start.

How VA rates PTSD

DC 9411: PTSD

DC 9411 rating criteria and monthly pay
RatingWhat VA looks forMonthly pay (2026, veteran alone)Calculator
0%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$0.00Not applicable
10%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$180.42Try it
30%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)$552.47Try it
50%Occupational and social impairment with reduced reliability and productivity$1,132.90Try it
70%Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood$1,808.45Try it
100%Total occupational and social impairment$3,938.58Try it

Rated under the General Rating Formula for Mental Disorders (38 CFR § 4.130), which covers DCs 9201 through 9440. Each level lists its symptoms after the words "due to such symptoms as", so the symptoms are examples of the level of occupational and social impairment rather than a checklist. Panic attacks weekly or less often are listed at 30 percent and panic attacks more than once a week at 50 percent. The same formula applies to the listed mental health diagnostic codes, including DC 9400 (anxiety), DC 9404 (OCD), DC 9411 (PTSD), DC 9432 (bipolar), DC 9434 (MDD), and DC 9440 (chronic adjustment disorder). When a mental disorder that develops in service as a result of a highly stressful event is severe enough to bring about release from active service, § 4.129 requires an evaluation of not less than 50 percent and an examination within six months after discharge. ADHD is not named in the schedule and must not be mapped automatically to DC 9440.

Monthly pay is the basic amount for a veteran alone at that overall rating. Separate ratings combine under VA rules; the payments do not add together. Combine your ratings in the calculator or read the VA compensation rates (opens in a new tab).

Criteria checked against 38 CFR Part 4 (eCFR) as of 2026-07-01. 38 CFR § 4.130 explained (official text (opens in a new tab)).

VA forms for PTSD

A Disability Benefits Questionnaire (DBQ) is a VA form your clinician uses to document your condition and its effects.

The Initial PTSD DBQ is not available as a public download. This form is for a PTSD review.

On this page
  1. TL;DR
  2. PTSD VA rating chart under 38 CFR § 4.130
  3. Why most PTSD ratings land at 70 percent
  4. 50 vs 70 percent PTSD: what moves the rating
    1. What to ask your therapist or psychiatrist to document
  5. TDIU with a 70 percent PTSD rating
    1. What VA Form 21-8940 asks
  6. The PTSD C&P exam and DBQ
    1. Reading your DBQ before the exam
  7. How to prove a PTSD stressor
    1. Combat stressors and the presumption under 38 USC § 1154(b)
    2. Fear of hostile military or terrorist activity
    3. Non-combat stressors
  8. PTSD from military sexual trauma (MST)
  9. PTSD and secondary claims
  10. New rules for PTSD VA compensation: the 2022 proposal
  11. Can VA reduce your PTSD rating?
  12. Questions veterans ask about PTSD ratings
    1. Is a 70 percent PTSD rating permanent?
    2. Can PTSD and depression be rated separately?
    3. Can PTSD qualify for special monthly compensation?
    4. Is PTSD a presumptive condition?
    5. Do I need a nexus letter for PTSD?
    6. Can I get TDIU with a 70 percent PTSD rating?
  13. Bottom Line
  14. Related Conditions

About 1.76 million veterans are service-connected for PTSD, according to VA's Annual Benefits Report for fiscal year 2025. Many of them are rated at 70 percent. Not because most veterans living with PTSD have moderate symptoms (most have severe ones), but because 38 CFR § 4.130 is built so that "total occupational and social impairment" at the 100 percent tier is harder to clear than the words suggest. Severe but not total impairment lands at 70. That's the population stack.

The 70-to-100 jump is a real compensation gap on paper. At the rates effective December 1, 2025 (the 2026 rates), that's the difference between $1,808.45 and $3,938.58 per month for a single veteran with no dependents (about $25,560 a year, tax-free). But there are two ways to close it. The first is the schedular climb, which is steep. The second is TDIU under 38 CFR § 4.16, which pays at the 100 percent rate when service-connected conditions prevent substantially gainful employment, even if the schedular rating stays at 70. A 70 percent PTSD rating clears the single-disability TDIU threshold automatically. The harder part is documenting unemployability itself.

This page covers the PTSD rating chart, why 70 percent is the most common outcome, how TDIU works as the second path to the same monthly check, the 50-to-70 line that turns on occupational impact documentation, how to prove a stressor, the MST evidence rules, the secondary chain that runs from PTSD into sleep apnea, GERD, hypertension, and migraines, the 2022 proposal to change mental health ratings, and when VA can reduce a PTSD rating.



TL;DR

  • PTSD is rated under 38 CFR § 4.130, the General Rating Formula for Mental Disorders, at six tiers: 0%, 10%, 30%, 50%, 70%, and 100%.
  • Approximately 1.76 million veterans are service-connected for PTSD per VA's Annual Benefits Report for fiscal year 2025, making it one of the most-rated conditions in the system.
  • The 70% tier captures the largest share of rated PTSD veterans because the 100% schedular requires a level of impairment that's both severe and persistent in ways the lower tiers don't.
  • TDIU (Total Disability based on Individual Unemployability) lets a veteran at 70% PTSD draw the same monthly compensation as a 100% rating, $3,938.58 per month for a single veteran with no dependents at the rates effective December 1, 2025, if unemployability is documented.
  • The 50-to-70 line in BVA decisions often turns on occupational impact documentation, not on whether the underlying symptoms are present.
  • VA proposed in 2022 to replace the mental health rating formula with a five-domain model. As of early October 2026 it is still a proposal, and § 4.130 is the rule VA applies.

PTSD VA rating chart under 38 CFR § 4.130

PTSD doesn't have its own dedicated rating schedule. It's rated under the General Rating Formula for Mental Disorders at 38 CFR § 4.130, which applies to every psychiatric condition VA recognizes: PTSD, major depression, generalized anxiety, bipolar disorder, schizophrenia, and the rest of them.

That formula uses a single template. Six rating tiers, each defined by how much the condition impairs occupational and social functioning, with a non-exhaustive list of representative symptoms at each level.

Here's the framework in plain terms:

  • 0%: A diagnosed mental disorder is present but symptoms aren't severe enough to interfere with work or social functioning or to require continuous medication.
  • 10%: Mild or transient symptoms. Work efficiency and social functioning are decreased only during periods of significant stress, or symptoms are controlled by continuous medication.
  • 30%: Occasional decreases in work efficiency and intermittent inability to perform occupational tasks, with generally satisfactory functioning otherwise. Symptoms appear at this level but the veteran is mostly functional.
  • 50%: Reduced reliability and productivity. Work and social impairment is more consistent. Symptoms interfere with routine functioning in ways that show up across multiple life areas.
  • 70%: Deficiencies in most areas, meaning work, school, family relations, judgment, thinking, or mood. The impairment is significant enough that the veteran's functioning is compromised across most of their life.
  • 100%: Total occupational and social impairment. The veteran can't maintain employment and can't maintain functional relationships. The criteria here describe severe, persistent symptoms that prevent basic daily functioning.

The key thing about this structure is that the symptom lists at each tier are illustrative, not exhaustive. The rating decision is supposed to look at the overall impairment picture, not just check off which symptoms from the list are present. A veteran can match symptoms across multiple tiers and still get rated at the tier that best matches their overall functioning.

That sounds clean in theory. In practice, it's where most of the rating disputes happen.


Why most PTSD ratings land at 70 percent

The 70% tier captures the broad middle of rated PTSD veterans for a structural reason. The tier above it requires total impairment, and "total" carries a lot of weight in how VA and the BVA interpret it.

To clear the 100% schedular bar, a veteran's PTSD has to produce impairment severe enough that work isn't possible and meaningful social functioning isn't possible. Not difficult. Not significantly impaired. Total. The regulatory examples at this tier describe symptoms that affect basic orientation, basic communication, and basic ability to function safely.

That's a high bar. Many veterans with severe PTSD don't meet it, even when their condition is significantly disabling. They might be unable to maintain employment but still able to maintain some social relationships. They might be functionally housebound but still oriented and capable of basic self-care. They might have persistent intrusive symptoms but be able to communicate clearly with providers.

All of those presentations can be severely disabling. They just don't usually clear the "total" threshold under the schedular criteria.

The 70% tier, by contrast, captures veterans with deficiencies in most life areas. That's a much wider net. A veteran with persistent anger affecting family relationships, judgment issues affecting work performance, mood disturbances, and intrusive symptoms can land here without needing to be totally impaired.

So the population stacks up at 70%. It's the highest tier most severely impaired veterans qualify for under the schedular criteria, and it's where the rating system tends to settle when impairment is significant but not total.

This isn't a criticism of how the rating system was designed. It's how the General Rating Formula works mechanically. The tiers above 50% are narrower than the tiers below, and the 100% tier is the narrowest of all.


50 vs 70 percent PTSD: what moves the rating

The largest single decision in many PTSD rating appeals is whether the case lands at 50% or 70%. Both tiers describe meaningful impairment. The compensation difference is significant, and the structural difference in the criteria comes down to whether deficiencies appear in "most areas" of life.

In BVA decisions, the cases that move from 50% to 70% on appeal usually do it on the strength of occupational impact documentation. The medical impairment was already in the record. What was missing was specific evidence about how that impairment affected work performance.

This pattern shows up consistently. The C&P examiner might note symptoms like anxiety, irritability, sleep disturbance, and intrusive thoughts. Those symptoms appear in multiple tier descriptions. The rating decision lands at 50% because the file shows symptoms without specific documentation of how widely those symptoms impair life.

The appeal adds documentation. Employer statements, performance reviews, attendance records, statements from coworkers, the veteran's own detailed account of work impact, and treatment records that connect symptoms to specific functional limitations. With that evidence in the file, the same symptom picture moves from "reduced reliability and productivity" at 50% to "deficiencies in most areas" at 70%.

The medical condition didn't change. The documentation of impairment across life areas did.

The Board's standard for what makes a medical opinion or impairment finding persuasive comes up again and again in these cases. From the typical language used:

"A medical opinion is most probative if it is factually accurate, fully articulated, and based on sound reasoning."

A C&P examination that lists symptoms without articulating how they impair specific life areas isn't as probative as one that walks through occupational impact, social impact, and how the symptoms show up day to day. The same logic applies to lay statements and treatment records.

This is the area where the 70% rating is most often won or lost.

What to ask your therapist or psychiatrist to document

The strongest PTSD records do not just list symptoms. They translate symptoms into functional impact across the exact domains VA rates: work, school, family relations, judgment, thinking, and mood. The phrase "deficiencies in most areas" matters because it is the center of the 70 percent tier.

Useful clinical notes describe how often panic, anger, avoidance, sleep disruption, dissociation, suicidal ideation, impaired impulse control, memory gaps, or concentration problems interfere with daily life. They also explain whether the veteran can sustain tasks, handle supervision, tolerate coworkers, maintain family relationships, make decisions safely, and show up consistently.

This is where buddy statements for in-service stressor verification and spouse or coworker statements become useful. A therapist can document the clinical picture. Lay evidence can show what it looks like outside the clinic.


TDIU with a 70 percent PTSD rating

Here's the part of the framework that closes the compensation gap between 70% and 100%.

TDIU (Total Disability based on Individual Unemployability) is a separate rating mechanism under 38 CFR § 4.16. The TDIU guide covers the rule, the Board's numbers and the application in full. It pays at the 100% rate to veterans whose service-connected conditions prevent substantially gainful employment, even when their schedular rating is below 100%.

For PTSD, the typical TDIU path looks like this:

  • The veteran is rated at 70% for PTSD.
  • The PTSD makes it impossible to maintain substantially gainful employment.
  • The veteran applies for TDIU on VA Form 21-8940, documenting unemployability and the medical reasons for it.
  • If granted, the veteran's compensation jumps from the 70% rate to the 100% rate.

For a single veteran with no dependents, at the rates effective December 1, 2025 (the 2026 rates), that's the difference between $1,808.45 a month at 70% and $3,938.58 a month at 100%, or about $2,130 a month, tax-free. Across a year, about $25,560. That's the same monthly check a schedular 100% veteran draws.

The eligibility math for TDIU has two paths. The standard schedular TDIU requires either one disability rated at 60% or higher, or a combined rating of 70% or higher with at least one disability rated at 40% or higher. A 70% PTSD rating on its own clears the single-disability path. So for veterans with PTSD as their primary service-connected condition, the TDIU door is structurally open.

The harder part is documenting unemployability itself. The TDIU application asks for work history, education, training, and the specific medical reasons employment isn't sustainable. The supporting evidence usually includes vocational assessments, treatment records showing severity of impairment, employer statements when available, and detailed C&P opinions on functional capacity.

TDIU isn't automatic. A 70% PTSD rating doesn't trigger it. The veteran has to apply, document unemployability, and have the claim adjudicated. But once granted, the monthly compensation matches the 100% schedular rate.

The compensation gap between 70% and 100% schedular is real on paper. The TDIU pathway is what closes it for most veterans whose PTSD prevents work.

What VA Form 21-8940 asks

TDIU is not a vibe check. It is an evidence file. VA Form 21-8940 asks for the last date you worked full time, the date your disability affected full-time employment, the date you became too disabled to work, the type of work you did, your highest yearly earnings, your education, and any training you tried before becoming too impaired to keep working.

Most TDIU denials are documentation denials, not eligibility denials. A 70 percent PTSD rating clears the schedular threshold, but the file still has to show why substantially gainful employment is not sustainable. That usually means treatment notes describing work impairment, employer statements when available, a vocational opinion when the work history is complicated, and a clean evidence checklist for TDIU and PTSD claims so the application does not rely on one unsupported sentence.

If the rating is already 70 percent and the veteran is stuck below the 100 percent check, a gap analysis on a 70 percent rating is often the right planning step before filing. The question is not only "am I severe enough?" It is "does the file prove why work is no longer realistic?"


The PTSD C&P exam and DBQ

Every PTSD claim involves a C&P examination at some point, and the structure of that examination matters because it directly drives the rating decision.

The Disability Benefits Questionnaire for PTSD is VA Form 21-0960P-3. It's the form a C&P examiner fills out to assess PTSD severity for rating purposes. The form's structure mirrors the General Rating Formula. It asks the examiner to identify the veteran's level of occupational and social impairment by selecting one of the six rating tiers as the best descriptor.

The form lists symptoms grouped by tier. The examiner checks the symptoms that apply. At the end, the examiner picks the overall impairment level that best fits.

That overall impairment selection is what the rater uses to assign the percentage. Which means the C&P examiner's tier selection effectively functions as the rating recommendation.

Two things matter about how this plays out in practice.

First, examiners sometimes check symptoms across multiple tiers but then select an impairment level that doesn't match the symptom picture. A DBQ with five symptoms checked at the 70% level and an overall impairment selection of 50% creates the kind of inconsistency that gets challenged on appeal. The Board generally treats the overall impairment selection as the recommendation but reviews the symptom picture to assess whether it's supported.

Second, the DBQ asks for narrative explanations in several sections. Examiners who write short, conclusory responses tend to produce ratings closer to the symptom selection. Examiners who provide detailed narrative about impairment in work, family, and social functioning tend to produce ratings that hold up at higher tiers.

The C&P exam is one of the most consequential single events in the rating process. The DBQ that comes out of it carries significant weight in how the rating decision lands.

Reading your DBQ before the exam

The PTSD DBQ matters because the examiner selects an overall occupational-and-social-impairment level. That selection often becomes the spine of the rating decision. The symptom checkboxes matter too, but a DBQ can have 70 percent symptoms checked while the examiner still selects a 50 percent impairment level. That mismatch is where appeals often start.

Before the exam, review the domains the DBQ asks about: diagnosis, stressor, symptoms, occupational impairment, social impairment, treatment history, and functional impact. The goal is not to memorize perfect words. The goal is to be ready to explain what happens at work, at home, in public, during sleep, during conflict, and during periods of stress.

For many veterans, C&P exam prep for the PTSD DBQ is the difference between a generic symptom list and a record that actually describes how PTSD impairs functioning. If the DBQ comes back with symptoms and impairment level out of alignment, that inconsistency should be flagged quickly.


How to prove a PTSD stressor

Service connection for PTSD has a structural feature most other conditions don't have. The stressor that caused the PTSD has to be verified, and the verification standard depends on whether the stressor was combat-related.

Combat stressors and the presumption under 38 USC § 1154(b)

Combat veterans get a presumption. Lay testimony about a combat-related stressor is sufficient if the stressor is consistent with the veteran's documented combat service. The veteran doesn't need to produce records of the specific event. The combat itself, established through documentation like a CIB (Combat Infantryman Badge), a CAR (Combat Action Ribbon), a CMB (Combat Medical Badge), a Purple Heart, a combat deployment record, or other combat indicators, supports the stressor.

That presumption shortcut materially affects how combat-related PTSD claims develop. The medical opinion linking PTSD symptoms to combat-related stress is sufficient when the combat service is documented. There's no separate hurdle of proving a specific firefight or specific incident.

Fear of hostile military or terrorist activity

The 2010 regulatory change to 38 CFR § 3.304(f) added a category for fear of hostile military or terrorist activity. For veterans whose stressor relates to fear of hostile activity in a hazardous service area, the verification standard is similar to the combat presumption when a VA psychiatrist or psychologist, or one VA has contracted with, confirms the stressor is adequate and consistent with the veteran's service.

For traditional non-combat, non-hazardous-area stressors, the verification requirement remains. This is one of the more challenging parts of non-combat PTSD claims, especially for stressors that happened decades ago without contemporaneous documentation.

Non-combat stressors

Non-combat stressors don't have that presumption. Things like training accidents, vehicle accidents, witnessing a death outside combat, or personal assault require the veteran to verify the stressor through other means. That typically means personnel records, unit records, treatment records, lay statements from people who knew about the incident, official reports, or other documentation supporting that the stressor occurred. Sexual assault and harassment have their own special rules at 38 CFR § 3.304(f)(5), covered in the next section. The claim can still win, but the proof work is heavier.


PTSD from military sexual trauma (MST)

Military sexual trauma carries its own evidentiary framework at 38 CFR § 3.304(f)(5). The regulation recognizes that MST often doesn't produce contemporaneous documentation. Victims frequently don't report at the time. Records that would corroborate the assault sometimes don't exist.

In response, the regulation allows for "alternative sources" of evidence to corroborate the stressor. The list of recognized markers includes things like:

  • Records from rape crisis centers, mental health counseling centers, or other community organizations
  • Statements from family members, roommates, fellow service members, or clergy
  • Evidence of behavior changes following the claimed assault, including requests for transfer, deterioration in performance, substance abuse, depression, or relationship problems
  • Tests for sexually transmitted diseases or pregnancy around the time of the alleged assault
  • Statements from health care providers who treated the veteran for related conditions

The regulation also says VA will not deny a PTSD claim based on in-service personal assault without first telling the veteran that evidence from outside the service records, or evidence of behavior changes, may corroborate the stressor, and giving the veteran a chance to provide it. This is a meaningful change from the standard verification requirements for non-combat stressors.

VA examiners assessing MST-related PTSD are supposed to consider these alternative markers when evaluating whether the stressor is verified. The C&P examination process for MST claims includes specific protocols that account for the evidentiary challenges.

In the BVA decisions reviewed for this analysis, MST-related PTSD claims that succeed tend to lean heavily on the alternative-evidence framework rather than on direct stressor documentation. The Board specifically looks for behavior-change markers, contemporaneous mental health records, statements from people the veteran told at the time, and other documentation that fits within the § 3.304(f)(5) framework. When those markers are absent and only the veteran's own statement supports the stressor, the path is harder.

For veterans pursuing MST-related claims, the regulatory framework is more permissive than the standard non-combat stressor requirements. The evidentiary path is different. The grants are possible. But the documentation work usually has to be more comprehensive than what a combat-related PTSD claim requires.


PTSD and secondary claims

PTSD often becomes the anchor for secondary claims. Under 38 CFR § 3.310, a condition caused or worsened by service-connected PTSD is service connected too and rated on its own. In the Board's 2021 to 2026 rulings, sleep apnea is claimed secondary to PTSD far more often than any other condition, followed by high blood pressure, migraines, erectile dysfunction, GERD and IBS.

Secondary conditions to PTSD covers each one, which to file first and the Board's numbers for every pair, with pages for sleep apnea, hypertension, migraines, erectile dysfunction, GERD and IBS.

The rating math is why this matters. A veteran at 70 percent for PTSD who adds sleep apnea at 50 percent combines to 90 percent, and some combinations create a schedular path to 100 percent. The key is not filing every possible secondary. It is identifying the medically supported chain and documenting it with diagnosis, nexus, and severity evidence. Depression and PTSD often co-occur, but VA rates overlapping mental health symptoms together in one evaluation rather than paying twice for the same impairment.


New rules for PTSD VA compensation: the 2022 proposal

VA published a proposed rule on February 15, 2022 to rewrite how it rates mental disorders, PTSD included ("Schedule for Rating Disabilities: Mental Disorders," 87 FR 8498, RIN 2900-AQ82). This is the change most "new rules for PTSD compensation" articles describe. Here is what it would do, and where it stands.

  • Five domains instead of one impairment scale. Ratings would turn on how the condition affects five areas of functioning: cognition; interpersonal interactions and relationships; task completion and life activities; navigating environments; and self-care.
  • No more 0 percent. A diagnosed mental disorder would rate at least 10 percent.
  • A different 100 percent test. Instead of "total occupational and social impairment," 100 percent would require the most severe level of impairment in at least one domain, or the second most severe level in two or more domains.

Status. As of early October 2026 VA has not published a final rule. VA's regulatory agenda had listed a final rule for August 2026, and none appeared. Until a final rule takes effect, VA rates PTSD under the current § 4.130 formula on this page, and so does the Board.

Existing ratings. Under 38 CFR § 3.951(a), a change to the rating schedule is not grounds to reduce a rating already in effect unless the condition has actually improved. If the proposal becomes final, check its effective date and transition rules before filing for an increase under either formula.


Can VA reduce your PTSD rating?

VA can reduce a PTSD rating, but the rules get stricter the longer the rating has stood.

  • Five years or more at the same level. Under 38 CFR § 3.344, VA has to find sustained improvement under the ordinary conditions of life, from an examination as full as the one that set the rating. For conditions that improve and relapse, which § 3.344(a) names to include psychoneurotic reactions, one examination is not enough unless all the evidence clearly shows sustained improvement.
  • Twenty years or more. A rating held for 20 years cannot be reduced below that level except for fraud (38 CFR § 3.951(b)).
  • Service connection for ten years. It cannot be severed except for fraud or a lack of the required service (38 CFR § 3.957).
  • Notice first. Before any reduction VA has to propose it in writing and give you 60 days to send evidence, and 30 days to ask for a hearing (38 CFR § 3.105(e) and (i)).

A 70 percent rating is not "permanent" on its own. Permanent and total is a separate finding VA makes when a disability is rated total, through 100 percent or TDIU, and is not expected to improve. The Board section below shows how appeals of PTSD rating reductions have gone.


Questions veterans ask about PTSD ratings

Is a 70 percent PTSD rating permanent?

Not automatically. VA can re-examine a 70 percent rating, but the longer it stands the harder it is to reduce: after five years VA has to show sustained improvement, and after 20 years the rating is protected. Permanent and total is a separate designation tied to a total rating, either 100 percent or TDIU.

Can PTSD and depression be rated separately?

Usually not. VA rates all of a veteran's mental health diagnoses together under one evaluation when their symptoms overlap, because paying twice for the same impairment is not allowed (38 CFR § 4.14). The single rating reflects the combined effect of PTSD, depression, anxiety and any other diagnosis.

Can PTSD qualify for special monthly compensation?

It can. SMC at the housebound rate, SMC(s), is paid when one service-connected condition is rated 100 percent (schedular, or TDIU based on that one condition) and other conditions add up to 60 percent, or when that condition leaves you permanently housebound. SMC(l) is paid when you need regular aid and attendance, and VA counts a mental condition that leaves you needing protection from the hazards of daily life (38 CFR § 3.352(a)). The higher R1 and R2 levels require entitlement to the top SMC rates first plus a need for aid and attendance, which PTSD alone rarely reaches.

Is PTSD a presumptive condition?

Not in the way PACT Act conditions are. What combat veterans and veterans who feared hostile military or terrorist activity get is an easier way to prove the stressor (38 USC § 1154(b) and 38 CFR § 3.304(f)(3)). You still need a current PTSD diagnosis and a medical link between the stressor and your symptoms.

Do I need a nexus letter for PTSD?

You need medical evidence linking your symptoms to the in-service stressor (38 CFR § 3.304(f)). The VA examiner often provides it. A private opinion matters most when the VA exam finds no PTSD diagnosis, ties the symptoms to something else, or skips the stressor you described.

Can I get TDIU with a 70 percent PTSD rating?

Yes, if your service-connected conditions keep you from substantially gainful work. A single 70 percent rating meets the schedular threshold under 38 CFR § 4.16(a), and TDIU pays at the 100 percent rate. The TDIU guide covers how to prove it.


Bottom Line

PTSD is rated under 38 CFR § 4.130, the General Rating Formula for Mental Disorders, at six tiers: 0%, 10%, 30%, 50%, 70%, and 100%. The 70% tier captures the largest share of rated veterans because the 100% schedular requires total impairment, and most severely impaired veterans clear the "deficiencies in most areas" bar at 70% without clearing the "total occupational and social impairment" bar at 100%. The TDIU pathway under 38 CFR § 4.16 pays at the 100% rate to veterans whose service-connected conditions prevent substantially gainful employment, which structurally closes the compensation gap for many veterans rated at 70% PTSD. The line between adjacent rating tiers in BVA decisions usually comes down to documentation of impairment across life areas, particularly occupational impact, rather than the underlying medical condition itself. Combat veterans benefit from the stressor presumption at 38 USC § 1154(b), MST-related claims have their own evidentiary framework at 38 CFR § 3.304(f)(5), and non-combat stressors generally require corroborating evidence. The C&P examination and the DBQ at form 21-0960P-3 carry significant weight because the examiner's overall impairment selection effectively functions as the rating recommendation. A 2022 proposal would replace the formula with a five-domain model, but as of early October 2026 it is not final, and existing ratings are not reduced just because the schedule changes.


PTSD often connects to sleep apnea (see sleep apnea secondary to PTSD), GERD, depression, migraines, and hypertension. Veterans already rated at 70 percent should also review the secondary conditions tool and gap analysis before deciding whether the next claim should be schedular, secondary, or TDIU.


Methodology and Limitations

  • Data source: Rating criteria are paraphrased from 38 CFR § 4.130 (General Rating Formula for Mental Disorders). Stressor verification rules are drawn from 38 USC § 1154(b) and 38 CFR § 3.304(f). TDIU eligibility is described under 38 CFR § 4.16. Reduction protections are from 38 CFR §§ 3.105, 3.344, 3.951 and 3.957; SMC from 38 CFR §§ 3.350 and 3.352. The proposed rule is "Schedule for Rating Disabilities: Mental Disorders," 87 FR 8498 (February 15, 2022), RIN 2900-AQ82; its status was checked in early October 2026. Service-connection prevalence is drawn from VA's Annual Benefits Report for fiscal year 2025. Compensation figures are VA disability pay rates effective December 1, 2025 (the 2026 rates) for a single veteran with no dependents.
  • Sample size: Patterns in this analysis are drawn from Claim Raven's read of 511,036 Board of Veterans' Appeals decisions from 2021 to 2026, which contain 1,378,030 rulings. A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Across 41,911 decided Board rulings on PTSD from 2021 to 2026, 37.6% were granted, 38.4% denied and 24.0% remanded. Dismissed, withdrawn and moot rulings are excluded. The Board figures shown on this page come from the same data.
  • Limitations: The General Rating Formula uses representative symptom lists at each tier that are illustrative, not exhaustive. Actual rating decisions are supposed to evaluate overall impairment, not check off specific symptoms. Compensation figures reflect VA disability pay rates effective December 1, 2025 (the 2026 rates) for a single veteran with no dependents. Family rates differ at 30% and above because of dependent allowances. Extraschedular TDIU under 38 CFR § 4.16(b) follows a different process and is decided case by case. These observations reflect patterns from the regulatory text and BVA decisions. They are not predictions of individual outcomes, and Claim Raven is data analysis, not legal, medical, or VA-accredited advice.

What Board appeals show for PTSD

These are outcomes at the Board of Veterans' Appeals, not first-time claims, and not your personal odds. They show where appeals on this issue tend to land.

How appeals on this issue ended

37.6%

granted across 41,911 decided Board rulings on PTSD, 2021 to 2026.

  • Granted15,776 37.6%
  • Denied16,078 38.4%
  • Sent back10,057 24.0%

"Sent back" means remanded: the Board returned the claim to VA for more work instead of deciding it.

When the Board discussed a private medical opinion

Granted or denied rulings where the Board's decision discussed a private medical opinion (2,311)72.4%

All PTSD granted or denied rulings (31,854)49.5%

Both rows leave out remands, because the Board weighs this evidence only when it grants or denies. Association, not cause; the Board may simply discuss stronger evidence more.

The full evidence breakdown, with grant rates for every evidence type and language from actual Board decisions, is in Raven Insights, included with every paid plan.

Why the Board denied PTSD claims

In 2,605 service connection rulings the Board denied, 2021 to 2026, it found this part of the claim not shown:

  • A current diagnosis73.3%
  • An event, injury or exposure in service37.5%
  • A link between PTSD and service (nexus)25.8%

A denial can fail more than one part, so the shares can add up to more than 100%.

Why the Board sent PTSD claims back

Of 10,057 PTSD rulings the Board remanded, 2021 to 2026:

  • VA still had records to get50.9%
  • The VA exam or opinion was not adequate24.0%
  • The exam was out of date or the condition had worsened19.9%
  • VA had not given an exam10.3%

A remand can ask for records and a new exam at once, so these overlap.

What happened after a remand

Legacy appeals the Board remanded and then decided again on the same docket, with the second decision in 2010 to 2026.

  • Granted when the Board decided it again39.5% of 14,239
  • Granted when the Board found the exam done after the remand inadequate72.0% of 535

Associations, not causes. Appeals under the 2019 system start a new docket each time, so they cannot be followed this way.

Results by what the appeal asked for

Board rulings on PTSD, 2021 to 2026, by the question the Board decided. The share is granted out of every decided ruling, remands included.

  • A higher rating34.9% of 23,566
  • Service connection33.9% of 9,710
  • An earlier effective date43.1% of 6,555
  • Reopening a denied claim with new evidence76.6% of 1,140
  • A rating VA reduced78.6% of 472
  • Cause of death (DIC)44.0% of 268
  • Accrued benefits43.6% of 117

What the Board did with medical opinions

Service connection rulings on PTSD the Board granted or denied, 2021 to 2026, by the medical opinion it relied on. The share is granted.

  • It relied on a favorable medical opinion98.9% of 2,786
  • It found the VA opinion inadequate or gave it less weight51.0% of 600
  • It relied on an opinion against the claim0.1% of 1,535
  • It weighed no medical opinion23.3% of 973

All granted or denied PTSD service connection rulings: 55.8% of 5,894.

Remands are left out on both sides, because the Board weighs medical opinions only when it grants or denies. Associations, not causes.

Direct, secondary and presumptive claims

Service connection rulings on PTSD, 2021 to 2026, by how the claim was argued. The share is granted out of every decided ruling, remands included.

  • Direct: it began in service34.6% of 9,107
  • Secondary: caused or worsened by a service-connected condition22.9% of 603
  • Presumptive: the law presumes the link38.9% of 447

All PTSD service connection rulings: 33.9% of 9,710.

A presumptive claim is also counted as direct or secondary.

How PTSD appeals have gone since 1992

Every Board ruling on PTSD since 1992, by when it was decided. The share is granted out of every decided ruling.

  • 1992 to 200217.1% of 41,488
  • 2003 to February 201921.0% of 112,976
  • February 2019 to August 2022 (new appeals system)28.9% of 44,601
  • Since August 2022 (PACT Act)33.8% of 45,133

These rows come from a simpler reading of every decision's order since 1992, so they are a different measure from the 2021 to 2026 figures elsewhere on this page. Issues with unclear outcomes, or with both a decision and a remand, are left out.

Secondary conditions and PTSD

Service connection rulings, 2021 to 2026, on a claim the Board's order wrote as one condition secondary to (or due to, or aggravated by) another. The share is granted out of every decided ruling, remands included.

Claimed secondary to PTSD

Every condition claimed secondary to PTSD

Each pair is shown only after a sample of its Board orders was read by hand and the automatic reading was right at least 85% of the time.

What the Board cites in PTSD decisions

Board decisions from 2019 to 2026 on PTSD alone, and the rules and cases they cite far more often than other decisions on the same kind of issue. Each share is the part of these decisions that cite it at least once, against the same share across all decisions on that issue.

Service connection 6,005 decisions

  • 38 CFR § 3.304 Direct service connection; wartime and peacetime53.2% vs 14.0%
  • 38 CFR § 4.125 Diagnosis of mental disorders36.3% vs 2.8%
  • Cohen v. Brown 10 Vet. App. 12813.8% vs 1.0%
  • Moreau v. Brown 9 Vet. App. 3895.5% vs 0.4%
  • Arzio v. Shinseki 602 F.3d 13434.7% vs 0.3%
  • Menegassi v. Shinseki 638 F.3d 13794.3% vs 0.3%

A higher rating 9,870 decisions

  • 38 CFR § 4.130 Schedule of ratings: Mental disorders61.8% vs 12.2%
  • Vazquez-Claudio v. Shinseki 713 F.3d 11247.4% vs 9.0%
  • Mauerhan v. Principi 16 Vet. App. 43644.4% vs 9.3%
  • 38 CFR § 4.126 Evaluation of disability from mental disorders42.2% vs 8.0%
  • Bankhead v. Shulkin 29 Vet. App. 1030.4% vs 5.9%
  • Sellers v. Principi 372 F.3d 13185.2% vs 0.9%

Read from the decision text. A citation shows what the Board discussed, not which side it helped, and Board decisions are not precedential.

Do you need a nexus letter for PTSD?

A nexus opinion may matter when VA disputes whether this condition is connected to service or to an already service-connected condition.

  • If service connection is already established, the dispute may be about rating severity rather than nexus.
  • If a presumptive rule covers the condition and service, a separate nexus opinion may not be required.
  • If the current diagnosis, event, or medical explanation is missing, locate that evidence before asking a clinician for an opinion.

Do you need a nexus letter for this condition? View Raven Nexus.

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