A PTSD claim is different from almost every other VA claim, and the difference is the stressor: you have to prove the traumatic event actually happened. This is the whole claim in one place. What you have to prove, the two forms you file, the one exam you can't skip, and how the VA turns all of it into a rating on six levels.
Call 988 and press 1, text 838255, or chat at VeteransCrisisLine.net. It's free, confidential, and available 24/7, whatever your discharge status or enrollment. You can also walk into any VA medical center and be seen. Care first. The claim can wait.
The video is the quick tour. This page is the complete guide, with every form and a primary-source citation for each rule.
What makes a PTSD claim different
The VA gives post-traumatic stress disorder a diagnostic code, 9411, and rates it with the same formula it uses for depression, anxiety, and almost every other mental-health condition. Where it's different is getting service-connected. Under the regulation, a PTSD claim has three parts, and you need all three.
A current PTSD diagnosis that meets the medical standard, the DSM-5.
A link between your symptoms and a specific event during your service.
Credible evidence that the event, the stressor, actually happened.
38 CFR §3.304(f) Depression and anxiety carry no stressor requirement. PTSD does. That third part is where the claim is won or lost.
Proving the stressor: the five paths
The stressor is the traumatic event in service. Normally you'd need evidence it happened. But the VA writes five situations where your own testimony can carry it, or where other kinds of evidence count. Find the one that fits your service, because it decides exactly what you have to prove.
If you engaged in combat with the enemy and your stressor is related to that combat, your statement alone can establish it, as long as it's consistent with your service and there's no clear evidence against it. No separate paper trail required.
This covers incoming rocket or mortar fire, an IED, suspected sniper fire, and your response of fear or helplessness. If a VA psychologist or psychiatrist confirms the stressor fits your diagnosis, your statement alone can establish it. This one reaches many veterans who served in a war zone without being in direct ground combat.
If you were diagnosed with PTSD while still in uniform and the stressor is tied to your service, your own statement can establish the event. This one carries weight because the diagnosis already sits in your service record. Pull your service treatment records, because that history is what qualifies you here.
If you were held as a prisoner of war and your stressor relates to that captivity, your statement alone can establish it. Your POW status is already documented, so the VA doesn't make you re-prove the events.
These often aren't in service records, so the VA accepts other evidence: records from a counseling center, a doctor, or law enforcement; statements from family or fellow service members; and behavior changes after the assault, like a transfer request, a drop in work performance, or new depression or anxiety.
Find which path fits you. Once you know that, you know the evidence to gather, and you're ready to file.
If your discharge is in the way
Some veterans stop here, and they shouldn't. If your discharge was other than honorable, bad conduct, or dishonorable, you may not be eligible for disability compensation, but the VA names two ways to try to qualify. You can apply for a discharge upgrade, or ask the VA for a Character of Discharge review. Neither is a guarantee, and both take time. They matter for PTSD specifically, because misconduct that ended a career sometimes traces back to a condition that was never diagnosed.
Separate from any claim, the VA provides free treatment for physical and mental health conditions related to military sexual trauma. You don't need to have reported it at the time, you don't need other proof it happened, you don't need a disability rating, and the usual length-of-service rules don't apply. That's care, available now, whether or not you ever file.
The two forms you actually file
The claim itself is VA Form 21-526EZ, the Application for Disability Compensation. You can file it online, mail it to the VA's intake center, or bring it to a regional office. That form covers any disability claim. For PTSD, there's a second form, and it's the one veterans miss.
Two timing rules can be worth real money. Before you file, consider submitting an intent to file: it holds your effective date while you gather evidence, and your effective date is what back pay is calculated from. And if you're recently out, file within one year of separating and your compensation can date back to the day after you left service; miss that window and it generally starts the day you file instead.
If you're still in, you can start before you're out. The Benefits Delivery at Discharge program lets you file between 180 and 90 days before your separation date, as long as you have a known separation date and can make VA exams within 45 days. And you don't have to do the paperwork alone: the VA will connect you with an accredited representative, often through a Veterans Service Organization, and that help is free.
The diagnosis has to be legitimate
The VA requires the diagnosis to conform to the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5. Here's the part that protects you: if an examiner's diagnosis doesn't fit the manual, or the exam doesn't support it, the VA sends the report back to be corrected rather than denying you on it.
The exam you can't skip
After you file, the VA schedules a Compensation and Pension exam, your C&P exam. An examiner evaluates your condition and documents what they see, and that write-up drives the rating more than almost anything else in your file. The examiner works from a Disability Benefits Questionnaire, a DBQ. For most conditions your own doctor can fill one out and you submit it with your claim. PTSD is the exception, and this is the part that costs veterans money.
The Initial PTSD questionnaire is on the VA's not-for-public-use list, so only a VA or VA-contracted examiner can complete it. If someone offers to sell you an initial PTSD DBQ filled out by a private doctor, it can't replace the VA exam. Save your money.
None of that means your private doctor doesn't matter. Their treatment records, their notes, and their opinion on how the condition affects you all go in your file and all get weighed. What a private provider can't do is replace the VA's initial exam. At that exam, two things cost veterans an accurate rating: minimizing, saying "I'm fine" out of habit, and overstating, which reads as not credible. Describe your worst days and your normal days honestly and specifically. We've got a full guide to the C&P exam if you want to walk in prepared.
How it's rated: the six levels
The rating measures your occupational and social impairment, how much the condition disrupts your work and your relationships. It runs on six levels, and a higher level means more disruption and more money. The diagnosis never changes across them; what changes is how much the condition takes from your life.
Service-connected, but symptoms aren't affecting work or relationships, and you're not on continuous medication. It's recognized, and it can be increased later if things get worse.
Mild or occasional symptoms that dip your work only during periods of significant stress. Also applies when medication keeps symptoms controlled.
A lot of veterans land here. Generally functioning, but with occasional drops in efficiency: depressed mood, anxiety, suspiciousness, occasional panic attacks, sleep trouble, mild memory slips.
Working, but the condition steadily lowers reliability: flattened affect, panic more than once a week, memory trouble, impaired judgment, difficulty keeping effective relationships.
Work, family, judgment, thinking, and mood, affected at once: suicidal thinking, near-continuous panic or depression, impaired impulse control, neglect of hygiene, inability to keep relationships.
The condition has taken your ability to work and to be in relationships almost entirely: gross impairment in thought or communication, persistent delusions or hallucinations, being a persistent danger to self or others, disorientation, memory loss.
38 CFR §4.130 This formula is public. You can read it yourself at ecfr.gov and compare your symptoms to each level.
Call the Veterans Crisis Line: 988, press 1, or text 838255. It doesn't matter what your discharge status is or whether you're enrolled in VA health care.
One note on the GAF score. For years, mental-health ratings leaned on a single number, the Global Assessment of Functioning, from the older diagnostic manual. The VA switched to the DSM-5 for claims in 2014, and the GAF went with it. So if an older decision of yours mentions a GAF number, that's why. Your rating today isn't a GAF score; it's the impairment, measured against these six levels.
The two rules that set your level
At each level, the VA lists example symptoms. Read the regulation closely and you'll see the phrase "such symptoms as," which means those symptoms are examples, not a checklist. You don't need every one of them to be rated at a level. And when your disability picture sits between two levels, the VA assigns the higher one if your overall picture more nearly approximates it. It's not a symptom count; it's which level your whole picture looks most like.
Two more rules work in your favor. Your rating is based on all the evidence in your file, not one appointment on one day, so a good hour at your C&P exam doesn't erase months of treatment records, and a couple of good months don't mean you'll be cut. And while the VA counts your social impairment, it can't rate you on social impairment alone: isolation matters, but the rating has to reflect the whole picture, work included.
One mind, one rating
If you're diagnosed with PTSD, depression, and an anxiety disorder, you get one mental-health rating, not three. The formula rates impairment, not diagnoses, and these conditions push on the same things: your mood, sleep, focus, and relationships. The VA's rule against pyramiding means it won't rate the same impairment twice under different names. Still put every condition and every symptom in front of the VA, not to stack ratings, but because the more complete the record of your total impairment, the more accurately that one rating reflects what you're carrying.
When a 70 pays like a 100
You don't have to be rated 100% to be paid at the 100% rate. If the condition keeps you from holding steady, gainful work, a separate benefit called TDIU, total disability based on individual unemployability, can pay you at the total rate.
38 CFR §4.16(a) TDIU is its own claim, built on your work history and why steady work isn't possible. If you're stuck at 70 and genuinely can't work, read the TDIU guide next.
What PTSD can bring with it
Post-traumatic stress often leads to other conditions, and when a service-connected condition causes another, that second one can be service-connected too. The VA calls it a secondary. Common examples tied to PTSD: sleep problems and sleep apnea, reflux, and side effects of the medications you take for the condition, including erectile dysfunction. Each can carry its own rating on top, but a secondary is never automatic. You need medical evidence linking it to the service-connected condition, a nexus. Not "I have this, so I get those," but "a doctor connected this to my condition, so it's service-connected." We cover how to build that link in the secondary conditions guide.
If your condition gets worse
Your rating reflects how you were when they rated you. PTSD doesn't hold still, and if yours has gotten worse, you can file for an increase against the same six levels. This is where that review questionnaire matters: because you're already service-connected, the PTSD Review DBQ is public, so your own treating doctor can complete it and you submit it with your claim.
Timing affects your back pay. If the VA can see from the evidence when your condition got worse and you file within one year of that date, your increase can be paid back to when the worsening happened; file later and it generally runs from your filing date. One thing to go in knowing: filing for an increase puts your condition back in front of an examiner, so make sure your records support the worsening. We walk through it in the increasing-your-rating guide.
If they deny you
A denial isn't the end of the claim. The VA gives you three ways to challenge a decision, and picking the right one matters.
For when you have new and relevant evidence the VA didn't have before.
Your same file in front of a more senior reviewer. You can't add new evidence.
To a Veterans Law Judge at the Board of Veterans' Appeals.
Each has its own deadline, so check the current window on VA.gov before you file. For PTSD claims, read the denial reason closely: a denial because the stressor wasn't verified sends you back to the five paths above; a denial over the severity of your symptoms is about evidence of impairment. They're different fixes.
The 2026 update, straight
There's a proposed change to the mental-health rating formula, published in 2022 under RIN 2900-AQ82. As of today it's not law and hasn't been finalized. The six levels above are the rules deciding ratings right now. Even after a change like this is finalized, it usually takes a couple of months before it applies, so there's no need to rush a claim or hold one back over a rule that isn't in effect. You can check it yourself: if it's still a proposed rule, it's not the law you're rated under.
Can they take it back?
The VA can reduce a rating after you have it, but not on a whim and not on one bad exam. To cut a total rating, the VA needs an exam showing material improvement, and it has to weigh whether you actually improved "under the ordinary conditions of life," out in the real world at work and with people. Not one good day in the exam chair. Two clocks then work in your favor.
A rating held at the same level for five years or more gets extra protection from being cut on a single, less-thorough reexam.
Once service connection has been in place for ten or more years, the VA can't sever it, except for fraud or a service record that never supported it.
Be precise about the 10-year rule: they can still adjust the percentage if your condition improves. What they can't do after ten years is undo the service connection itself.
One more rule protects you at the start. If PTSD was severe enough to end your active service, the VA must rate it at no less than 50% to begin, then reexamine you within six months to set the rating going forward. That six-month exam decides your baseline, so prepare for it the same way you'd prepare for any C&P exam.
Your next moves
- Figure out which of the five stressor paths fits your service. That decides the evidence you gather.
- Pull your service treatment records and your DD-214, and gather statements from people who see the condition, yourself included.
- Consider an intent to file to hold your effective date, then file VA Form 21-526EZ with the required 21-0781.
- Go to the C&P exam the VA schedules, and describe your worst days and normal days accurately.
- If you're kept from steady work, look at TDIU. If PTSD caused another condition, build the nexus for a secondary.
- If you're denied, read the reason, then pick the right decision review. If your condition worsens, file for an increase within a year of the change.
- If you're struggling right now, call 988 and press 1. Care first.
Get the whole picture — free
This is one chapter of the Veteran Field Manual. The full Volume 1 guide covers ratings, claims, appeals, and the benefits most veterans never collect.
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Primary federal law and official VA program pages. Rules and figures change; confirm current details at these sources before acting.
- PTSD service connection and the five stressor paths: 38 CFR § 3.304(f) · VA.gov — PTSD eligibility
- The rating formula and the six levels: 38 CFR § 4.130 (free at ecfr.gov)
- Diagnosis must conform to the DSM-5: 38 CFR § 4.125
- Examples are not a checklist; the benefit of the doubt between levels: 38 CFR § 4.7
- All evidence weighed; social impairment can't stand alone: 38 CFR § 4.126
- One rating for combined mental-health conditions (no pyramiding): 38 CFR § 4.14
- TDIU thresholds (paid at 100% below a 100% rating): 38 CFR § 4.16(a)
- Secondary service connection (the nexus requirement): 38 CFR § 3.310
- Effective dates and back pay (separation and increases): 38 CFR § 3.400
- Reductions require material improvement: 38 CFR § 3.343 · five-year stability: 38 CFR § 3.344
- Rated at least 50% when PTSD ends your service, reexam in six months: 38 CFR § 4.129
- Ten-year protection against severance: 38 U.S.C. § 1159
- The forms: 21-526EZ · 21-0781 · 21-10210 (lay/witness)
- The exam and the public-use DBQ list: VA — DBQs available for public use
- Pre-discharge filing (BDD): VA.gov — pre-discharge claim · free accredited help: VA.gov
- Military sexual trauma care: VA.gov — MST · decision reviews after a denial: VA.gov
- The 2026 proposal (not in effect): Federal Register — RIN 2900-AQ82, proposed rule, 2022
Veteran Field Manual is an independent educational resource. Not affiliated with, endorsed by, or representing the U.S. Department of Veterans Affairs or any government agency. Informational only, not legal, medical, or VA-accredited claims advice. If you're in crisis, call the Veterans Crisis Line at 988 and press 1.