Top 5 Mental Health Disabilities and Ratings

Mental Health

Sadness, guilt, anxiety, reliving of trauma, and even thoughts of death and suicide. These complex feelings are often a response to surviving traumatic events, which Veterans are acutely familiar with. 

For many Veterans these feelings fade with time as they adjust to civilian life, work out new routines, and build new connections. However, some may find themselves trapped in an unstable emotional state, which may often be a sign of a serious mental disability.

In 2017, RAND published an article based on a thorough analysis of the mental state of US Veterans deployed in Iraq and Afghanistan. According to their data, up to 20% of the deployed Veterans show symptoms of PTSD, depression, and other serious mental health disorders.

The official data from the VA states that about 30% of the overall Veteran population shows elevated rates of anxiety disorders, which include panic disorders, phobias, and PTSD. For most of them, symptoms of those mental health conditions are accompanied or aggravated by alcohol and substance abuse, making it even more difficult to adjust to civilian life, find stable employment, and build healthy relationships.

At VCU, we often come across cases when Veterans either don’t recognize the problem, write off the symptoms off to regular stress, or deny it entirely thinking that admitting a mental health disorder will make them look weak or even prevent them from receiving their hard-earned benefits.

However, the VA recognizes mental health disorders just like any other service-connected disabilities and provides a system of ratings and benefits based on the severity of your condition and its effect on your life.

Since May is Mental Health Awareness Month, let’s look at the  5 most common mental health disabilities and their rates, explain how the VA evaluates mental conditions according to the Schedule of Ratings, and help you make sure that you successfully claim the compensation you are entitled to.

VA Rates for Mental Health Disorders

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) contains about 300 mental health conditions. The World Health Organisation (WHO) divides them into 8 classes

The VA recognizes most of them and assigns disability rates for those “invisible” disabilities just like it does for physical conditions caused or worsened by military service.

While each mental health condition has its diagnostic code in the Schedule of Ratings, all of them technically have the same rating criteria based on the severity and frequency of symptoms.

  • 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
  • 10% – Occupational and social impairment due to mild or transient symptoms that decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication
  • 30% – Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks
  • 50% – Occupational and social impairment with reduced reliability and productivity
  • 70% – Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood
  • 100% – Total occupational and social impairment

The following 5 conditions are some of the most common mental health disorders amongst Veterans. This trend may be explained by the fact that their symptoms are usually triggered or aggravated by the stressful environment, and risk of mental and physical trauma, associated with military service.

1) Post-Traumatic Stress Disorder (PTSD)

PTSD is recognized as a distinct class of mental health conditions. It can develop after experiencing or witnessing a traumatic event such as combat, accidents, physical or sexual assault, or other life-threatening situations. 

According to the National Center for PTSD, 23% of Veterans experience this mental health condition at some point. Its symptoms may include: 

  • Flashbacks
  • Nightmares
  • Intrusive thoughts or memories of the event
  • Hypervigilance (sensitivity to potential threats or dangers)
  • Negative changes in mood or cognition
  • Changes in arousal and reactivity

These symptoms can appear immediately after the traumatic event or show themselves after a while. That is why it is never too late to claim your PTSD as a service-connected disability. Although PTSD may not be recognized automatically as a presumptive condition, its symptoms can be easily linked with military service if you experienced combat, military sexual trauma, or any other traumatic event while in service.

PTSD has its diagnostic code (9411). But like any other mental health disability, it is rated according to the common General Rating Formula for Mental Disorders.

Symptoms of PTSD can aggravate several serious physical and mental conditions. In turn, this mental health condition can develop as a side-effect of many service-connected disabilities such as:

  • Sleep apnea
  • Gastroesophageal reflux disease (GERD)
  • Hypertension
  • Migraines
  • Erectile dysfunction
  • Alcohol and Substance Abuse

This is called a Secondary Service Connection. Once you have medical records and a nexus statement that establishes the link between two conditions, you will be able to increase your VA disability rate and compensation.

2) Bipolar Disorder

Bipolar disorder is another distinct class of mental health conditions with over 40 million people diagnosed with it worldwide. According to the data from VA Healthcare, about 130,000 US Veterans receive treatment for this condition every year.

Bipolar disorder is also called a mood disorder, as its symptoms usually include severe mood swings, emotional highs (mania or hypomania), and lows (depression).

Due to its complexity, bipolar disorder has two diagnostic codes in the Schedule of Ratings:

  • Code 9431 Cyclothymic disorder
    It is the most common case, assigned to Veterans with milder average symptoms of bipolar disorder. People with Cyclothymic disorder can normally maintain routine tasks and behaviors, self-care, and conversations. This condition is usually rated  at 30%.
  • Code 9432 Bipolar disorder (severe with psychotic behavior)
    This code is relevant if the condition causes a significant effect on your daily functioning or may include psychotic behaviors such as hallucinations and delusions. It also has a greater restriction on gainful employment than the first option. This case can be rated from 50% to 100% depending on the occupational and social impairment it may cause

Many factors associated with military service can cause bipolar disorder. Those may be:

  • Traumatic experiences
  • Sleep disruption
  • Injuries 
  • Substance abuse

There is also evidence that bipolar disorder can be triggered by a stressful environment if a person is genetically predisposed to this condition, or has a history of mental illness in the family. 

While technically bipolar disorder and PTSD belong to different classes of mental health disabilities, there is a strong relation between the two common service-connected conditions due to shared symptoms. That is why bipolar disorder often becomes secondary to PTSD. 

This link is also bidirectional. It means that if you were diagnosed with bipolar disorder, you can claim PTSD as a secondary condition.

Bipolar disorder can also be linked to your military service and recognized as a secondary condition if you went through physical trauma such as:

  • Explosion
  • Improvised explosive device (IED) attack
  • Car accident
  • Combat injury

Sometimes the symptoms of bipolar disorder get so severe that you may not be able to gain a steady job and income. In this case, along with other VA disability benefits, you may be eligible for TDIU.

3) Panic Disorder

Panic disorder belongs to the class of anxiety disorders, which affect over 301 million people worldwide. According to the National Institute of Health (NIH), about 10% of Veterans, especially those deployed to Afghanistan and Iraq report having symptoms of panic disorder. 

Veterans who suffer from this mental condition have frequent and unexpected panic attacks and bouts of severe fear.

Symptoms of panic disorder usually include:

  • Chills
  • Nausea
  • Dizziness or feeling faint
  • Extreme fear or dread
  • Irritability or anger
  • Sweating or hot flashes
  • Shortness of breath
  • Chest pain
  • Numbness
  • Trembling or shaking
  • A feeling of a lack of control over yourself or a situation

While experts are still speculating about what exactly may cause the development of a panic disorder, such factors as an extremely stressful environment and exposure to physical and emotional trauma are recognized as the main contributors. 

That is why panic disorder is assigned a diagnostic code (9412) and is rated by the VA according to the standard schedule for mental disorders. 

Like many other mental health disabilities caused by physical or mental trauma that may happen during your time in the military, panic disorder often becomes a secondary condition to PTSD. However, it is also linked to other mental disabilities that can be claimed as service-related conditions. Schizophrenia is one of them.

4) Schizophrenia

Mayo Clinic defines schizophrenia as “a serious mental disorder in which people interpret reality abnormally.” In other words, a person who suffers from schizophrenia may experience hallucinations, and delusions, and think and behave irrationally. The WHO recognises schizophrenia as a distinct class of mental health disorders.

Here are some common symptoms of schizophrenia:

  • Hallucinations
    Seeing things that aren’t real, hearing voices, or feeling sensations that others don’t experience are all common types of hallucinations. However, auditory hallucinations (hearing voices) are the most common type of hallucination among schizophrenia patients.
  • Delusions
    Delusions are false beliefs that occur despite obvious evidence. For example, those may be beliefs of persecution (feeling targeted or harassed), grandiosity (believing one has exceptional abilities or status), or paranoia (feeling suspicious of others).
  • Disorganized Thinking
    It is difficult to organize your thoughts. It usually leads to disorganized speech, making it hard to follow conversations.
  • Disorganized or Abnormal Motor Behavior
    This can manifest as unpredictable or inappropriate movements, unusual postures, or repetitive behaviors. It may also include catatonia, a state of immobility and unresponsiveness.
  • Cognitive Impairment
    Schizophrenia often leads to difficulties with attention, memory, problem-solving, and decision-making. 

The VA Healthcare resources claim that about 120,000 Veterans receive treatment for this severe chronic psychiatric disease. Schizophrenia has a diagnostic code 9201 and is rated from 0% to 100% by the VA depending on the severity of symptoms and their effect on your life. 

What differentiates schizophrenia from most other service-connected disabilities is that this mental illness develops over time. It hardly shows itself right after the traumatic event and may become visible several months or even years after discharge. That is why it may be harder to prove a service connection of schizophrenia and it is best to address professionals who can track the current symptoms and their development to a particular event or experience in the past.

However, schizophrenia can be easily linked to other mental health conditions, commonly recognized as service-connected. Those can be PTSD, panic, and bipolar disorders. Once you have a clear diagnosis and service connection for one of those conditions, any symptoms of schizophrenia that develop with time may serve as a strong link and help you claim a secondary condition to increase your VA disability benefits.

5) Depression

Depressive disorders is the broadest class of mental health conditions, causing a persistent feeling of sadness and loss of interest. 

Also called major depressive disorder or clinical depression, it affects how you feel, think, and behave and can lead to a variety of emotional and physical problems. 

According to the official data from the VA, 1 in 3 Veterans suffer from symptoms of depression. About 20% of them have a prolonged history of depression and 12% suffer from major depression, which may become life-threatening if not treated by professionals.

Depression is a wide term, which makes it probably the most common mental health problem among Veterans. Its symptoms can be triggered by many factors, typically associated with military service and further transition to civilian life:

  • Combat exposure
  • Deployment-related trauma
  • Separation from family
  • Challenges of finding employment and establishing new bonds after discharge

Chronic pain and other physical disabilities that can occur or develop as a result of service-connected trauma are also associated with the development of depression. That is why, depression is also often connected as a secondary condition.

While depression has its own diagnostic code (9434), it is rarely recognized as an independent service-related disability. Depression is usually described as an underlying symptom of many service-connected mental conditions such as PTSD, and SUD. 

Normally, you will not be able to receive a separate VA rate for depression because it falls under the term Pyramiding Conditions.

Pyramiding Conditions is a term introduced by the VA to prevent double-rating of the same symptoms. It means that if you have two disabilities with the same symptoms, only the highest-rated one will be considered in your final VA disability rate. 

For example, if you are claiming VA disabilities for PTSD, depression probably will not be rated separately. It will be considered a symptom of the primary disability. 

However, if you prove that depression developed as a result of your primary disability due to struggles of physical disfigurement or chronic pain, depression can be recognized as a secondary condition, get you a combined rate and even make you eligible for TDIU in case it prevents you from securing a stable job.

Help for Veterans with Mental Health Conditions

If left untreated, any of these conditions can worsen dramatically. The VA provides services and tools for Veterans suffering from all sorts of mental health conditions. Some of them are available even if you are not enrolled in the VA Healthcare Program. To get help:

Final Words

Your experience in the military may leave you with severe trauma. And the fact that some scars are not visible does not mean that you do not deserve compensation for your sacrifice.

While the mental health of Veterans remains a sensitive and severely stigmatized topic, it is important to stay informed and have qualified knowledgeable professionals by your side. That way you can make sure to receive the maximum in the VA benefits you are entitled to.

Contact VCU right now, and book your free 30-minute call with one of our experts. Together we will go through your case and, with the help of our network of independent professionals and medical experts make sure that you receive your compensation in full.

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