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9433
§ 4.130 Schedule of ratings—Mental disorders.

Persistent depressive disorder (dysthymia)

Chronic depression (persistent depressive disorder) with long-lasting low mood

What the rating means

Persistent depressive disorder (dysthymia) is rated under the General Rating Formula for Mental Disorders, which VA uses for most mental health conditions. Six percentage levels are possible: 0%, 10%, 30%, 50%, 70%, and 100%.

At 0%, a diagnosis exists but symptoms do not interfere with work or social life and do not require continuous medication. At 10%, symptoms are mild or come and go, and they reduce your work efficiency only during periods of significant stress, or your symptoms are controlled by continuous medication. At 30%, you have occasional drops in work efficiency and intermittent periods where you cannot perform work tasks, though you generally function satisfactorily. At 50%, your reliability and productivity at work and in social settings are reduced. At 70%, you have deficiencies in most areas of life — work, school, family relations, judgment, thinking, or mood. At 100%, your occupational and social functioning is totally impaired.

Evidence that helps

Medical records documenting your diagnosis under DSM-5 criteria form the foundation of the evidence. For a 10% rating, records or a provider's notes showing symptoms that appear mainly under stress, or a prescription showing continuous medication use, would be relevant. For 30%, treatment notes or VA exam findings reflecting depressed mood, anxiety, panic attacks occurring weekly or less, or chronic sleep impairment help show that level of impact. For 50%, records showing panic attacks more than once a week, memory problems, impaired judgment, or speech disturbances support that rating. For 70%, documentation of suicidal ideation, near-continuous depression, inability to maintain relationships, or difficulty adapting to a work setting is relevant. For 100%, records reflecting gross disorientation, persistent hallucinations or delusions, or inability to maintain basic personal hygiene would apply. Your own statements, or statements from family members and coworkers, describing how symptoms affect your daily tasks, attendance, and relationships directly tie to the functional criteria at each level.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.

  • Erectile dysfunction
  • GERD (acid reflux)
  • High blood pressure
  • Sleep apnea