Code of Federal Regulations (alpha)

CFR /  Title 38  /  Part 4  /  Sec. 4.130 Schedule of ratings--Mental disorders.

The nomenclature employed in this portion of the rating schedule is based upon the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (see Sec. 4.125 for availability information). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in Sec. 4.125 through Sec. 4.129 and to apply the general rating formula for mental disorders in Sec. 4.130. The schedule for rating for mental disorders is set forth as follows: 9201 Schizophrenia9202 [Removed]9203 [Removed]9204 [Removed]9205 [Removed]9208 Delusional disorder9210 Other specified and unspecified schizophrenia spectrum and other

psychotic disorders9211 Schizoaffective disorder9300 Delirium9301 Major or mild neurocognitive disorder due to HIV or other

infections9304 Major or mild neurocognitive disorder due to traumatic brain injury9305 Major or mild vascular neurocognitive disorder9310 Unspecified neurocognitive disorder9312 Major or mild neurocognitive disorder due to Alzheimer's disease9326 Major or mild neurocognitive disorder due to another medical

condition or substance/medication-induced major or mild

neurocognitive disorder9327 [Removed]9400 Generalized anxiety disorder9403 Specific phobia; social anxiety disorder (social phobia)9404 Obsessive compulsive disorder9410 Other specified anxiety disorder9411 Posttraumatic stress disorder9412 Panic disorder and/or agoraphobia9413 Unspecified anxiety disorder9416 Dissociative amnesia; dissociative identity disorder9417 Depersonalization/Derealization disorder9421 Somatic symptom disorder9422 Other specified somatic symptom and related disorder9423 Unspecified somatic symptom and related disorder 9424 Conversion disorder (functional neurological symptom disorder)9425 Illness anxiety disorder9431 Cyclothymic disorder9432 Bipolar disorder9433 Persistent depressive disorder (dysthymia)9434 Major depressive disorder9435 Unspecified depressive disorder9440 Chronic adjustment disorder

General Rating Formula for Mental Disorders------------------------------------------------------------------------

Rating------------------------------------------------------------------------Total occupational and social impairment, due to such 100

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 deficiencies in most 70

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.Occupational and social impairment with reduced reliability 50

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 occasional decrease 30

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 due to mild or transient 10

symptoms which decrease work efficiency and ability to

perform occupational tasks only during periods of

significant stress, or symptoms controlled by continuous

medication.A mental condition has been formally diagnosed, but symptoms 0

are not severe enough either to interfere with occupational

and social functioning or to require continuous medication.------------------------------------------------------------------------ 9520 Anorexia nervosa9521 Bulimia nervosa

Rating Formula for Eating Disorders------------------------------------------------------------------------

Rating------------------------------------------------------------------------Self-induced weight loss to less than 80 percent of expected 100

minimum weight, with incapacitating episodes of at least six

weeks total duration per year, and requiring hospitalization

more than twice a year for parenteral nutrition or tube

feeding.Self-induced weight loss to less than 85 percent of expected 60

minimum weight with incapacitating episodes of six or more

weeks total duration per year.Self-induced weight loss to less than 85 percent of expected 30

minimum weight with incapacitating episodes of more than two

but less than six weeks total duration per year.Binge eating followed by self-induced vomiting or other 10

measures to prevent weight gain, or resistance to weight

gain even when below expected minimum weight, with diagnosis

of an eating disorder and incapacitating episodes of up to

two weeks total duration per year.Binge eating followed by self-induced vomiting or other 0

measures to prevent weight gain, or resistance to weight

gain even when below expected minimum weight, with diagnosis

of an eating disorder but without incapacitating episodes.------------------------------------------------------------------------Note 1: An incapacitating episode is a period during which bed rest and

treatment by a physician are required.Note 2: Ratings under diagnostic codes 9201 to 9440 will be evaluated

using the General Rating Formula for Mental Disorders. Ratings under

diagnostic codes 9520 and 9521 will be evaluated using the General

Rating Formula for Eating Disorders. (Authority: 38 U.S.C. 1155) [79 FR 45100, Aug. 4, 2014]

Dental and Oral Conditions Sec. 4.149 [Reserved]