This tool provides estimates for educational purposes only. We are not accredited by the Department of Veterans Affairs and do not file claims, provide legal advice, or represent veterans before the VA (38 U.S.C. § 5904). For official assistance, contact a VSO, CVSO, or VA-accredited attorney.
Major Depressive Disorder
- Depression and PTSD cannot be rated separately, all mental health conditions share the same General Rating Formula and are rated as a single disability.
- If both PTSD and depression are diagnosed, the VA assigns one combined mental health rating reflecting all symptoms.
- Commonly claimed as secondary to chronic pain conditions (back pain, migraines, fibromyalgia), tinnitus, and hearing loss.
- The rating criteria are identical to PTSD, the key evidence is the level of occupational and social impairment, not the specific diagnosis.
- Veterans with an existing PTSD rating who develop depression should ensure all symptoms from both conditions are documented in VA examinations.
Based on VA's Schedule for Rating Disabilities (38 CFR Part 4) and related service-connection regulations. This page is a free community resource. We are not VA-accredited and do not file claims or provide legal advice (per 38 U.S.C. § 5904).
Last reviewed: April 2026 · Next review: October 2026
Maintained by: Veterans Benefits Navigator editorial team. Every citation links to a primary federal or state source. See editorial standards and our privacy posture.
Primary sources: 38 CFR Part 4 (Schedule for Rating Disabilities), VA.gov disability compensation, 38 CFR § 3.310 (secondary service connection)
Overview
Major depressive disorder is a mental health condition rated under Diagnostic Code 9434 using the General Rating Formula for Mental Disorders, the same rating criteria used for PTSD and all other mental health conditions. Ratings range from 0% to 100% based on the level of occupational and social impairment.
Because all mental health conditions share the same rating formula, a veteran cannot receive separate ratings for both PTSD and depression simultaneously. This is the pyramiding rule: the VA may not rate the same symptoms under multiple diagnostic codes. If a veteran has both conditions, the VA will assign a single rating reflecting the combined severity of all mental health symptoms. Veterans should ensure that all symptoms from all diagnosed mental health conditions are documented and considered in the single rating.
Major depressive disorder is frequently claimed as secondary to chronic pain conditions, including back pain, migraines, and fibromyalgia. The persistent pain, functional limitation, and reduced quality of life associated with chronic conditions are well-documented pathways to depression. It can also develop secondary to tinnitus, hearing loss, sleep apnea, and other conditions that cause ongoing distress and social isolation.
Rating Criteria
| Rating | Criteria |
|---|---|
| 0% | A mental condition has been formally diagnosed, but symptoms are not severe enough to interfere with occupational and social functioning or to require continuous medication. |
| 10% | Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform tasks only during periods of significant stress, or symptoms controlled by continuous medication. |
| 30% | Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform tasks, due to depressed mood, anxiety, chronic sleep impairment, or mild memory loss. |
| 50% | Reduced reliability and productivity due to flattened affect, circumstantial speech, panic attacks more than once per week, difficulty understanding complex commands, impaired judgment, difficulty in establishing and maintaining effective work and social relationships. |
| 70% | Deficiencies in most areas such as work, family relations, judgment, thinking, or mood, due to symptoms such as suicidal ideation, obsessional rituals, near-continuous panic or depression, impaired impulse control, spatial disorientation, neglect of personal appearance, inability to establish and maintain effective relationships. |
| 100% | Total occupational and social impairment due to symptoms such as gross impairment in thought processes, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting self or others, inability to perform activities of daily living, disorientation, or memory loss for close relatives or own name. |
- 0%
A mental condition has been formally diagnosed, but symptoms are not severe enough to interfere with occupational and social functioning or to require continuous medication.
- 10%
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform tasks only during periods of significant stress, or symptoms controlled by continuous medication.
- 30%
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform tasks, due to depressed mood, anxiety, chronic sleep impairment, or mild memory loss.
- 50%
Reduced reliability and productivity due to flattened affect, circumstantial speech, panic attacks more than once per week, difficulty understanding complex commands, impaired judgment, difficulty in establishing and maintaining effective work and social relationships.
- 70%
Deficiencies in most areas such as work, family relations, judgment, thinking, or mood, due to symptoms such as suicidal ideation, obsessional rituals, near-continuous panic or depression, impaired impulse control, spatial disorientation, neglect of personal appearance, inability to establish and maintain effective relationships.
- 100%
Total occupational and social impairment due to symptoms such as gross impairment in thought processes, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting self or others, inability to perform activities of daily living, disorientation, or memory loss for close relatives or own name.
These criteria describe how a VA Compensation & Pension examiner evaluates the condition during a rating exam. They are not a self-test. For mental health conditions under 38 CFR 4.130, a diagnosis must be made by a qualified clinician under DSM-5. Actual ratings depend on the totality of evidence reviewed by the VA.
Evidence Checklist
Required
Psychiatric evaluation
A current diagnosis of major depressive disorder from a psychiatrist, psychologist, or other qualified mental health provider using DSM-5 criteria.
Treatment records
Mental health treatment records showing ongoing symptoms, medication history, therapy notes, and the progression of the condition over time.
Recommended
Medication history
Documentation of antidepressant medications prescribed, dosages, changes, and effectiveness, demonstrating the ongoing need for pharmacological treatment.
Vocational assessment
Assessment of how depressive symptoms affect occupational functioning, including any work history changes, missed days, or reduced performance.
Helpful
Buddy statements
Statements from family, friends, or coworkers describing observed changes in mood, behavior, motivation, and social engagement.
Nexus to primary condition
If claimed as secondary, a medical opinion explaining how the primary service-connected condition (chronic pain, tinnitus, etc.) caused or contributes to depression.
Secondary Conditions
These conditions may be claimed as secondary to Major Depressive Disorder. A nexus is the medical link between a service-connected condition and a related condition. Nexus strength indicates the level of established medical evidence supporting that connection.
Sleep Apnea
DC 6847, Typical range: 0%, 30%, 50%, 100%
Hypertension
DC 7101, Typical range: 0%, 10%, 20%, 40%
GERD
DC 7346, Typical range: 10%, 30%, 60%
Erectile Dysfunction
DC 7522, Typical range: 0%, 20%
Substance Use Disorder
DC 9431, Typical range: 0%, 10%, 30%, 50%, 70%, 100%
Explore all secondary conditions in the Secondary Condition Mapper tool.
Related DBQs
Mental Disorders (Other Than PTSD)
Form 21-0960P-2
Search all DBQ forms in the DBQ Finder tool.
Next Steps
This information is for educational purposes only. We are not accredited by the Department of Veterans Affairs and do not file claims, provide legal advice, or represent veterans before the VA (38 U.S.C. § 5904). For official assistance, contact a VSO, CVSO, or VA-accredited attorney.