Chapter Thriteen

The Rating Board

This is a good point to begin to explain to you what the Rating Board is looking for when they award a Veteran a 100% Rating for PTSD. You will begin to see how the previously mentioned letters from friends or family can be very helpful to substantiate your PTSD Claim.

At the beginning of this booklet we told you about the 38 CFR (Title 38 Code of Federal Regulations). The 38 CFR is the book which lays out criteria needed for the Rating Board to reach its’ decision about what percentage of disability a Veteran is warranted.

The General Rating Formula for Psychoneurotic disorders are found in the 38 CFR under section 4, part .132 . Each illness is listed by a Diagnostic Code Number. The Diagnostic Codes are numbered 9400 through 9411. There are ten Psychoneurotic Disorders. The following list of Diagnostic Codes arre taken directly from the 38 CFR, section 4, part .132 .

9400 Generalized anxiety disorder
9401 Psychogenic amnesia; psychogenic fugue; multiple personality
9402 Conversion disorder; psychogenic pain disorder
9403 Phobic disorder
9404 Obsessive compulsive disorder
9405 Dysthymic disorder: Adjustment disorder with depressed mood; Major Depression without melancholia
9406 (reserved)
9407 (reserved)
9408 Depersonalization disorder
9409 Hypochondriasis
9410 Other and unspecified neurosis
9411 Post-traumatic stress disorder

There are four notes which apply to the rating formula. The Rating Board Officer is required to review notes one thru four to see if any of the information in these notes may apply to the Veterans requesting a Rating Board decision. The following four notes are taken directly from the 38 CFR, part 4, section .132 .

The Four Notes

NOTE 1)
Social impairment Per Se will not be used as the sole basis for any specific percentage evaluation, but is of value only in substantiating the degree of disability on all of the findings.

NOTE 2)
The requirements for a compensation rating are not met when the psychiatric findings are not more characteristic than minor alterations of mood beyond normal limits; fatigue or anxiety incident to actual situations; minor compulsive acts or phobias; occasional stuttering or stammering; minor habit spasms or tics; minor subjective sensory disturbances such as anosmia, deafness, loss of sense of taste, anesthesia, parenthesis, etc. When such findings actually interfere with employability to a mild degree, a 10 percent rating under the general rating formula may be assigned.

NOTE 3)
It is to be emphasized that vague complaints are not to be erected into a concept of conversion disorder. A diagnosis of conversion disorder must be established on the basis of specific distinctive findings characteristic of such disturbance and not merely by exclusion of organic disease. If a diagnosis of conversion disorder is found by the Rating Board to be inadequately supported by findings, the report of examination will be returned through channels to the examiner for reconsideration.

NOTE 4)
When two diagnosis, one organic and the other psychological or psychoneurotic, are presented covering the organic and psychiatric aspects of a single disability entity, only one percentage evaluation will be assigned under the appropriate Diagnostic Code determined by the Rating Board to represent the major degree of disability. When the diagnosis of the same basic disability is changed from an organic one to one in the psychological or psychoneurotic categories, the condition will be rated under the new diagnosis.

NOTES 1) and 2) generally apply toward PTSD ratings. NOTE 3) applies more towards a conversation disorder rather than PTSD. NOTE 4) applies to a diagnosis of two disorders, one being organic (Physical brain damage) and one being psychiatric (PTSD).

NOTE 1) basically say’s just because a person can not relate sociably or participate in having an active role in Social Activities, this can not be the entire basis for a compensation rating. However, it does have a value as the Rating Board considers the OVERALL FINDINGS (other criteria, such as PTSD symptoms) concerning the disability of the Veteran.

NOTE 2) says a Veterans’ claimed disorder is not a disorder if a Psychiatrist interviews the Veteran and decides the problem(s) are simply minor complaints. However, if the minor complaints actually interfere with the Veterans job, the Veteran can be awarded a 10% disability rating.

General Rating Formula for PTSD
(Psychoneurotic Disorder)
----- ----- ----- ----- ----- ----- ----- -----
The following General Rating Formula is taken directly from the 38 CFR, part 4, section .132 .

For a 100% Rating; The attitudes of all contacts except the most intimate are so adversely affected as to result in virtual isolation in the community. Totally incapacitating psychoneurotic symptoms bordering on gross repudiation of reality with disturbed thought or behavioral processes associated with almost all daily activities such as fantasy, confusion, panic and explosions of aggressive energy resulting in profound retreat from mature behavior. Demonstrably unable to obtain or retain employment.

For a 70% Rating;
Ability to establish and maintain effective or favorable relationships with people is severely impaired. The psychoneurotic symptoms are of such severity and persistence that there is severe impairment in the ability to obtain or retain employment.

For a 50% Rating:
Ability to establish and maintain effective or favorable relationships with people is considerably impaired. By reason of psychoneurotic symptoms the reliability, flexibility and efficiency levels are so reduced as to result in considerable industrial impairment.

For a 30% Rating:
Definite impairment in the ability to establish or maintain effective and wholesome relationships with people. The psychoneurotic symptoms result in such reduction in initiative, flexibility, efficiency and reliability levels as to produce definite industrial impairment.

For a 10% Rating;
Less than criteria for the 30 percent, with emotional tension or other evidence of anxiety productive of mild social and industrial impairment.

For a 0% Rating (but service connected);
There are neurotic symptoms which may somewhat adversely affect relationships with others but which do no cause impairment of working ability.

The above Rating Formulas are the exact words from the 38 CFR used by the Rating Board to determine what percentage of disability a Veteran is warranted. If the Veterans evidence happens to fall between two of the formula percentages, then the Rating Board may award a higher Rating. For example, if the evidence presents itself as being greater than 30% but less than 50% the Rating Board may award a 40% Rating.