Table of Contents

1. Introduction: Why Mental Health Claims Matter

2. Understanding Mental Health Conditions in Veterans

3. PTSD (Post-Traumatic Stress Disorder)

4. Depression (Major Depressive Disorder & Persistent Depressive Disorder)

5. Anxiety Disorders (Generalized Anxiety, Panic Disorder, Adjustment Disorder)

6. How the VA Evaluates Mental Health Conditions

7. Building a Strong Mental Health Claim

8. Evidence You Need for Approval

9. C&P Exams for Mental Health: What Actually Happens

10. Common Reasons Claims Are Denied

11. Appealing a Denial & Using IMOs/DBQs

12. Secondary Mental Health Claims

13. Increasing Your Rating: From 0% to 100%

14. Frequently Asked Questions

15. Final Thoughts: You Are Not Alone

**Chapter 1

Introduction: Why Mental Health Claims Matter**

Mental health conditions are among the most common and most disabling service-connected conditions for veterans. Combat exposure, high-stress environments, military sexual trauma (MST), long deployments, and intense operational tempo all contribute to long-term emotional and psychological injuries.

Many veterans suffer for years before seeking help.

The VA recognizes this and offers compensation, treatment, and support—but you must file a claim correctly, provide evidence, and understand how the VA rates these conditions.

This book will guide you step-by-step.

**Chapter 2

Understanding Mental Health Conditions in Veterans**

The three most common mental health conditions claimed by veterans are:

✔ PTSD

✔ Depression

✔ Anxiety

Although different, these conditions often overlap—and they can all be service-connected if properly documented.

The VA uses the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria when assessing your condition.

**Chapter 3

PTSD (Post-Traumatic Stress Disorder)**

PTSD can occur after exposure to:

• Combat

• Life-threatening events

• Training accidents

• Severe injury

• Military sexual trauma (MST)

• Witnessing violent incidents

• Sudden loss of friends or fellow servicemembers

The VA requires these elements for PTSD service connection:

1. A current diagnosis of PTSD by a licensed mental health provider

2. A verified stressor (the event that caused the condition)

3. A medical nexus linking the stressor to your PTSD

Your stressor can be:

• Combat → Automatically conceded under certain conditions

• Fear of hostile military or terrorist activity → Often conceded

• MST → Does not require official reporting; “markers” are accepted

PTSD ratings often range from 30% to 70%, though severe cases can reach 100%.

**Chapter 4

Depression (Major Depressive Disorder & Persistent Depressive Disorder)**

Depression is extremely common among veterans and may be:

• Service-connected directly

• Secondary to physical conditions

• Secondary to chronic pain

• Secondary to PTSD or anxiety

• Caused by MST

• Related to transition stress

Symptoms include:

• Loss of interest

• Fatigue

• Sleep disturbances

• Irritability

• Feelings of hopelessness

• Difficulty functioning socially or at work

The VA rates depression the same way it rates all mental health disorders using a unified system.

**Chapter 5

Anxiety Disorders**

The VA commonly rates:

• Generalized Anxiety Disorder (GAD)

• Panic Disorder (with or without agoraphobia)

• Social Anxiety Disorder

• Adjustment Disorder with Anxiety

Symptoms may include:

• Excessive worry

• Panic attacks

• Hypervigilance

• Difficulty concentrating

• Restlessness

• Sleep problems

• Social withdrawal

Anxiety often overlaps with PTSD or depression.

**Chapter 6

How the VA Evaluates Mental Health Conditions**

The VA rates all mental health conditions under the General Rating Formula for Mental Disorders (38 CFR §4.130).

Ratings include:

• 0% – Diagnosis but minimal impairment

• 10% – Mild symptoms

• 30% – Occasional decrease in work efficiency

• 50% – Reduced reliability and productivity

• 70% – Deficiencies in most areas (work, family relations, judgment)

• 100% – Total occupational and social impairment

Mental health ratings are based on severity, not the name of the condition.

**Chapter 7

Building a Strong Mental Health Claim**

To win your claim, you need:

✔ A clear diagnosis

✔ Documented symptoms

✔ Service connection (direct or secondary)

✔ Evidence of functional impairment

The VA looks at:

• Work problems

• Social withdrawal

• Relationship conflicts

• Suicidal ideation

• Panic attacks

• Hospitalizations

• Therapy notes

• Medication history

Your documentation must show how your condition affects your daily life.

**Chapter 8

Evidence You Need for Approval**

The strongest evidence includes:

1. Mental health diagnosis (DSM-5)

From a VA or private psychologist/psychiatrist.

2. Ongoing treatment notes

Therapy, medication, mental health appointments.

3. Nexus letter (if needed)

Explains connection between condition and service.

4. Lay statements

From you, family, or friends describing changes.

5. Stressor statements (PTSD only)

6. “Markers” in records (for MST)

**Chapter 9

C&P Exams for Mental Health: What to Expect**

During a Compensation & Pension (C&P) exam, the examiner will:

• Review symptoms

• Ask about your stressor

• Evaluate your functional level

• Assess social and occupational impairment

• Review your records

Important tips:

• Be honest (never minimize symptoms)

• Describe your worst days

• Don’t say “I’m fine” out of habit

• Explain how symptoms affect work, relationships, and daily life

C&P exams heavily influence your rating.

**Chapter 10

Common Reasons Mental Health Claims Are Denied**

The most frequent denials occur because:

• No current diagnosis

• No verified PTSD stressor

• Examiner says “less likely than not”

• Incomplete evidence

• No treatment records

• Symptoms don’t match rating criteria

• Veteran downplayed their condition

These issues can be fixed through appeals and better evidence.

**Chapter 11

Appealing a Denial (IMOs, DBQs & Supplemental Claims)**

If denied:

✔ File a Supplemental Claim with new evidence

✔ Get an Independent Medical Opinion (IMO)

✔ Get a private DBQ (Disability Benefits Questionnaire)

✔ Request a Higher-Level Review

✔ Appeal to the Board of Veterans’ Appeals if needed

Denials are common—but very fixable with strong evidence.

**Chapter 12

Secondary Mental Health Claims**

Many veterans receive service-connected mental health ratings as secondary conditions, such as:

• Depression caused by chronic pain

• Anxiety caused by tinnitus

• PTSD leading to alcohol/substance misuse

• Sleep apnea secondary to PTSD

• Panic disorder secondary to asthma or heart issues

Secondary claims are powerful and commonly approved with the right evidence.

**Chapter 13

Increasing Your Rating: From 0% to 100%**

If your condition worsens:

• Request an increase

• Provide updated mental health records

• Submit new lay statements

• Document any hospitalizations

• Show occupational and social decline

Most veterans with severe PTSD, depression, or anxiety fall between 50% and 100%.

**Chapter 14

Frequently Asked Questions**

Can I get 100% for mental health?

Yes. Severe PTSD, depression, or anxiety can qualify.

Can multiple mental health conditions be rated together?

No—mental health conditions are combined into one rating.

Does the VA reduce ratings?

Possible, but rare if you have continued treatment.

Do I need a private psychologist?

Not always, but private IMOs/DBQs can strengthen your case.

**Chapter 15

Final Thoughts: You Are Not Alone**

Your mental health is just as important as your physical health.

Whether your struggle comes from combat, MST, training injuries, personal loss, or years of service stress—you deserve help, benefits, and support.

This book is your roadmap.

You are not alone.

Help is available.

And your claim can be approved.