VA PTSD Ratings Under DC 6260: A Symptom-by-Symptom Guide

PTSD is the most-claimed mental health condition in the VA system — over 1.3 million veterans receive compensation for it as of 2024 — and the rating criteria are widely misunderstood. The VA does not rate PTSD by diagnosis alone, by the number of traumatic events, or by combat exposure. It rates PTSD by the degree of occupational and social impairment, using the same General Rating Formula for Mental Disorders that applies to depression and anxiety. What makes PTSD claims different is the diagnostic framework (DSM-5 Criteria A through E), the stressor corroboration rules that differ between combat and non-combat cases, and the specific symptom profile the C&P examiner is looking for. This guide walks through all of it.

Diagnostic Code 6260: what it covers

PTSD in the VA rating schedule is assigned Diagnostic Code (DC) 6260 under 38 CFR § 4.130. Related codes include DC 6261 (chronic PTSD), DC 6262 (acute PTSD), DC 6263 (subsyndromal PTSD), DC 6264 (PTSD chronic with dissociative features), and DC 6265 (PTSD with delayed onset). In practice, raters almost always use DC 9411 — the modern PTSD diagnostic code added to the schedule in 2010 — but the criteria and the rating formula are the same.

Despite the existence of multiple codes, all PTSD-related diagnoses are rated under the General Rating Formula for Mental Disorders, which produces ratings of 0%, 10%, 30%, 50%, 70%, or 100%. There are no 20%, 40%, 60%, 80%, or 90% ratings for PTSD — only the six tiers defined in the formula. The diagnostic code identifies the condition; the formula determines the percentage.

This means that a combat veteran with severe PTSD from a single IED event and a non-combat veteran with PTSD from a military sexual trauma can both receive the same rating. The combat factor affects stressor corroboration (discussed below), not the rating itself. Two veterans with the same diagnosis and similar impairment will receive similar ratings regardless of how dramatic the underlying trauma was.

DSM-5 Criterion A: the stressor

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, published by the American Psychiatric Association) defines PTSD using five diagnostic criteria labeled A through E. Criterion A is the stressor criterion — the requirement that the person was exposed to actual or threatened death, serious injury, or sexual violence. The exposure can be:

• Direct exposure — the veteran personally experienced the event.
• Witnessing — the veteran saw the event happen to others.
• Learning — the veteran learned that a close family member or close friend experienced an actual or threatened violent or accidental event.
• Repeated or extreme exposure — the veteran experienced repeated or extreme exposure to aversive details of traumatic events (e.g., medics who handled human remains, mortuary affairs specialists, first responders).

For VA purposes, the stressor must be consistent with the "places, types, and circumstances of service" — language from 38 CFR § 3.304(f). The veteran's statement about the stressor is generally accepted as sufficient if the stressor is related to combat or to fear of hostile military or terrorist activity. For non-combat stressors, independent corroboration is required (see the combat vs. non-combat section below).

Criterion A also requires that the exposure was not experienced through electronic media, television, movies, or pictures — unless the exposure was work-related (such as a drone operator viewing live combat feeds, which the VA treats case-by-case). This is a frequent point of confusion; a veteran who developed PTSD after watching news coverage of an attack on their former unit does not meet Criterion A through that exposure alone.

DSM-5 Criteria B through E: the symptom picture

Criteria B through E describe the symptoms that must follow the stressor exposure for a PTSD diagnosis. Each criterion requires a minimum number of symptoms from a defined list, and the symptoms must persist for more than one month and cause clinically significant distress or impairment.

The C&P examiner will inventory symptoms across all four criteria during the diagnostic interview. The number and severity of symptoms influences the impairment rating — but the rating is not a mechanical count of symptoms. A veteran with five Criterion E symptoms but only mild functional impact may rate 30%, while a veteran with three symptoms across all criteria but severe functional impact may rate 70%. Functional impairment drives the percentage, not the symptom count.

Combat vs. non-combat stressor corroboration

This is one of the most important distinctions in PTSD claims. The VA applies different stressor corroboration rules depending on whether the claimed stressor was combat-related, related to fear of hostile military or terrorist activity, or some other type of in-service trauma.

Combat stressors (38 CFR § 3.304(f)): If the veteran's claimed stressor is related to combat, the veteran's statement that the stressor occurred is sufficient proof — provided the stressor is consistent with the circumstances, conditions, and hardships of service. The VA cannot require additional corroboration. The veteran's DD Form 214 with a combat designation (or other evidence of combat service, such as awards like the Combat Action Ribbon, Combat Infantryman Badge, or Purple Heart) plus the veteran's statement on VA Form 21-0781 is generally enough.

Fear of hostile military or terrorist activity (38 CFR § 3.304(f)(3)): For veterans who served in a designated combat zone but whose stressor was not a direct firefight — for example, living under constant mortar attack, receiving incoming fire while on patrol, or experiencing the threat of attack — the VA accepts the veteran's statement as proof if a VA psychiatrist or psychologist confirms the stressor is adequate to support a PTSD diagnosis and the stressor is consistent with the circumstances of service.

Non-combat stressors (38 CFR § 3.304(f)(4)): For stressors that are not combat-related (military sexual trauma, training accidents, assaults, witnessing a suicide, motor vehicle accidents), the veteran must provide independent corroboration that the event occurred. This is the strictest standard. Acceptable corroboration includes:

• Military police reports, CID reports, or other law enforcement records.
• Medical or mental health treatment records from the period.
• Sick-call entries or restricted-duty reports that match the date of the claimed event.
• Buddy statements on Form 21-10210 from fellow service members who witnessed the event or its aftermath.
• Photos, letters, or journal entries contemporaneous with the event.
• Newspaper articles, unit morning reports, or ship deck logs.

A common reason for denial of non-combat PTSD claims is the veteran's failure to provide any contemporaneous corroboration. The duty to assist under 38 CFR § 3.159 requires the VA to help obtain records you specifically identify, but it does not require the VA to manufacture corroboration that does not exist.

How the VA rates by impairment, not by trauma

This point deserves emphasis because it confuses many veterans: the rating is not based on how severe the trauma was, how many deployments you had, or whether you have a Combat Action Ribbon. The rating is based on the present-day impairment in occupational and social functioning.

The rating tiers, drawn from the General Rating Formula in 38 CFR § 4.130, look like this for PTSD:

• 0%: Diagnosis confirmed, but symptoms are not severe enough to interfere with occupational or social functioning.
• 10%: Mild or transient symptoms that decrease work efficiency only during periods of significant stress.
• 30%: Occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily.
• 50%: Reduced reliability and productivity due to symptoms such as flattened affect, panic attacks more than once a week, memory impairment, impaired judgment, difficulty in establishing and maintaining effective work and social relationships.
• 70%: Deficiencies in most areas — suicidal ideation, near-continuous panic or depression affecting independent functioning, impaired impulse control, spatial disorientation, neglect of personal appearance and hygiene, difficulty adapting to stressful circumstances, inability to establish and maintain effective relationships.
• 100%: Total occupational and social impairment — persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting self or others, intermittent inability to perform activities of daily living, memory loss to the degree of forgetting close relatives or own name.

Notice that none of these tiers mention combat, deployments, or the type of trauma. The rater looks at the examiner's symptom inventory and functional assessment and matches the impairment to the closest tier.

C&P exam tips specific to PTSD

The PTSD C&P exam is more structured than most. The examiner — typically a VA-contracted psychologist or psychiatrist — administers a structured diagnostic interview (often the Clinician-Administered PTSD Scale, or CAPS-5) and completes a DBQ specifically designed for PTSD (VA Form 21-0960P-3, the Initial Post-Traumatic Stress Disorder Disorder Disability Benefits Questionnaire).

What to expect, and how to navigate it:

• The examiner will ask detailed questions about the stressor. Be prepared to describe the event(s) in some detail — date, location, what happened, who else was present. For combat stressors, the examiner is verifying consistency, not asking you to relive the trauma in graphic detail. For non-combat stressors, the examiner is documenting the basis for corroboration.
• You will be asked about each symptom cluster (B, C, D, E). Have concrete examples ready: "I have nightmares about the ambush two to three times a week, and I wake up sweating and unable to get back to sleep" beats "I have nightmares."
• Be honest about frequency and duration. Examiners are trained to detect exaggeration and minimization. Specific, credible detail moves ratings; vague generalities do not.
• Bring a list of medications and any side effects you experience. Sleep medication, prazosin for nightmares, SSRIs, and benzodiazepines all signal symptom severity.
• Bring treatment records from your VA or private therapist if you've been in ongoing treatment. The examiner will review them.
• Bring a family member or close friend if the examiner permits third-party input. Their observation of your symptoms (hypervigilance, withdrawal, anger outbursts, sleep disturbance) can corroborate your self-report.
• Do not minimize. Stoicism costs ratings. If you have panic attacks weekly, say so. If you have had suicidal thoughts, even fleeting, say so. The examiner cannot read your mind and will only document what you tell them.

One subtle point: the examiner will ask about your "best day" and your "worst day." The rating reflects your typical functioning over the past 6–12 months, not your worst day. If your worst day is bad but your typical day is mild, the rating will reflect the typical day. Be honest about both.

Common mistakes that lower PTSD ratings

A handful of recurring patterns explain most PTSD ratings that come in lower than the veteran expected. Watch for these:

• Minimizing in the exam. The most common cause. Veterans describe symptoms in past tense ("I used to have nightmares"), downplay current impairment ("I'm managing okay"), or omit symptoms out of embarrassment. The examiner documents what was said, and the rating follows the document.
• Inadequate stressor corroboration (non-combat). For non-combat PTSD claims, failure to provide contemporaneous corroboration is a frequent denial basis. Identify and submit specific records — buddy statements, MP reports, medical treatment entries — before the exam.
• Confusing improvement with recovery. Treatment often produces improvement — fewer nightmares, less hypervigilance. But "improved" is not "recovered." If you still have symptoms several times a week even with treatment, the rating should reflect that. Bring treatment records showing ongoing symptoms despite medication and therapy.
• Not documenting functional impact. The examiner needs to know how symptoms affect your work and relationships. "I have nightmares" is a symptom; "I have nightmares 3 nights a week, I'm exhausted at work the next day, my supervisor has written me up for tardiness, and my wife sleeps in a different room" is a functional impairment. The second version is what moves ratings.
• Filing too early. If you've just started treatment and symptoms are still fluctuating, the exam may capture a relatively good period. Many VSOs recommend waiting 6–12 months after diagnosis stabilization before filing, so the rating reflects the chronic picture.
• Skipping the exam. Even with strong private evidence, the VA will usually require a C&P exam. Missing it without good cause is grounds for denial under 38 CFR § 3.655.

Common secondary conditions tied to PTSD

PTSD rarely exists in isolation. The VA recognizes that PTSD can cause or aggravate other conditions, and secondary service connection under 38 CFR § 3.310 is available. The most common PTSD secondary claims include:

Each secondary claim requires its own nexus evidence — the PTSD rating alone does not establish a link. See our secondary service connection guide for the full framework.

When PTSD supports Individual Unemployability

Severe PTSD is one of the most common bases for Total Disability based on Individual Unemployability (TDIU) under 38 CFR § 4.16. A veteran rated at 70% for PTSD — even without other ratings — can qualify for TDIU at the 100% pay rate if the PTSD prevents substantially gainful employment.

The standard under § 4.16(a) is "marginal employment" — meaning employment that does not exceed the annual poverty threshold for a single person (about $15,000 in 2024). A veteran who has been fired from multiple jobs due to PTSD symptoms, who has been unable to maintain employment for 12+ months, or who works only in a sheltered environment (such as a family business where expectations are reduced) may meet the standard.

Key evidence for PTSD-based TDIU:

• Employment records showing terminations, leaves of absence, or accommodations tied to PTSD symptoms.
• VA Form 21-4192 completed by each employer for the past 5 years.
• A vocational expert opinion (often from a Vocational Rehabilitation Counselor) that the veteran is unemployable due to PTSD.
• Treatment records showing persistent severe symptoms despite medication and therapy.
• Letters from family members on Form 21-10210 describing daily functional impact.

TDIU is not automatic with a 70% PTSD rating — the veteran must affirmatively file a claim (VA Form 21-8940). See our TDIU eligibility guide for the complete checklist.

If your PTSD rating is too low

PTSD ratings that come in lower than expected are common, and they are highly appealable because the rating criteria are specific and the symptom documentation is concrete. The modern appeals system (Appeals Modernization Act, in effect since February 2019) gives three paths:

• Higher-Level Review (HLR): A senior rating officer reviews the file. Best for cases where the original rater misapplied the criteria or overlooked evidence. No new evidence allowed. Decision typically within 4–5 months.
• Supplemental Claim: New and relevant evidence is submitted. Best for cases where you have new treatment records, a private DBQ, or additional buddy statements. The VA has a duty to assist in developing the new evidence. Decision typically within 4–5 months.
• Board Appeal (Notice of Disagreement): The case goes to the Board of Veterans' Appeals. Best for cases where the issue is interpretation of law or where you want a hearing. Direct review (no hearing) typically takes 12–18 months; hearing dockets can take 2–3 years.

For most low PTSD ratings, the Supplemental Claim with a private DBQ from your treating psychologist or psychiatrist is the most effective path. The private DBQ can document specific symptoms from the tier you believe applies — panic attack frequency, suicidal ideation, hypervigilance, impaired impulse control — that the original C&P exam may have missed or under-documented.

Takeaways

PTSD claims under DC 6260 are governed by the General Rating Formula for Mental Disorders — the rating reflects functional impairment, not the severity of the trauma. The DSM-5 criteria A through E define the diagnosis; the § 4.130 formula defines the percentage. Combat stressors are presumed; non-combat stressors require independent corroboration, which is the most common denial basis for non-combat PTSD claims. The C&P exam is the most influential piece of evidence, and honest, specific, functional reporting of symptoms is what moves ratings upward. PTSD commonly produces secondary conditions (sleep apnea, depression, substance use, migraines) that can be separately claimed under 38 CFR § 3.310. A 70% PTSD rating can support TDIU at the 100% pay rate if the condition prevents substantially gainful employment.