Anxiety disorders and depression are among the most common mental health conditions claimed by veterans. The good news: VA rates all mental health conditions—including anxiety, depression, and PTSD—under the same criteria in 38 CFR § 4.130. This guide explains exactly how these ratings work.
How VA Rates Anxiety and Depression
All mental health conditions are rated under the "General Rating Formula for Mental Disorders." VA looks at your overall level of occupational and social impairment, not specific diagnoses.
Key insight: If you have both anxiety AND depression (or multiple mental health diagnoses), VA assigns ONE combined rating for all mental health conditions. They don't rate each separately—this is called the "pyramiding" rule.
Mental Health Rating Criteria
| Rating | VA Criteria |
|---|---|
| 0% | Diagnosis confirmed but symptoms not severe enough to interfere with occupational/social functioning, or controlled by medication |
| 10% | Mild symptoms (e.g., depressed mood, mild anxiety) causing decreased work efficiency only during stress |
| 30% | Occasional decrease in work efficiency with intermittent inability to perform tasks due to symptoms like depressed mood, anxiety, chronic sleep impairment |
| 50% | Reduced reliability and productivity due to flattened affect, difficulty understanding complex commands, impaired judgment, disturbances of mood, difficulty establishing relationships |
| 70% | Deficiencies in most areas (work, family, judgment, thinking, mood) due to symptoms like suicidal ideation, obsessional rituals, near-continuous panic, difficulty adapting to stress, inability to establish relationships |
| 100% | Total occupational and social impairment with symptoms like gross impairment in thought/communication, persistent danger to self/others, inability to perform ADLs, disorientation, severe memory loss |
Symptoms That Support Higher Ratings
For 50% Rating:
- Flattened affect (reduced emotional expression)
- Circumstantial or stereotyped speech
- Panic attacks more than once a week
- Difficulty understanding complex commands
- Impaired short and long-term memory
- Impaired judgment
- Disturbances of motivation and mood
- Difficulty establishing and maintaining effective work and social relationships
For 70% Rating:
- Suicidal ideation (even without plan or intent)
- Obsessional rituals that interfere with routine activities
- Intermittently illogical, obscure, or irrelevant speech
- Near-continuous panic or depression affecting ability to function
- Impaired impulse control (unprovoked irritability with periods of violence)
- Spatial disorientation
- Neglect of personal appearance and hygiene
- Difficulty adapting to stressful circumstances
- Inability to establish and maintain effective relationships
Important distinction: 50% uses "difficulty establishing relationships" while 70% uses "inability to establish relationships." Document which applies to you.
Service Connection for Anxiety/Depression
Direct Service Connection
You need to show:
- Current diagnosis of anxiety disorder or depression
- In-service event, injury, or stressor
- Nexus (medical link) connecting current condition to service
Secondary Service Connection
Anxiety and depression are commonly claimed as secondary to other SC conditions:
- Chronic pain conditions (back, knees, etc.) → Depression
- Tinnitus → Anxiety, depression
- Sleep apnea → Depression, anxiety
- PTSD → Already rated together under same criteria
- Any condition limiting activities → Depression
Secondary strategy: If you have chronic pain rated by VA, getting a nexus letter connecting depression to that pain is often easier than proving direct service connection.
Evidence That Wins
- ✓Consistent mental health treatment records over time
- ✓Documented prescriptions for psychiatric medications
- ✓Statements from family/friends describing behavior changes
- ✓Records of hospitalizations or crisis interventions
- ✓Work records showing performance issues or absences
- ✓Nexus letter from psychiatrist or psychologist
- ✓Symptom diary documenting daily struggles
Evidence That Loses
- ✗No current diagnosis from a qualified mental health provider
- ✗No treatment records (suggests condition isn't serious)
- ✗Minimizing symptoms during C&P exam
- ✗Inconsistent statements about symptoms
- ✗Only reporting symptoms on 'good days'
C&P Exam Tips for Mental Health
- Be honest about your worst days—examiners need to see the full picture
- Mention specific symptoms: sleep problems, nightmares, panic attacks, irritability
- Describe how symptoms affect work, relationships, and daily activities
- If you've had suicidal thoughts, say so (you don't need a plan to report ideation)
- Bring a written list of symptoms so you don't forget anything
- Have a family member write a buddy statement about changes they've observed
Don't minimize: Many veterans downplay mental health symptoms out of habit or pride. The C&P examiner can only rate what you tell them. If you say you're "fine," that's what goes in the report.
Filing Tips
- Get a current diagnosis from a psychiatrist or psychologist (not just a GP)
- If claiming secondary, get a nexus letter specifically connecting your mental health to the SC condition
- Submit buddy statements from people who see your daily struggles
- Keep a symptom diary for at least 30 days before filing
- Be specific about frequency: "panic attacks 3-4 times per week" vs. "occasional panic"