VA Diagnostic Code 9433Persistent depressive disorder (dysthymia)

Persistent Depressive Disorder (Dysthymia) — VA Disability Rating Guide

Diagnostic Code 9433 · 38 CFR § 4.130 · Mental Disorders

What This Condition Is

Persistent depressive disorder (dysthymia) is a mental health condition classified by the VA under Mental Disorders. Like other conditions in this category, it is evaluated using the General Rating Formula for Mental Disorders found in 38 CFR § 4.130.

Under this formula, the VA does not assign a rating based on the diagnosis alone. Instead, it looks at how the condition affects your daily life — specifically the degree of occupational and social impairment caused by your symptoms.

How the VA Rates This Condition

The General Rating Formula for Mental Disorders provides six possible rating levels. Each level reflects a different degree of impairment in work and social functioning. Below is a plain-language summary of what each level describes.

100% — Total Impairment

Total occupational and social impairment. This may be shown through symptoms such as gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting oneself or others; an intermittent inability to perform activities of daily living (including maintaining minimal personal hygiene); disorientation to time or place; or memory loss for the names of close relatives, one's own occupation, or one's own name.

70% — Deficiencies in Most Areas

Occupational and social impairment with deficiencies in most areas — such as work, school, family relations, judgment, thinking, or mood. Symptoms at this level may include suicidal ideation; obsessional rituals that interfere with routine activities; speech that is intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty adapting to stressful circumstances (including a work or work-like setting); or an inability to establish and maintain effective relationships.

50% — Reduced Reliability and Productivity

Occupational and social impairment with reduced reliability and productivity. Symptoms may include flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty understanding complex commands; impairment of short- and long-term memory (for example, retaining only highly learned material or forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; or difficulty establishing and maintaining effective work and social relationships.

30% — Occasional Decrease in Work Efficiency

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks — while generally functioning satisfactorily, with routine behavior, self-care, and conversation normal. Symptoms may include depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, or mild memory loss (such as forgetting names, directions, or recent events).

10% — Mild or Transient Symptoms

Occupational and social impairment due to mild or transient symptoms that decrease work efficiency and the ability to perform occupational tasks only during periods of significant stress — or symptoms that are controlled by continuous medication.

0% — Diagnosed, Minimal Impact

A mental condition has been formally diagnosed, but symptoms are not severe enough to interfere with occupational and social functioning or to require continuous medication.

What the VA Looks For

When rating persistent depressive disorder, the VA focuses on:

• The degree of occupational and social impairment your symptoms cause — this is the central question at every rating level.
• The specific symptoms present and how they affect your ability to work, maintain relationships, and function day to day.
• Whether symptoms require continuous medication to be controlled, and whether they appear only during periods of significant stress or more consistently.

Because the same General Rating Formula applies across mental health conditions, the rating reflects the overall picture of how your condition affects your life — not just the label of the diagnosis.

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This information is a plain-language summary of the rating criteria under 38 CFR § 4.130 for Diagnostic Code 9433. It is provided for general educational purposes and does not guarantee any particular rating or outcome.