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e-CFR Data is current as of February 4, 2010


Title 38: Pensions, Bonuses, and Veterans' Relief
PART 4—SCHEDULE FOR RATING DISABILITIES
Subpart B—Disability Ratings
Mental Disorders

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§ 4.130   Schedule of ratings—mental disorders.

The nomenclature employed in this portion of the rating schedule is based upon the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, of the American Psychiatric Association (DSM-IV). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in §4.125 through §4.129 and to apply the general rating formula for mental disorders in §4.130. The schedule for rating for mental disorders is set forth as follows:

  Rating
Schizophrenia and Other Psychotic Disorders
9201  Schizophrenia, disorganized type
9202  Schizophrenia, catatonic type
9203  Schizophrenia, paranoid type
9204  Schizophrenia, undifferentiated type
9205  Schizophrenia, residual type; other and unspecified types
9208  Delusional disorder
9210  Psychotic disorder, not otherwise specified (atypical psychosis)
9211  Schizoaffective disorder
Delirium, Dementia, and Amnestic and Other Cognitive Disorders
9300  Delirium
9301  Dementia due to infection (HIV infection, syphilis, or other systemic or intracranial infections)
9304  Dementia due to head trauma
9305  Vascular dementia
9310  Dementia of unknown etiology
9312  Dementia of the Alzheimer's type
9326  Dementia due to other neurologic or general medical conditions (endocrine disorders, metabolic disorders, Pick's disease, brain tumors, etc.) or that are substance-induced (drugs, alcohol, poisons)
9327  Organic mental disorder, other (including personality change due to a general medical condition)
Anxiety Disorders
9400  Generalized anxiety disorder
9403  Specific (simple) phobia; social phobia
9404  Obsessive compulsive disorder
9410  Other and unspecified neurosis
9411  Posttraumatic stress disorder
9412  Panic disorder and/or agoraphobia
9413  Anxiety disorder, not otherwise specified
Dissociative Disorders
9416  Dissociative amnesia; dissociative fugue; dissociative identity disorder (multiple personality disorder)
9417  Depersonalization disorder
Somatoform Disorders
9421  Somatization disorder
9422  Pain disorder
9423  Undifferentiated somatoform disorder
9424  Conversion disorder
9425  Hypochondriasis
Mood Disorders
9431  Cyclothymic disorder
9432  Bipolar disorder
9433  Dysthymic disorder
9434  Major depressive disorder
9435  Mood disorder, not otherwise specified
Chronic Adjustment Disorder
9440  Chronic adjustment disorder
General Rating Formula for Mental Disorders:
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 name100
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 relationships70
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 relationships50
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)30
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 medication10
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 medication0
Eating Disorders
9520  Anorexia nervosa
9521  Bulimia nervosa
Rating Formula for Eating Disorders:
Self-induced weight loss to less than 80 percent of expected minimum weight, with incapacitating episodes of at least six weeks total duration per year, and requiring hospitalization more than twice a year for parenteral nutrition or tube feeding100
Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of six or more weeks total duration per year60
Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of more than two but less than six weeks total duration per year30
Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder and incapacitating episodes of up to two weeks total duration per year10
Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder but without incapacitating episodes0

Note: An incapacitating episode is a period during which bed rest and treatment by a physician are required.

(Authority: 38 U.S.C. 1155)

[61 FR 52700, Oct. 8, 1996, as amended at 74 FR 18467, Apr. 23, 2009]

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