VA Anxiety Claims: How Generalized Anxiety, Panic, and Phobias Are Rated

Anxiety disorders are among the most commonly service-connected mental health conditions after PTSD. The VA groups generalized anxiety disorder, panic disorder, specific phobias, social anxiety, and other anxiety-spectrum diagnoses under a shared rating formula. This guide explains the diagnostic codes, how service connection actually gets established (direct and secondary), how the rating formula works, the single-rating rule when anxiety coexists with other mental health conditions, the evidence that wins, why these claims get denied, a checklist before you file, what the claims process looks like step by step, how to read your decision letter, and what to do whether you win or you're denied.

Last updated: July 2026 · Educational use only. Not legal advice. Verify current rules at VA.gov or eCFR.

Overview

Anxiety disorders are rated under the General Rating Formula for Mental Disorders at 38 CFR 4.130, using whichever diagnostic code best matches the diagnosis, most commonly DC 9400 (generalized anxiety disorder), DC 9412 (panic disorder and/or agoraphobia), or DC 9403 (specific phobia or social anxiety disorder). One important thing up front: VA generally reads an anxiety claim broadly to cover any mental health condition your symptoms and records point to, whether that turns out to be generalized anxiety disorder, depression, adjustment disorder, or PTSD. So the service-connection lessons in this guide apply to acquired psychiatric disorders generally, not just to claims that use the word anxiety.

Two different fights. Winning service connection for anxiety in the first place, and winning a higher rating (or an earlier effective date) once you already have service connection, are two different fights that turn on different evidence. If you are already service-connected, figure out which fight you are actually in before you gather evidence.

Anxiety Disorders the VA Recognizes

The VA's rating schedule lists several diagnostic codes for anxiety-spectrum conditions. All of them are rated under the same General Rating Formula for Mental Disorders at 38 CFR 4.130. The diagnosis determines which code applies. The code does not change how the rating level is calculated.

DC 9400: Generalized Anxiety Disorder

GAD involves persistent, excessive worry about multiple areas of daily life (work, health, finances) for at least six months, with physical symptoms such as muscle tension, fatigue, poor concentration, and sleep disruption. Diagnosed under DSM-5 criteria.

DC 9412: Panic Disorder and/or Agoraphobia

Recurrent unexpected panic attacks with persistent concern about future attacks or their consequences. Agoraphobia (avoidance of situations where escape seems difficult) can accompany or stand alone. Rated under the same formula.

DC 9403: Specific Phobia and Social Anxiety Disorder

Marked fear or anxiety about a specific object or situation (specific phobia) or social or performance situations (social anxiety disorder), leading to avoidance or significant impairment.

DC 9410 / 9413: Other and Unspecified Anxiety

DC 9410 (other specified anxiety disorder) covers clinically significant anxiety that does not meet full criteria for a named category. DC 9413 (unspecified anxiety disorder) is used when a diagnosis is deferred or more information is needed.

DSM-5 diagnosis is required. Under 38 CFR 4.125, the VA must use the DSM-5 diagnostic standards when evaluating mental disorders. A diagnosis from a private provider using DSM-5 criteria carries the same weight as a VA diagnosis for rating purposes.

How Service Connection Works, At a High Level

Before getting into the specific paths below, it helps to understand the three things every anxiety claim ultimately has to show on a direct basis. This is the same basic test that applies to any VA disability claim, just applied to this condition.

A current diagnosis. A doctor must diagnose a real mental health condition now, such as generalized anxiety disorder, under DSM-5 criteria. Where there is no diagnosis at all, only a veteran's belief that something is wrong, the claim fails at this first step.
An in-service cause or event. Something documented during service, such as a traumatic event, an assault, harassment, operational stress, or documented nervousness or worry. A vague statement that the military lifestyle in general was stressful, without pointing to a specific event, is not enough.
A medical link (nexus). A qualified clinician must connect the current anxiety to that in-service event, or to an already service-connected condition, and explain the reasoning rather than just stating a conclusion.

Benefit of the doubt. If the positive and negative evidence on any of these three points is roughly equal, the law gives you the benefit of the doubt and the claim should be granted (38 CFR 3.102; 38 USC 5107(b)). You do not have to prove your case beyond doubt, only that it is at least as likely as not. See the Service Connection Guide for how this test works generally.

VA reads an anxiety claim broadly. Under the rule from Clemons v. Shinseki, 23 Vet. App. 1 (2009), a claim for anxiety also reaches depression, PTSD, adjustment disorder, and any other psychiatric diagnosis your record supports, so you do not lose just because the clinical label changes between the time you filed and the time a doctor examines you.

Go deeper: open the full anxiety disorder breakdown

What the VA measures at your C&P exam
Evidence that has won at the Board
Inside the rater's playbook: grant, denial, and remand rates
Secondary condition map

See the full DC 9400 breakdown →

What VA Looks For: Tests, Records, and Diagnostic Codes

Whether you are filing directly or secondary to another condition, the record VA actually reviews centers on a small set of documents and data points.

A DSM-5 diagnosis: from a psychiatrist, psychologist, or licensed clinical social worker, specifying the category that maps to the correct code, DC 9400, 9403, 9410, 9412, or 9413.
Service records documenting the in-service event or stressor: personnel records, service treatment records (STRs), separation exam notes flagging nervous trouble or excessive worry, disciplinary records tied to a documented cause, or, for military sexual trauma, the markers discussed below.
The Mental Disorders DBQ: the Disability Benefits Questionnaire an examiner completes, capturing the diagnosis, current symptoms, and the occupational and social impairment language the rating formula uses.
A nexus opinion: connecting the diagnosis to the in-service event or to a service-connected primary condition, discussed in the evidence section below.
Treatment history: therapy notes, prescription records, and any hospitalizations for mental health crises since service, showing continuity of the condition over time.

Anxiety from military sexual trauma or personal assault has special proof rules. Because assaults are often not documented in service records, VA may accept other markers instead, such as behavior changes, requests for transfer, or later counseling records, under 38 CFR 3.304(f)(5).

Favorable findings already made by VA are locked in. If the regional office already conceded a diagnosis, a stressor, or an in-service event earlier in your claim, that finding is binding going forward and cannot be undone absent clear and unmistakable error (38 CFR 3.104(c)).

Service-Connection Paths

Direct service connection

To establish anxiety disorder directly, a veteran needs: (1) a current DSM-5 diagnosis, (2) an in-service event, injury, or stressor, and (3) a medical nexus linking the two. The in-service stressor does not have to be a traumatic event. It can be any documented stressor during service (operational stress, harassment, injury, combat support duties) that a medical professional ties to the onset or worsening of the anxiety condition. Symptoms written down at the time help: a separation exam checking nervous trouble or excessive worry, or disciplinary action explained by documented worry and anxiety, are the kind of contemporaneous notes that support a direct grant.

Secondary service connection (38 CFR 3.310)

Secondary service connection under 38 CFR 3.310 is one of the most common routes for anxiety disorders. A veteran does not need the anxiety to have started in service; it only needs to be caused or aggravated by a service-connected condition. Documented secondary pathways include:

Secondary to Chronic Pain

Ongoing pain from a service-connected musculoskeletal condition (back, knee, shoulder) is one of the most frequently cited causes of secondary anxiety. The nexus opinion should describe how living with the pain, and its effect on activity, sleep, and mood, contributed to or worsened the anxiety.

Secondary to Tinnitus (DC 6260)

The constant noise of service-connected tinnitus drives hypervigilance and anxiety in a well-documented pathway. A nexus opinion should explain how the tinnitus itself, not just having a hearing condition generally, produces or aggravates the anxious symptoms.

Secondary to Traumatic Brain Injury (TBI)

TBI-related changes in neurological function and emotional regulation commonly cause or worsen anxiety. A neurological or psychiatric nexus opinion should tie the anxiety to the specific TBI-related changes documented in the record.

Secondary to Sleep Apnea and Other Sleep Disorders

Poor sleep quality from a service-connected sleep disorder such as sleep apnea (DC 6847) can produce or worsen anxiety symptoms. See the Sleep Apnea Claims Guide for the sleep-apnea side of this same pathway.

Secondary to Other Service-Connected Mental Health Conditions

Anxiety disorders frequently co-occur with PTSD or depression. When they do, the secondary nexus is the interaction between the conditions. The rating, however, is a single combined evaluation, not a second rating stacked on top, as explained in the single-rating section below.

For a nexus letter establishing secondary connection, the physician must state that it is "at least as likely as not" that the anxiety was caused or aggravated by the named service-connected condition. See the nexus letters guide.

Aggravation

If a veteran had a pre-existing anxiety disorder before service, and service worsened it beyond its natural progression, the condition can be service-connected for the degree of aggravation under 38 CFR 3.306. The VA must establish a pre-service baseline and compare it to post-service severity.

How the Rating Formula Works

All anxiety disorder diagnostic codes are evaluated under the General Rating Formula for Mental Disorders at 38 CFR 4.130. The formula sets six possible ratings: 0, 10, 30, 50, 70, and 100 percent. The key driver at every level is the degree of occupational and social impairment. The rating levels:

100%Total occupational and social impairment

Total occupational and social impairment, with symptoms such as persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting oneself or others, or intermittent inability to perform activities of daily living.

70%Deficiencies in most areas of functioning

Deficiencies in most areas (work, school, family relations, judgment, thinking, or mood), with symptoms such as near-continuous panic or depression affecting the ability to function independently.

50%Reduced reliability and productivity

Reduced reliability and productivity, with symptoms such as panic attacks more than once a week, difficulty understanding complex commands, impaired short-term memory, mood disturbances, and difficulty adapting to stress.

30%Occasional decrease in work efficiency

Occasional decrease in work efficiency and intermittent periods of inability to perform tasks, with otherwise normal functioning.

10%Mild or transient symptoms

Mild or transient symptoms that decrease work efficiency only during periods of significant stress, or mild symptoms controlled by medication.

0%No occupational or social impairment

Diagnosis confirmed but no occupational or social impairment, or only mild symptoms that improve with medication.

For the full verbatim criteria at each level, including the listed example symptoms, see the dedicated page: VA Mental Health Rating Formula Guide.

Rating turns on function, not symptom count. The formula asks how severely the anxiety impairs work and social life, not how many named symptoms are present. A veteran with a single overwhelming symptom (such as panic attacks more than once a week) can reach 50% even if other listed symptoms are absent.

Listed Symptoms Are Examples, Not a Checklist

Under the rating formula, the listed symptoms at each level (such as "panic attacks more than once a week" at 50%) are examples of the kind of impairment that warrants that rating. They are not a mandatory checklist that a veteran must match item-by-item.

The Federal Circuit confirmed this in Mauerhan v. Principi, 16 Vet. App. 436 (2002): the list of symptoms in 38 CFR 4.130 is "non-exhaustive." A veteran does not need to exhibit the exact symptoms enumerated at a given level. Symptoms not on the list can still support a rating at that level if they reflect the corresponding degree of occupational and social impairment.

What this means in practice: if your anxiety causes occupational or social impairment consistent with a particular rating level, that level can apply even if your specific symptoms differ from the examples listed in the regulation.

The Single-Rating Rule When Multiple Mental Health Conditions Coexist

The VA assigns only one combined rating for all of a veteran's co-existing mental health conditions. This is not a punishment. It is the application of the anti-pyramiding rule at 38 CFR 4.14 and the specific guidance in 38 CFR 4.130, which directs raters to evaluate all mental disorders together under a single evaluation.

In practical terms: if a veteran has both service-connected generalized anxiety disorder (DC 9400) and service-connected PTSD (DC 9411), the VA will assign a single mental health rating that accounts for the combined picture. It will not pay separately for each condition on top of the other.

Important for secondary anxiety claims: if anxiety is service-connected secondary to a physical condition (such as chronic pain or tinnitus) but the veteran already has a service-connected mental health rating for PTSD or depression, the secondary anxiety does not add a second rating. The new condition is folded into the existing combined mental health evaluation and may raise that rating if the overall impairment is worse. See the secondary vs aggravation guide.

The single-rating rule applies to the symptom overlap. If you believe your combined impairment from anxiety plus another mental health condition is worse than your current rating reflects, a rating increase claim is the path to raise the combined evaluation.

Evidence That Wins These Claims

Across the Board's published DC 9400 decisions, a private nexus opinion in the file goes with a much higher grant rate, shown below.

A DSM-5 diagnosis. Required under 38 CFR 4.125. A diagnosis from a licensed mental health provider (psychiatrist, psychologist, licensed clinical social worker) using DSM-5 criteria qualifies. The label on the diagnosis matters: make sure the provider specifies the DSM-5 category that maps to DC 9400, 9403, 9410, 9412, or 9413.
The Mental Disorders DBQ. The Disability Benefits Questionnaire for mental disorders captures the exact occupational and social impairment language the rating formula uses. A private provider who fills out this DBQ, or a similar narrative that addresses the same criteria, significantly strengthens the claim. See the DBQ guide.
Documentation of occupational and social impairment. Performance reviews, supervisor statements, records of missed work, school records, or documentation of social withdrawal are concrete evidence of function-level impairment at the relevant rating tier.
Lay statements on continuity and daily impact. The veteran's own written statement describing how anxiety affects work, relationships, and daily activities is admissible evidence. Buddy statements from family members or coworkers who observed the impairment add independent corroboration. See buddy statements.
A nexus letter for secondary claims. For secondary service connection, the key document is a medical nexus letter in which the provider ties the anxiety to a specific service-connected condition and uses the "at least as likely as not" standard. See nexus letters.
Treatment records showing continuity. Records from mental health treatment since service (therapy notes, prescription records, hospitalizations for mental health crises) demonstrate that the condition was present and treated over time.
Service records for direct claims. Personnel records, medical records from service, STRs showing in-service treatment for anxiety or related complaints, and any documentation of the in-service stressor all strengthen a direct claim.
A nexus opinion that shows its work. The opinions that win are the ones that review the record, state a clear conclusion, and give a full rationale, not a bare conclusion with no explanation. An opinion naming a specific in-service event and tying it to service records (a documented incident, a separation exam entry, a service record confirming the event happened) carries far more weight than a general statement that service caused the condition.

Why These Claims Get Denied

Beyond the general "no nexus" and "no diagnosis" reasons covered elsewhere in this guide, a few specific denial patterns show up often enough to call out on their own.

A confirmed diagnosis with no connection to service. Having a real mental health diagnosis on record, even a clearly documented one, is not enough by itself. Claims are denied where the disorder plainly exists but nothing in the record ties it to an in-service event or to a service-connected condition.
A vague "the military lifestyle was stressful" stressor. General statements about the ordinary stress or lifestyle of military service, without pointing to a specific event, are not enough to establish an in-service stressor. Where nothing specific is identified, VA can find no exam is even warranted because there is no in-service event to evaluate.
A stressor account that shifts. When a veteran's description of what happened changes materially between statements, that inconsistency itself becomes a reason the claim is not found credible, particularly in personal-assault or military sexual trauma claims where the stressor itself is rarely documented in the record.
A long, unexplained gap with no documented symptoms. When there are no psychiatric symptoms in the record for many years after service, and no explanation is offered for the delay, especially where the veteran had earlier denied any psychiatric history, the gap weighs against a direct connection.
A nexus opinion that only repeats an already-questioned account. A medical opinion built entirely on the veteran's own report of what happened in service is weak where that account has already been found not credible elsewhere in the record. The opinion needs support beyond the veteran's own restated history, and a general lay assertion with no medical support behind it carries no real weight on its own.
A diagnosis that is actually a personality disorder. A personality disorder is not a disability VA can compensate under 38 CFR 3.303(c). Where examiners conclude the correct diagnosis was a personality disorder rooted in a period before service, rather than an acquired anxiety disorder, the claim fails, and it can also support VA later taking back a rating that was already granted.

Common Mistakes

Patterns the published DC 9400 decisions and the rating rule flag most often. In the Board's service-connection denials for anxiety, a missing medical nexus is the single largest reason.

No nexus opinion in the file. "No nexus" is the leading denial reason for DC 9400. In the published decisions, a private nexus opinion goes with a much higher grant rate. A useful opinion names the in-service stressor or the service-connected primary and states that the anxiety is at least as likely as not caused or aggravated by it.
No DSM-5 diagnosis on record. A missing current diagnosis is another leading denial reason. The VA evaluates mental disorders under DSM-5 criteria (38 CFR 4.125), so a diagnosis from a licensed provider mapping to DC 9400 is the foundation of the claim.
No documented in-service event. Some denials turn on the lack of an in-service event, injury, or stressor. For a direct claim, personnel records, STRs, or buddy statements that fix the stressor in service close that gap.
Expecting a second rating for anxiety alongside PTSD or depression. Under 38 CFR 4.14 and 4.130, all co-existing mental health conditions share one combined evaluation. Anxiety folds into that single rating rather than adding a separate percentage, so the path to more compensation is a rating increase on the combined evaluation.
Treating the listed symptoms as a checklist. Per Mauerhan v. Principi, the symptoms named at each level of 38 CFR 4.130 are non-exhaustive examples. A claim framed only around matching listed symptoms can understate the occupational and social impairment that actually drives the rating.

Do's and Don'ts

A condensed version of everything above, in the order it actually matters when you sit down to build your file.

Get a nexus opinion that reviews your record, states a clear conclusion, and explains its reasoning, not a bare conclusion.
Name a specific in-service event or stressor and tie it to whatever service records confirm it.
Let VA read your claim broadly. Don't narrow yourself to the word anxiety; symptoms can support any psychiatric diagnosis the record shows.
Point to symptoms written down at the time, separation-exam notes, sick-call records, or discipline explained by documented worry or anxiety.
Use the benefit of the doubt when the evidence is evenly balanced. You do not have to prove your case beyond doubt.
Add buddy, spouse, and family statements describing your symptoms and when they started.
Keep your account of the stressor and its onset consistent across every statement, form, and exam.
If you already have service connection, decide whether your real fight is the rating, the effective date, or a proposed severance, and gather evidence for that specific fight.

Don't

Don't assume a diagnosis alone wins the claim. You still need the in-service event and the nexus.
Don't rely on a vague "military lifestyle was stressful" description as your stressor.
Don't let your account of what happened shift between statements and exams. Inconsistency undermines credibility more than almost anything else.
Don't wait years with no documented symptoms and no explanation for the gap.
Don't lean on a nexus opinion that just repeats your own account with nothing else behind it, especially if that account has been questioned elsewhere.
Don't expect a personality disorder to be service-connected. It isn't a compensable disability under VA's own rule.
Don't expect a second, stacked rating for anxiety on top of an existing PTSD or depression rating. They share one combined mental-health evaluation.

Common Secondary Conditions

These are the conditions most often linked with anxiety in the Board's published decisions. Each bar is the BVA grant rate for DC 9400, with the number of decisions below it. They describe what the Board's record shows across many veterans, not a prediction about any one claim.

Conditions that can cause anxiety (anxiety as the secondary)

Claims where anxiety was argued as secondary to an already service-connected condition. This is the "ways to connect via another condition" list, and it's usually the easier route into a grant:

Conditions anxiety can cause (anxiety as the primary)

Conditions veterans have claimed as caused or aggravated by a service-connected anxiety:

Quick Checklist Before You File

Bring these together before you submit anything.

A current mental health diagnosis from a qualified clinician, using DSM-5 criteria.
A specific in-service event, stressor, or documented symptom, and any records that confirm it.
A nexus opinion that reviews your record and fully explains why your anxiety is linked to service, or to a specific service-connected condition.
Buddy, spouse, and family statements describing your symptoms and when they started.
Your account of what happened, kept consistent everywhere you tell it.
A note to let VA consider every psychiatric diagnosis your symptoms support, not just the word anxiety.
If you already have service connection: a clear sense of whether your real issue is the rating, the effective date, or a proposed severance, with evidence gathered for that specific fight.

For the mechanics of actually submitting the claim, see the Standard Claim Guide and the Fully Developed Claim Guide (filing with all your evidence up front can speed up the decision).

The Claims Process, Step by Step

Once you file, your claim moves through a series of hand-offs. Understanding who does what helps you know who to contact, and what to expect, at each stage.

You file the claim. Directly with VA, through VA.gov, or with the help of an accredited representative.
VA acknowledges the claim and assigns it for development. A Veteran Service Representative (VSR) is assigned to gather your service treatment records, VA and private mental health records, and any other evidence needed.
The VSR orders a Compensation & Pension (C&P) exam if one is needed. Most direct anxiety claims require a mental health exam, and secondary claims especially need a nexus opinion.
The C&P exam is conducted. By a VA clinician or a contracted examiner, who completes the Mental Disorders Disability Benefits Questionnaire (DBQ) documenting the diagnosis, current symptoms, and, where relevant, a nexus opinion.
The file goes to a Rating Veteran Service Representative (RVSR), the "rater." The rater reviews the complete file, including the exam results, and decides whether service connection is warranted and at what percentage.
A senior reviewer may review the decision before it's finalized, depending on the complexity of the claim.
VA issues the decision letter. This states whether the claim is granted or denied, the rating percentage if granted, and the reasons behind the decision.
If you disagree, you choose an appeal lane. Higher-Level Review, Supplemental Claim, or a Board appeal, covered later in this guide.

Who's who: VSO vs. VSR vs. Rater vs. C&P Examiner

Your VSO

An accredited representative from a veterans service organization, or an accredited attorney or claims agent. Not a VA employee. Helps you prepare, gather evidence, and file, and can represent you through an appeal. Has no authority to decide your claim.

VSR (Veteran Service Representative)

VA staff who "develops" your claim: requests records, schedules the C&P exam, and assembles the file. Does not decide the rating.

Rater (RVSR)

VA staff who reviews the completed file and makes the actual decision, service connection or denial, and the percentage. This is the person whose judgment the decision letter reflects.

C&P Examiner

A VA clinician or a contracted medical examiner who conducts the exam and completes the DBQ. Documents findings and, where asked, a nexus opinion. Does not decide the claim.

For the full walkthrough of every stage with more detail, see Inside Your Claim and Claim Stages.

DBQs and Your C&P Exam

A Disability Benefits Questionnaire (DBQ) is the standardized form an examiner completes for your condition. For mental disorders it structures the exam findings into the exact occupational and social impairment language the rating schedule uses. See the DBQ Guide for how these forms work, including whether a private DBQ completed by your own provider can be submitted instead of relying solely on a VA exam.

Before your C&P exam, bring a clear, specific account of your symptoms, focus on your worst days and how the condition affects work and relationships, not just how you feel on an average day. Be consistent with what's already in your medical records and prior statements. For a full walkthrough of what to expect and how to prepare, see the C&P Exam Prep Guide.

Reading Your Decision Letter, and What to Do If Denied

Your decision letter has two parts: a narrative section explaining the reasoning (often called "reasons and bases"), and a codesheet showing the actual rating percentage, the effective date, and the diagnostic code used. See the Reading Your Decision Letter Guide for how to find and interpret each part, or use the Letter Interpreter tool to upload your own letter and get a plain-English breakdown.

If your claim is denied, or the rating is lower than you expected, you have three main lanes:

Supplemental Claim: refile with new and relevant evidence, such as a new nexus opinion or updated treatment records. See Supplemental Claim Guide.
Higher-Level Review (HLR): a senior reviewer looks at the same evidence again for a difference of opinion, no new evidence is added. See HLR Guide.
Board Appeal: your case goes to a Veterans Law Judge at the Board of Veterans' Appeals, with options for a direct review, an evidence docket, or a hearing. See Board Appeal Guide.

Not sure which lane fits your situation? See the Appeals decision guide for a side-by-side comparison of all three.

After You Win: Ratings, Effective Dates, and Maintaining Your Rating

Once you're already service-connected for anxiety, your next fight, if there is one, is usually about the rating (how much), the effective date (how far back), or occasionally a proposal to sever a past grant. These are different fights from the service-connection fight covered earlier in this guide, and they turn on different evidence.

The 100 percent rating requires total impairment in both areas. A 100 percent rating under 38 CFR 4.130 requires total occupational and social impairment. Veterans who kept a job or kept meaningful relationships have been held to less than total impairment, even with severe symptoms, so a higher-rating claim resting only on isolated severe episodes can fall short of the top tier.
Occasional or inconsistent severe symptoms may not reach the top rating on their own, particularly where they are inconsistent with other exam findings in the file. The top rating is reserved for impairment that is genuinely total, not for periodic severe episodes against an otherwise more functional baseline.
Effective dates generally run from your claim or intent to file, not from when your symptoms actually began. An earlier effective date generally requires an earlier claim already in the record; for unemployability specifically, the effective date can instead run from the date the record makes clear you could no longer work.
VA can take away (sever) a past grant for clear and unmistakable error, such as a corrected diagnosis, under 38 CFR 3.105. The burden is on VA to prove the error, but VA can succeed, which is one more reason an accurate diagnosis at the outset matters.

Keep your treatment consistent. Continued follow-up with a mental health provider, and records showing ongoing treatment, protects you if VA schedules a future reexamination. Not every rating gets reexamined; understand when a rating becomes protected from future review (including Permanent and Total status) and what to do if VA proposes to reduce it. See Protect Your Rating and Future Reexaminations for the specifics.

If your anxiety worsens after the initial grant, you can file for an increased rating on the combined mental-health evaluation. See the Rating Increase Guide.

Quick Reference Tables

Secondary Connection Pathways

Primary Condition	Mechanism	Evidence Needed
Chronic pain (musculoskeletal)	Ongoing pain affects mood, sleep, and daily function	Nexus opinion tying the pain condition to the anxious symptoms
Tinnitus (DC 6260)	Constant noise drives hypervigilance and anxiety	Nexus opinion specific to the tinnitus, not hearing loss generally
TBI	Neurological changes affecting emotional regulation	Neurological or psychiatric nexus opinion
Sleep apnea (DC 6847) and other sleep disorders	Poor sleep quality worsens anxious symptoms	Nexus opinion linking the sleep disorder to the anxiety
Other service-connected mental health conditions (PTSD, depression)	Overlapping and interacting psychiatric symptoms	DSM-5 diagnosis + nexus; rated as one combined evaluation, not stacked

From Filing to Decision: Who Does What

Role	Does	Decides your rating?
VSO / accredited representative	Helps prepare, gather evidence, and file; represents you on appeal	No
VSR	Develops the claim: orders records and the C&P exam	No
C&P Examiner	Conducts the exam, completes the DBQ, may give a nexus opinion	No / but has a strong impact
Rater (RVSR)	Reviews the full file and decides service connection and percentage	Yes

Proposed 2022 Revision to 38 CFR 4.130

In the Federal Register dated February 15, 2022, VA published a proposed rule that would revise the General Rating Formula for Mental Disorders at 38 CFR 4.130. The proposal would reorganize the rating criteria and modify how symptom clusters and impairment are described at each level.

As of June 2026, this proposed rule has not been finalized. The current rating formula remains in effect. If and when the rule is finalized, VA typically allows claims filed under the old criteria to be evaluated under whichever version is more favorable to the veteran. Verify current regulatory status directly at eCFR 38 CFR 4.130 before filing.

Frequently Asked Questions

Can I get a VA rating for anxiety if I already have a PTSD rating?

Yes, you can service-connect anxiety as a separate condition, but you will not receive a separate rating stacked on top of your PTSD rating. Under 38 CFR 4.14 and 4.130, VA assigns one combined mental health rating that covers all co-existing mental health conditions. If anxiety adds to your overall impairment beyond what your current PTSD rating reflects, the path is a rating increase on the combined mental health evaluation.

My anxiety was diagnosed after I left the military. Can I still get service connection?

Yes. The onset of symptoms after service does not automatically disqualify a claim. Many mental health conditions do not surface or receive a formal diagnosis until months or years after separation. A medical nexus linking the current diagnosis to an in-service stressor or event is what matters. For secondary claims, the question is whether the anxiety is caused or aggravated by an already service-connected condition, regardless of when the anxiety was diagnosed. That said, a long gap with no documented symptoms and no explanation can itself weigh against the claim, so it helps to address the gap directly rather than leave it unexplained.

How do I claim anxiety secondary to tinnitus or chronic pain?

You file a claim for secondary service connection under 38 CFR 3.310, identifying the already service-connected condition (e.g., DC 6260 tinnitus, or a musculoskeletal code) as the cause or aggravating factor. The key evidence is a nexus letter from a medical provider stating it is at least as likely as not that the anxiety is caused or aggravated by that service-connected condition. See the nexus letters guide.

What does "occupational and social impairment" mean at the 50% level?

The 50% level requires "reduced reliability and productivity." The regulation lists example symptoms (panic attacks more than once a week, impaired short-term memory, difficulty understanding complex commands, mood disturbances) but these are illustrative, not exclusive, per Mauerhan v. Principi. What the rater is measuring is whether anxiety has meaningfully reduced how reliably and productively you perform at work and in social situations, even if you are still working. Documentation of missed days, reduced output, difficulty with co-worker relationships, or avoidance of professional responsibilities is directly on point.

Do I need the exact symptoms listed in the regulation to get a certain rating?

No. The Federal Circuit held in Mauerhan v. Principi, 16 Vet. App. 436 (2002), that the listed symptoms in 38 CFR 4.130 are non-exhaustive examples. A veteran does not need to match the specific symptoms enumerated at a given level. Any symptoms that reflect the corresponding degree of occupational and social impairment can support that rating.

Can VA take away my anxiety rating after I've already won?

Only in limited circumstances. VA can sever (take back) a past grant of service connection if the original award was based on clear and unmistakable error, such as a diagnosis that examiners later conclude was actually a non-compensable personality disorder rather than an acquired anxiety disorder. The burden is on VA to prove that error, and it is a higher bar than an ordinary disagreement about severity. Keeping consistent, accurate treatment records over time is one of the best protections against this outcome. See Protect Your Rating.

Related Tools and Guides

DC 9400: Generalized Anxiety Disorder

Per-code page with rating levels, BVA grant data, and secondary condition links.

Mental Health Rating Formula

Full verbatim criteria for all six levels of 38 CFR 4.130, including every listed symptom example.

PTSD Claims Guide

Stressor categories, the automatic 50% rule, secondary conditions, and the single-rating rule in the PTSD context.

Secondary vs Aggravation

The legal difference between secondary service connection and aggravation, and when each applies.

Nexus Letters

What a strong nexus letter says, how to request one, and common reasons letters get rejected.

Buddy Statements

How lay statements from the veteran or witnesses document occupational and social impairment.

Service Connection Guide

The three-element test that underlies every VA disability claim.

Sleep Apnea Claims Guide

The other side of the anxiety-sleep-apnea secondary pathway.

DBQ Guide

The standardized exam form behind every C&P exam, including the Mental Disorders DBQ.

C&P Exam Prep

What to expect at the exam and how to describe your worst days.

Inside Your Claim

Who handles your claim at each stage, from VSR to rater.

Claim Stages

The full walkthrough of every stage of a VA claim.

Reading Your Decision Letter

How to find the rating, the effective date, and the reasoning in your letter.

Letter Interpreter Tool

Upload your decision letter for a plain-English breakdown.

Appeals Guide

Supplemental Claim vs Higher-Level Review vs Board appeal, side by side.

Higher-Level Review Guide

When a difference of opinion on the same evidence is the right lane.

Supplemental Claim Guide

Refiling with new and relevant evidence after a denial.

Board Appeal Guide

The three Board dockets, and how to choose among them.

Protect Your Rating

Permanent and Total status, reexaminations, and reduction or severance defense.

Future Reexaminations

When VA can schedule a reexamination, and what to expect.

Rating Increase Guide

Filing when your combined mental-health impairment has worsened.

Standard Claim Guide

The basic filing mechanics for any VA disability claim.

Fully Developed Claim Guide

Filing with all your evidence up front to speed up the decision.

Disclaimer. This guide is written for educational purposes and describes how the VA's rules and regulations work in general. It is not legal advice, and it does not constitute representation. Individual claims have unique facts, and outcomes depend on the specific evidence presented. It is not a prediction of any individual claim's outcome. Veterans seeking help with their claims should work with a VA-accredited VSO representative, claims agent, or attorney. The laws, regulations, and benefit rates referenced in this guide are current as of July 2026. Verify current rules at VA.gov or eCFR or through your VSO. Find an accredited representative →

Sources

38 CFR 4.130, Diagnostic Codes 9400, 9403, 9410, 9411, 9412, 9413, 9435, 9440, General Rating Formula for Mental Disorders
38 CFR 4.125, DSM-5 diagnosis requirement
38 CFR 3.303, 3.303(b), and 3.303(d), basic rules for direct service connection and disease diagnosed after discharge
38 CFR 3.303(c), personality disorders are not compensable disabilities
38 CFR 3.310, secondary service connection
38 CFR 3.306, aggravation of a pre-existing condition
38 CFR 3.304(b), presumption of soundness at entry; 38 CFR 3.304(f) and 3.304(f)(5), PTSD stressors and personal-assault proof markers
38 CFR 3.102 and 38 USC 5107(b), benefit of the doubt
38 CFR 3.104(c), Board bound by VA's own favorable findings
38 CFR 3.105, severance of service connection for clear and unmistakable error
38 CFR 3.156 and 3.2501, new and relevant evidence and supplemental claims
38 CFR 3.159, VA's duty to assist, including when a medical exam is required
Mauerhan v. Principi, 16 Vet. App. 436 (2002), symptoms listed in 38 CFR 4.130 are non-exhaustive examples
Clemons v. Shinseki, 23 Vet. App. 1 (2009), a claim for one psychiatric diagnosis is read to reach any diagnosis the record supports
Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004), the three elements of direct service connection
Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008), what makes a medical opinion persuasive
McLendon v. Nicholson, 20 Vet. App. 79 (2006), the low threshold for when VA must provide a medical exam
Caluza v. Brown, 7 Vet. App. 498 (1995), weighing the credibility of lay and medical statements
Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021), the benefit-of-the-doubt standard
VA.gov, mental health disability eligibility

This guide is educational, not legal or medical advice, and not a prediction of any individual claim outcome. Rating criteria change; confirm current details at eCFR 38 CFR 4.130. For help with your own claim, talk to a VA-accredited representative.