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Image Credit: Gang & Associates
Summary: Veterans who believe their PTSD VA rating is too low may have options to seek a higher disability rating. The appropriate path depends on whether VA made an error in the original rating decision, whether PTSD symptoms have worsened, and what medical and lay evidence supports the claim.
A PTSD VA rating can have long-term consequences for a veteran’s disability compensation, but the percentage assigned by the Department of Veterans Affairs may not always reflect the severity of the veteran’s symptoms or their impact on daily life, relationships, and employment. When a veteran believes a PTSD rating is too low, the key question is whether the evidence supports an appeal of the existing rating or a claim for an increased disability rating.
VA currently evaluates posttraumatic stress disorder under the General Rating Formula for Mental Disorders in 38 C.F.R. § 4.130. PTSD is rated at 0%, 10%, 30%, 50%, 70%, or 100%, with the rating criteria generally based on the degree of occupational and social impairment caused by the condition.
How Can a Veteran Get a Higher PTSD VA Rating?
A veteran may be able to seek a higher PTSD VA rating when the evidence shows that the condition causes a greater level of occupational and social impairment than the current rating reflects. The appropriate approach depends on why the current rating is considered too low.
In general, a veteran may need to:
- Review the existing VA rating decision and the evidence VA considered.
- Compare the documented symptoms and functional limitations with the applicable PTSD rating criteria.
- Provide current medical evidence when PTSD symptoms have worsened.
- Provide relevant lay evidence describing changes in behavior, relationships, daily functioning, or employment.
- Determine whether the issue is an error in the original rating decision or a subsequent worsening of PTSD.
- Consider whether TDIU may apply when service-connected disabilities prevent substantially gainful employment.
The distinction between challenging an existing rating and seeking an increased rating can affect the appropriate VA filing and the evidence needed to support it.
How VA Assigns a PTSD Rating
The VA PTSD rating schedule does not assign a fixed percentage to each individual PTSD symptom. Instead, the rating generally reflects the overall level of occupational and social impairment caused by the condition. A 30% rating, for example, addresses occupational and social impairment involving occasional decreases in work efficiency, while the 50% level addresses reduced reliability and productivity. The 70% criteria describe deficiencies in most areas, including work, family relations, judgment, thinking, or mood. A 100% rating requires total occupational and social impairment.
That structure can make the quality of the evidence important. The question is not simply whether a veteran experiences anxiety, sleep problems, panic, irritability, memory difficulties, or other PTSD symptoms. The record also needs to help VA understand their frequency, severity, and effect on occupational and social functioning.
Eric Gang is a veterans disability attorney and founder of Gang & Associates, a law firm focused on helping veterans obtain the VA disability benefits they have earned through service. He represents veterans nationwide in VA disability claims and appeals, including cases before the Board of Veterans’ Appeals and the U.S. Court of Appeals for Veterans Claims. His practice includes complex VA disability matters involving PTSD, traumatic brain injuries, toxic exposure, and secondary service-connected disabilities.
Why a PTSD Rating May Feel Too Low
According to veterans disability attorney Eric Gang, veterans who believe their PTSD VA rating is too low should first compare the rating decision with the evidence VA considered. A rating may not reflect the veteran’s current level of impairment when important treatment records, workplace difficulties, relationship problems, or changes in PTSD symptoms are not adequately documented in the record.
Evidence can come from more than one source. VA’s guidance for increased disability claims states that veterans should provide current evidence showing that a service-connected disability has worsened. VA identifies medical records or medical opinions and lay evidence, such as a buddy statement, as possible supporting materials.
Statements from spouses, family members, friends, or others who regularly observe the veteran may provide additional context about changes in behavior or functioning. VA also notes that supporting statements can describe how a condition has worsened.
This type of evidence can be particularly useful when the veteran’s symptoms affect everyday functioning in ways that may not be fully captured during a medical examination.
Should You Appeal a PTSD Rating or File for an Increase?
The appropriate path depends partly on whether the veteran is challenging the original PTSD rating decision or reporting that the service-connected condition has become worse since the rating was assigned. These situations can involve different VA processes and evidence requirements.
If a veteran believes VA assigned the wrong PTSD rating based on the evidence available when the decision was made, the VA decision-review system provides three general options: a Supplemental Claim, Higher-Level Review, or Board Appeal. A Supplemental Claim allows new and relevant evidence, while Higher-Level Review asks a senior reviewer to reconsider the existing record without accepting new evidence.
If the original rating was reasonable at the time but PTSD has since become worse, VA directs veterans toward an increased disability claim rather than a Supplemental Claim simply because the condition deteriorated.
The timing can also affect VA back pay and the effective date. VA states that an increased rating may sometimes date back to the earliest point when the increase in disability can be shown, provided the increased claim is received within one year of that date.
What Evidence Can Support a Higher PTSD VA Rating?
Evidence supporting a higher PTSD VA rating should help establish the severity of the condition and its impact on occupational and social functioning. Depending on the circumstances, relevant evidence may include:
- VA or private treatment records documenting PTSD symptoms and changes in severity.
- Medical opinions addressing the severity and functional effects of PTSD.
- Statements from spouses, family members, friends, coworkers, or others who regularly observe the veteran.
- Evidence describing difficulties with employment, relationships, judgment, concentration, or daily activities.
- Records documenting changes in treatment, medication, or mental health care.
- Other evidence that helps establish the frequency, severity, and functional impact of PTSD symptoms.
The strongest evidence depends on the reason the veteran’s current rating is considered inadequate and the specific rating level being sought.
When PTSD Affects the Ability to Work
For some veterans, the question is not simply whether PTSD supports a 50%, 70%, or 100% schedular rating. If service-connected disabilities prevent substantially gainful employment, Total Disability Individual Unemployability (TDIU) may also be relevant. VA says qualifying veterans may receive compensation at the 100% rate even when their underlying disability rating remains below 100%.
There is no automatic way to obtain a higher PTSD VA rating. A stronger approach begins by determining whether the current rating accurately reflects the veteran’s documented symptoms and level of occupational and social impairment. Veterans should also determine whether they are challenging an earlier rating decision or seeking an increase because PTSD has worsened since the original rating. Depending on the circumstances, the appropriate path may involve VA decision review, an increased disability claim, additional medical or lay evidence, or consideration of TDIU. For veterans facing complex PTSD claims or disputed disability ratings, an experienced veterans disability attorney can help evaluate the available options and evidence.
