Illness anxiety disorder
Illness anxiety disorder is rated under 38 CFR 38 CFR § 4.130, Diagnostic Code 9425, from 0% to 100% based on the frequency and functional severity of symptoms. The maximum 100% rating requires: 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.. Most claims establish the 0% or 10% rating before reaching the top tier.
What are the VA rating criteria for Illness anxiety disorder?
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.
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.
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).
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.
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.
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.
“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.”
Common Questions About Illness anxiety disorder VA Ratings
What is the VA rating range for Illness anxiety disorder?
The VA rates Illness anxiety disorder under Diagnostic Code 9425 at 0%, 10%, 30%, 50%, 70%, 100%. The minimum 0% rating requires: 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.. The maximum 100% rating requires: 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..
Which 38 CFR diagnostic code does the VA use for Illness anxiety disorder?
The VA rates Illness anxiety disorder under Diagnostic Code (DC) 9425, governed by 38 CFR 38 CFR § 4.130. The diagnostic code establishes the specific rating tiers and severity criteria the VA examiner applies.
What is the difference between a 0% and a 100% rating for Illness anxiety disorder?
A 0% rating requires: 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.. A 100% rating requires: 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.. The difference typically reflects the frequency, severity, or functional impact of the condition as documented in medical records and C&P examination findings.
Can Illness anxiety disorder qualify for TDIU (Total Disability Individual Unemployability)?
Veterans rated for Illness anxiety disorder may qualify for TDIU if the condition — alone or in combination with other service-connected disabilities — prevents substantially gainful employment. A single disability rated at 60% or higher (or multiple disabilities combining to 70%, with one at 40%) can support a TDIU claim under 38 CFR § 4.16.
What evidence do I need to establish service connection for Illness anxiety disorder?
Service connection for Illness anxiety disorder requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease, and (3) a medical nexus linking the current diagnosis to that in-service occurrence. A nexus letter from a treating or independent medical examiner is the most reliable nexus evidence.
What is the C&P exam like for Illness anxiety disorder?
A Compensation & Pension (C&P) exam for Illness anxiety disorder uses a Disability Benefits Questionnaire (DBQ) specific to the body system involved. The examiner documents the frequency, severity, and functional impact of your symptoms. Bring all relevant treatment records and be prepared to describe your worst-day symptoms — the examiner rates your condition based on the full clinical picture, not a single visit.
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