How does the VA rate depression?

I’ve had a wildly emotional day.
Not really sure why I didn’t realize it would totally wipe me out. I was planning on going to the car dealership today but that definitely didn’t happen.

After 3 long years I finally got my TDRL* re-assessment and the interviewer ended the conversation with:
“So… as you can probably tell, I’m NOT recommending you return to duty.”
I told my friends that it felt like equal parts “Ouch” and “lol duh”.

It was the answer I was expecting but there’s still a part of me that feels disappointed that I’ll never serve on active duty again.
I take comfort in the fact that through this blog I plan to continue serving, leading, and taking care of Sailors in my own way.
I figured it would be a good time to discuss how the VA even rates depression or mental health in general.

*TDRL is “Temporary Disability Retired List”.
I went through a MEDBOARD and they determined that I should be medically retired temporarily to see if my condition stabilizes.

What references are used?

As Sailors we always want to know “What instruction is that in?”
VA Disability ratings all use the “38 CFR Book C, Schedule for Rating Disabilities“

Which is found under the Web Automated Reference Material System (WARMS)
The WARMS includes manuals, directives, handbooks, Title 38 Code of Federal Regulations and more. The publications provide information about the Department of Veterans Affairs benefits policies.

Any reference materials you need for your VA benefits including Compensation and Pension, Education, Home Loans, etc. will be found in WARMS.

When you look a little deeper at the “Mental Disorders” section, you’ll see that the VA also use the DSM-IV as their reference.

So back to Book C.
Book C lists all diseases and disorders by systems.
For example “The Musculoskeletal System”, “The Respiratory System”, “The Endocrine System”, etc.

Hope you paid attention in Biology class.

Mental Disorders falls under appendices 4.125 – 4.130 (Just hit Ctrl+F to find it)

What’s The Process Like?

When you apply for VA disability pay, they hand you a blank piece of paper and tell you to “list everything that’s wrong with you from head to toe”. (Your experience may vary but this was mine.)

When I was asked to do this I was really confused and asked if there was a list I could look at.
Some kind of word bank like in a crossword puzzle.

It’s not that I was trying to claim anything that wasn’t genuinely wrong with me. It’s that I’ve ignored my health so much over my career that I actually don’t know what anything is called.

I just knew my whole life hurt.

The gentleman I talked to told me there was no list. Maybe I didn’t ask the right question.

Book C.
That’s it. That’s the list.

(I’ll go more in depth on this process on a later post.)

Are depression and anxiety rated differently than PTSD?

No.
While all mental health diagnoses vary, they all share the same general rating formula.

It’s not about the diagnosis, it’s about how it affects your life. 

The only mental disorder that has its own rating formula is eating disorders; anorexia and bulimia.

Just for ease, I’ve provided the General Rating Formula for Mental Disorders below.
If you actually go to the VA website that I linked you have to download the .doc file
If you have other disorders, you’ll have to go there and download each system individually.

What questions do they ask?

Whether it’s your initial assessment or a reassessment I’ve found that the questions I was asked basically go almost verbatim off of the general rating formula.

They will ask how your depression or anxiety has affected your professional and personal life.
Personally, I was asked:

• about my occupations and the jobs I’ve held since being retired
• about school and if I’ve gotten a degree
• about my hobbies
• about my short and long term memory
• if I’ve had problems sleeping
• if I had friends

Most awkwardly, I was asked if I had gotten married, divorced, started dating anyone since I’ve retired. (HAHAHAHA!)

I should note that my interview today was on the DOD side, not the VA side.
But they do ask basically the same thing and go off of the same formula.

What should I say?

Just be honest.
Don’t try to lie just to get a higher rating.
However, don’t shortchange yourself and try to make it sound like you’re doing better than you really are. By being honest you may even realize that you’re worse than you thought.

It was really hard for me to admit that I had issues with personal hygiene and finances but I mentioned it because it was an indication that my condition had actually worsened since retiring.

Please be fair to yourself and get the rating you deserve.

Veteran’s Affairs General Rating Formula for Mental Disorders

 

VA Rating	Description
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
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
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
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)
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
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