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Rating guide · Mental health

Depression & Anxiety: When Pain Becomes Something More

A service injury rarely stays just physical. Years of pain, poor sleep or losing the work you loved can bring on depression and anxiety, and the VA can rate that as part of your claim.

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Rating criteria quoted
Secondary connection
One shared rating
What to bring to the exam

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The most common route

Connecting Depression to a Physical Condition

Depression and anxiety don’t have to start in uniform. If a service-connected condition caused or worsened them, they can be connected on a secondary basis. Frequent examples:

Chronic back or knee pain that forced you out of farm work, trades or a job you loved
Tinnitus that never lets you rest
Frequent migraines or the effects of a brain injury

What wins these claims is a medical opinion explaining how the physical condition led to the mental health condition, not just that both exist.

38 CFR 4.130

The Mental Health Rating Criteria

One formula covers depression, anxiety, PTSD and other diagnoses. 2026 pay for a veteran with no dependents.

Current as of October 2026. Pay effective December 1, 2025; dependents add more at 30% and above.
Rating	VA criteria	2026 pay (alone)
100%	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.	$3,938.58
70%	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.	$1,808.45
50%	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.	$1,132.90
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), 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).	$552.47
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.	$180.42
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.	$0.00

Good to know

Why You Get One Rating, Not Two

If you’re diagnosed with both depression and anxiety, or with either one plus PTSD, the VA combines them into a single mental health rating based on your overall impairment. That protects against paying twice for the same symptoms, but it also means the exam should capture all of them together.

Before the exam, list your symptoms, how often they show up, and what they’ve cost you at work and at home. Be honest about the bad days.

FAQ

Depression & Anxiety VA Rating: Common Questions

Can chronic pain make depression service-connected?

Yes. If the painful condition is service-connected and a medical opinion links your depression to it, the depression can be service-connected on a secondary basis.

Do I need a VA psychiatrist’s diagnosis?

No. A diagnosis from a qualified private provider counts, though the VA will usually schedule its own exam.

I have depression and PTSD. Two ratings?

No. The VA rates all mental health conditions together as one rating reflecting your overall symptoms.

Does medication lower my rating?

Not on its own. Symptoms controlled by continuous medication support 10%, and higher ratings reflect the impairment that remains.

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