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VA Disability Rating

VA Disability Rating for PTSD

Post-traumatic stress disorder is one of the most-claimed VA mental-health conditions, rated on how much the symptoms impair your work and daily functioning.

Diagnostic code 9411 · §4.130 · Mental disorders · up to 100%

How the VA rates PTSD

The VA assigns one of these ratings for Posttraumatic stress disorder (PTSD), based on the severity of your condition. These criteria are summarized from §4.130:

RatingWhen it applies
100%Total occupational and social impairment due to: gross impairment in thought processes or communication, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting self or others, inability to perform ADLs, disorientation to time or place, memory loss for names of close relatives, own occupation, or own name
70%Deficiencies in most areas (work, school, family, judgment, thinking, mood) due to: suicidal ideation, obsessional rituals, illogical/obscure speech, near-continuous panic or depression, impaired impulse control, spatial disorientation, neglect of appearance/hygiene, difficulty adapting to stress, inability to establish effective relationships
50%Reduced reliability and productivity due to: flattened affect, panic attacks more than once a week, difficulty understanding complex commands, impaired short/long-term memory, impaired judgment, disturbances of motivation and mood, difficulty establishing effective relationships
30%Occasional decrease in work efficiency with intermittent inability to perform tasks due to: depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss
10%Mild or transient symptoms that decrease work efficiency only during periods of significant stress, or symptoms controlled by continuous medication
0%Diagnosed, but symptoms not severe enough to interfere with occupational/social functioning or require continuous medication

Conditions commonly connected to PTSD

PTSD is frequently claimed alongside, or as a secondary to, these conditions. If you have any of them, they may be separately ratable:

Sleep apnea (secondary to PTSD)Major depressive disorderMigraine headachesErectile dysfunctionSubstance abuse disorderHypertension (secondary to PTSD)GERD/acid refluxBruxism/TMJ

How to strengthen a PTSD claim

The rating you receive depends almost entirely on your evidence and your C&P exam. To put your best claim forward:

Peer-Reviewed Research on PTSD

26 peer-reviewed studies linked to PTSD (diagnostic code 9411) in the VA Ready app, sourced from PubMed and the U.S. National Library of Medicine. Every citation is real and links to the source — bring them to your C&P exam or hand them to your VSO.

  1. Meta-analysisPrimary2023
    Studying the Prevalence of PTSD in Veterans, Combatants and Freed Soldiers of Iran-Iraq War.
    Psychology, health & medicine · 2023
    • Pooled prevalence of PTSD in combatants ~38 percent.
    • Prevalence in freed POWs substantially higher.
    • Time since exposure did not reduce prevalence — chronic course.

    Why it matters: Supports chronicity of combat PTSD; relevant for service connection and TDIU.

    View on PubMed ↗
  2. Systematic reviewPrimary2020
    Psychological and pharmacological interventions for PTSD and comorbid mental health problems following complex traumatic events.
    PLoS medicine · 2020
    • Multicomponent psychological interventions (TF-CBT, EMDR) reduced PTSD symptoms with moderate-to-large effect sizes.
    • Combined treatments addressing comorbid depression and anxiety produced additional benefit in complex PTSD.
    • Pharmacotherapy alone produced smaller effects than psychotherapy.

    Why it matters: Supports that combat veterans with comorbid depression and anxiety warrant multicomponent treatment.

    View on PubMed ↗
  3. Cohort studyPrimary2020
    Combat-Related PTSD and Comorbid Major Depression in U.S. Veterans: The Role of Deployment Cycle Adversity and Social Support.
    Journal of traumatic stress · 2020
    • Comorbid major depression occurred in over half of U.S. veterans with combat-related PTSD.
    • Higher deployment cycle adversity predicted greater comorbid depression severity.
    • Lower post-deployment social support was independently associated with PTSD-MDD comorbidity.

    Why it matters: Strong evidence supporting secondary service connection of MDD to combat PTSD.

    View on PubMed ↗
  4. Meta-analysisPrimary2020
    Epigenome-wide meta-analysis of PTSD across 10 military and civilian cohorts identifies methylation changes in AHRR.
    Nature communications · 2020
    • DNA methylation changes in AHRR gene associated with PTSD across 10 cohorts.
    • Biological signature of PTSD persists across trauma type and cohort.
    • Epigenetic markers may serve as future biomarkers.

    Why it matters: Provides biological evidence supporting legitimacy of the diagnosis in disability adjudication.

    View on PubMed ↗
  5. ReviewPrimary2019
    The Efficacy of Cognitive Processing Therapy for PTSD Related to Military Sexual Trauma in Veterans: A Review.
    Journal of evidence-based social work · 2019
    • CPT demonstrates significant efficacy for PTSD secondary to MST.
    • Veterans receiving CPT show clinically meaningful symptom reduction.
    • Gender-sensitive delivery improves engagement and outcomes.

    Why it matters: Supports MST-related PTSD as service-connected with established treatment.

    View on PubMed ↗
  6. Meta-analysisPrimary2015
    Benzodiazepines for PTSD: A Systematic Review and Meta-Analysis.
    Journal of psychiatric practice · 2015
    • Benzodiazepines are ineffective for PTSD treatment and may worsen outcomes.
    • Benzodiazepine use was associated with increased aggression, depression, and substance misuse in veterans with PTSD.
    • Evidence supports avoiding benzodiazepines in PTSD; trauma-focused psychotherapy and SSRIs remain first-line.

    Why it matters: Supports argument that veterans on benzodiazepines may have inadequately treated PTSD.

    View on PubMed ↗
  7. Meta-analysisPrimary2013
    Meta-analysis of the efficacy of treatments for posttraumatic stress disorder.
    The Journal of clinical psychiatry · 2013
    • Psychotherapy (notably trauma-focused CBT and EMDR) produced large effect sizes for PTSD symptom reduction.
    • SSRIs and SNRIs produced moderate effects; risperidone, topiramate, and venlafaxine had supportive evidence.
    • Benzodiazepines lacked evidence of benefit and are not recommended for PTSD.

    Why it matters: Foundational evidence supporting service-connected PTSD treatment efficacy.

    View on PubMed ↗
  8. ReviewPrimary2012
    Review: managing PTSD in combat veterans with comorbid traumatic brain injury.
    Journal of rehabilitation research and development · 2012
    • PTSD-TBI comorbidity highly prevalent in OEF/OIF veterans; complicates treatment.
    • Symptom overlap between PTSD and post-concussive syndrome can confound diagnosis.
    • Integrated multidisciplinary care improves outcomes.

    Why it matters: Supports secondary service connection of PTSD to documented TBI events.

    View on PubMed ↗
  9. Systematic reviewPrimary2010
    Prevalence estimates of combat-related post-traumatic stress disorder: critical review.
    The Australian and New Zealand journal of psychiatry · 2010
    • Lifetime PTSD prevalence among Vietnam veterans 10-30 percent depending on methodology.
    • Current PTSD prevalence in OEF/OIF veterans 4-17 percent.
    • Higher combat exposure consistently correlated with elevated PTSD risk.

    Why it matters: Authoritative prevalence data supporting combat-related PTSD as service-connected.

    View on PubMed ↗
  10. Meta-analysisSupporting2025
    Post-traumatic stress disorder, attention deficit and hyperactivity disorder, and 24 gastrointestinal diseases: Evidence from Mendelian randomization analysis
    Medicine (Baltimore) · 2025
    • Causal effect of PTSD on GERD demonstrated via MR
    • PTSD increases risk of multiple GI conditions including GERD and IBS
    • Robust to sensitivity analyses

    Why it matters: Strengthens causal argument for PTSD-secondary GERD

    View on PubMed ↗
  11. Case-controlSupporting2024
    Posttraumatic Stress Disorder and Obstructive Sleep Apnea in Twins.
    JAMA Network Open · 2024
    • Vietnam Era Twin Registry to test PTSD-OSA association controlling for shared genetics and early environment
    • PTSD severity associated with higher OSA prevalence within twin pairs
    • Causal interpretation: PTSD increases OSA risk independent of familial confounders

    Why it matters: Strongest available evidence for secondary service connection of OSA to PTSD

    View on PubMed ↗
  12. Cohort studySupporting2024
    Comorbidity Profiles of Posttraumatic Stress Disorder Across the Medical Phenome
    Biological Psychiatry Global Open Science · 2024
    • GERD ranks among most strongly elevated comorbidities in PTSD
    • Cross-system comorbidity confirmed across multiple EHR networks
    • Effect persists after demographic adjustment

    Why it matters: Population-level support for PTSD-secondary GERD claims

    View on PubMed ↗
  13. Cohort studySupporting2023
    Assessment of Post-traumatic Stress Disorder Among Objective Esophageal Motility and Reflux Phenotypes in Symptomatic Veterans
    Journal of Clinical Psychology in Medical Settings · 2023
    • PTSD significantly associated with functional esophageal disorders in veterans
    • Veterans with PTSD more likely to have reflux hypersensitivity and functional heartburn than true GERD
    • Symptom severity overlapped between true GERD and functional phenotypes with PTSD

    Why it matters: Supports service connection linkage between PTSD and GERD-spectrum esophageal disease

    View on PubMed ↗
  14. Cross-sectionalSupporting2023
    Initial assessment of medical post-traumatic stress among patients with chronic esophageal diseases
    Neurogastroenterology and Motility · 2023
    • Medical PTSD symptoms prevalent in chronic esophageal disease including GERD
    • Esophageal symptom flares correlate with traumatic stress responses
    • Bidirectional mind-gut relationship documented

    Why it matters: Peer-reviewed nexus between trauma-related stress and chronic GERD

    View on PubMed ↗
  15. Meta-analysisSupporting2023
    Investigating the shared genetic architecture of post-traumatic stress disorder and gastrointestinal tract disorders: a genome-wide cross-trait analysis
    Psychological Medicine · 2023
    • Significant shared genetic architecture between PTSD and GERD
    • Mendelian randomization supports causal effect of PTSD on GERD risk
    • Shared loci identified across PTSD and multiple GI disorders

    Why it matters: Provides biological mechanism for PTSD-GERD secondary service connection

    View on PubMed ↗
  16. Cross-sectionalSupporting2023
    Self-reported gastrointestinal disorders among veterans with Gulf War illness with and without posttraumatic stress disorder
    Neurogastroenterology and Motility · 2023
    • IBS more prevalent in Gulf War veterans with PTSD vs without
    • GWI plus PTSD multiplicatively increases GI burden
    • Functional dyspepsia also elevated

    Why it matters: Direct support for PTSD-secondary IBS in Gulf War veterans

    View on PubMed ↗
  17. ReviewSupporting2022
    Male Sexual Health Related Complications Among Combat Veterans
    Sexual Medicine Reviews · 2022
    • Contemporary review of ED and related complications in combat veterans
    • Multiple mechanisms documented
    • Comprehensive overview of veteran-specific issues

    Why it matters: Comprehensive overview for ED claims and ratings.

    View on PubMed ↗
  18. Meta-analysisSupporting2021
    The global prevalence of depression, suicide ideation, and attempts in the military forces: a systematic review and Meta-analysis.
    BMC psychiatry · 2021
    • Pooled global prevalence of depression in military forces ~23 percent.
    • Pooled prevalence of suicidal ideation ~11 percent.
    • Combat exposure and deployment were significant predictors.

    Why it matters: Globally representative evidence supporting MDD service connection.

    View on PubMed ↗
  19. Systematic reviewSupporting2021
    Relationship Between Posttraumatic Stress Disorder and Sexual Difficulties: A Systematic Review of Veterans and Military Personnel
    The Journal of Sexual Medicine · 2021
    • Comprehensive systematic review of PTSD-sexual dysfunction link
    • Consistent association across studies
    • Mechanisms include both psychological and pharmacological factors

    Why it matters: Highest-tier evidence for secondary service-connection of ED to PTSD.

    View on PubMed ↗
  20. Cohort studySupporting2021
    Posttraumatic stress disorder and the risk of erectile dysfunction: a nationwide cohort study in Taiwan
    Annals of General Psychiatry · 2021
    • Large nationwide cohort confirms PTSD as independent risk factor for ED
    • Effect persists after adjusting for confounders
    • International corroboration of US findings

    Why it matters: Corroborating international epidemiological evidence for PTSD-secondary ED.

    View on PubMed ↗
  21. Cohort studySupporting2019
    Risk factors for upper and lower functional gastrointestinal disorders in Persian Gulf War Veterans during and post-deployment
    Neurogastroenterology and Motility · 2019
    • Deployment-related stress, GI infection, and PTSD independently increased IBS risk
    • Post-infectious IBS pattern documented
    • Risk persists years post-deployment

    Why it matters: Establishes deployment as risk factor for IBS

    View on PubMed ↗
  22. Meta-analysisSupporting2018
    Prevalence of Mental Health Disorders in Elderly U.S. Military Veterans: A Meta-Analysis and Systematic Review.
    The American journal of geriatric psychiatry · 2018
    • Pooled prevalence of major depression in elderly U.S. veterans ~11 percent.
    • GAD prevalence in elderly veterans ~5 percent.
    • PTSD prevalence ~7 percent, higher in combat veterans.

    Why it matters: Authoritative prevalence baseline for service-connected MDD/GAD/PTSD in older veterans.

    View on PubMed ↗
  23. Systematic reviewSupporting2015
    Systematic Review of Sexual Dysfunction Among Veterans with Post-Traumatic Stress Disorder
    Sexual Medicine Reviews · 2015
    • Earlier systematic review establishing PTSD-sexual dysfunction connection in veterans
    • Multiple sexual dysfunction subtypes documented
    • Treatment implications outlined

    Why it matters: Historical evidence supporting secondary claims.

    View on PubMed ↗
  24. Cohort studySupporting2014
    Sexual dysfunction in male Iraq and Afghanistan war veterans: association with posttraumatic stress disorder and other combat-related mental health disorders: a population-based cohort study
    The Journal of Sexual Medicine · 2014
    • Population-based cohort linking PTSD and combat mental health disorders to ED in OEF/OIF veterans
    • Strong dose-response with PTSD severity
    • Other mental health disorders also associated

    Why it matters: Primary source for secondary service-connection of ED to PTSD.

    View on PubMed ↗
  25. Cross-sectionalSupporting2013
    Post-traumatic stress disorder, depression, and aggression in OEF/OIF veterans.
    Military medicine · 2013
    • OEF/OIF veterans with PTSD had significantly higher rates of comorbid major depression.
    • Combined PTSD and depression were associated with elevated aggression and impulsivity.
    • Comorbid presentations predicted greater functional impairment.

    Why it matters: Supports secondary service connection of MDD to PTSD in post-9/11 veterans.

    View on PubMed ↗
  26. Cross-sectionalSupporting2011
    Deployment-related TBI, persistent postconcussive symptoms, PTSD, and depression in OEF/OIF veterans.
    Rehabilitation psychology · 2011
    • Deployment-related TBI significantly associated with persistent post-concussive symptoms, PTSD, and depression.
    • Veterans with TBI had ~2x or greater risk of meeting criteria for major depression.
    • PTSD partially mediated the TBI-depression relationship.

    Why it matters: Supports secondary service connection of depression to in-service TBI.

    View on PubMed ↗

Citations are provided for general educational use and are not medical advice. The VA Ready app pairs every study with its key findings and a one-tap Claim Summary PDF appendix.

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Common questions

What is the VA rating for PTSD?

The VA rates Posttraumatic stress disorder (PTSD) under diagnostic code 9411 (§4.130). Ratings run up to 100%, assigned from the criteria in the table above based on the severity of your condition.

What diagnostic code does the VA use for PTSD?

Diagnostic code 9411, rated under §4.130 of the VA Schedule for Rating Disabilities.

Can PTSD be claimed as a secondary condition?

Yes. PTSD is commonly connected to conditions like Sleep apnea (secondary to PTSD), Major depressive disorder, Migraine headaches. A secondary claim needs a medical nexus linking it to your service-connected condition.

This page is for general informational purposes only and is not legal or medical advice. Rating criteria are summarized from 38 CFR Part 4; the VA determines actual ratings based on your evidence and exam. VA Ready is not affiliated with the U.S. Department of Veterans Affairs. Always verify current criteria at VA.gov and consult a VA-accredited representative.