Should You File for a VA Mental Health Rating Increase? How I'd Decide

Is your current mental health rating too low?

Have your symptoms worsened since the rating was assigned? Or are you wondering whether your symptoms and level of impairment were accurately captured in the first place?

Your rating percentage affects both your monthly compensation and the benefits available to you. If you're sitting at 30% when your disability should be rated at 70%, you could be missing out on more than $1,000 per month, depending on your circumstances. (See VA's current compensation rates.) That's a lot of money to leave on the table.

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‍But requesting an increase comes with risks.

Yes, your 30% rating could be increased to 70%.

But it could also stay at 30%, leaving you with nothing to show for the time and energy you spent filing.

Or, under certain circumstances, the VA could determine that your rating should actually be reduced.

‍When is it worth poking the bear?

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I started out believing I could offer fairly concrete guidance on when it’s worth asking for an increase. The closer I looked at the regulations, the less confident I became. The General Rating Formula for Mental Disorders (the “General Rating Formula”) leaves much undefined, as this article explains, and without clear standards for its symptoms and levels of impairment, even qualified examiners can reach different conclusions about the same veteran.

That means no one can reliably predict what rating the VA will assign, and I won’t pretend otherwise. But uncertainty doesn’t make the decision impossible. If I were in your position, I’d still want to gather what information I could. I’d take stock of what I know, what I don’t, and whether more evidence is worth pursuing. Then I’d weigh the potential benefits against the risks, including the possibility that a new exam could leave my rating unchanged or even lower it. And I’d do all of that in light of my own circumstances.

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Here's what I'd be looking at:

1. Does My Current Rating Match My Symptoms and Level of Impairment?
2. How Confident Can I Be in My Assessment?
3. What Are My Options, and What Risks and Protections Apply?
4. Given What I Know – and Don't Know – Is Pursuing a Higher Rating Worthwhile?

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Does My Current Rating Match My Symptoms and Level of Impairment?

I'd start with the Rating Formula, which is found in 38 CFR § 4.130. (If you're not familiar with how it's structured, I broke it down in this section of my DBQ and Rating Decision article.)

Then I'd compare my current rating with the higher percentages, looking at both the symptoms associated with each percentage and the corresponding descriptions of occupational and social impairment.

A few things to remember:

• The listed symptoms are examples, not an exhaustive list. Other symptoms can produce a comparable level of impairment.
• You don't need every symptom listed under a particular percentage to qualify for that rating.
• Having a symptom associated with a higher percentage doesn't guarantee that rating, either.

For example, if I were rated at 50%, I'd look at the symptoms associated with 70% and 100%. Am I experiencing any of those symptoms, or other symptoms that might be comparable in severity, frequency, and duration?

I'd also look at how my symptoms affect my functioning. Am I having significant difficulties at work, in my relationships, or in other areas of my life? How do those difficulties compare with the descriptions of occupational and social impairment associated with the higher ratings?

If I couldn't identify any symptoms associated with a higher rating, or other symptoms of comparable severity, I would be reluctant to pursue an increase – particularly if my level of occupational and social impairment also appeared consistent with my current percentage.

On the other hand, if my symptoms and impairment appeared more consistent with a higher rating, I'd have a reason to investigate further.

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How Confident Can I Be in My Assessment?

As I've discussed in my article on VA mental health ratings, the Rating Formula doesn't provide specific, measurable criteria for many of its symptoms or the levels of impairment.

This makes things tricky. Two sources of uncertainty stack on top of each other: how accurately I can assess myself, and how an examiner would assess me.

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Can I Trust My Own Read of My Symptoms?

Not completely, and the error can run in either direction. I might believe I have a symptom that I don't. I might also be experiencing symptoms I'm not aware of.

It's common for veterans to overlook or normalize mental health symptoms. Just because you don't recognize symptoms associated with a higher rating doesn't necessarily mean you aren't experiencing them.

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How Consistent Are Examiners?

Even a professional may identify a symptom that a Compensation and Pension (C&P) examiner interprets differently. There is variability in how examiners make their selections on the Disability Benefits Questionnaire (DBQ), both in identifying symptoms and in determining the level of occupational and social impairment. That's a significant unknown when you're trying to assess whether your rating should be higher.

But we do have some insight into how examiners approach these decisions.

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Symptom Selection

Here is an example of the guidance given to examiners at Veterans Evaluation Services (VES), one of the contractors the VA uses to conduct C&P exams, to help them decide which mental health symptoms to select on the DBQ: its Spring 2025 provider newsletter, pages 8–10.

Keep in mind that this guidance isn't an official regulatory definition, and there's no guarantee that all VES examiners follow it. But it gives us an example of how one VA contractor has interpreted the symptoms.

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Level of Impairment Selection

Between talking with other examiners and reviewing thousands of DBQs, I've encountered several different approaches to selecting the overall level of occupational and social impairment.

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For example, say a veteran has four symptoms listed under the 30% rating and one symptom listed under 70%. Depending on the approach an examiner takes, the impairment level selected might match:

• 70%: The examiner selects the level associated with the highest-rated symptom.
• 30%: The examiner selects the level associated with the greatest number of symptoms.
• 50%: The examiner chooses a level somewhere between the higher- and lower-rated symptoms.
• Independent judgment: The examiner independently assesses the veteran's occupational and social impairment and, for example, finds that it most closely matches the 50% description, regardless of the distribution of symptoms.

In another example, a veteran's symptoms all fall within the 30% level. Some examiners will automatically choose the 30% level. Others will choose whichever description from the 0%, 10%, or 30% levels best describes the veteran's level of functioning.

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These examples demonstrate the variety of approaches I've encountered. This is why even if I were confident about having accurately identified my symptoms and how they affect my functioning, I wouldn't be as confident that a C&P examiner would reach the same conclusions.

Among the DBQs I've reviewed, I haven't seen an examiner select an impairment level higher than the highest rating level represented by the checked symptoms. That is solely my observation – not an official rule or regulation. The checked symptom list does not set a legal ceiling on your rating. But personally, it's something I would factor in when weighing my options.

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Would a Professional Evaluation Help?

Potentially.

An experienced professional who asks the right questions may identify symptoms you've overlooked, normalized, or simply wouldn't have thought to mention. They may also help distinguish between symptoms that sound similar, and assess how your symptoms affect your functioning.

It wouldn't guarantee that a C&P examiner would reach the same conclusions, but it would be helpful information when you are considering your options.

The quality of that evaluation matters. I wouldn't put much confidence in an assessment that simply checks off symptoms and selects an impairment level without adequately explaining the findings.

But if a thorough, well-supported evaluation identifies symptoms or functional impairment that weren't adequately documented previously, the resulting report could provide meaningful evidence for the VA to consider.

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What Are My Options, and What Risks and Protections Apply?

Before deciding, I would want to know all of my available options: a claim for an increase, a decision review, and alternative pathways, such as Total Disability Based on Individual Unemployability (TDIU)?  An accredited representative can help determine which applies.

‍Which options are available in my circumstances?

• Filing a claim for an increase?
• Requesting a Higher-Level Review?
• Submitting a Supplemental Claim?
• Appealing to the Board of Veterans' Appeals?

• Are there alternative ways to obtain the compensation or benefits I'm seeking, such as Total Disability Based on Individual Unemployability (TDIU), that I should consider?

Then, for each option available to me, I'd want to consider the following questions.

What are the evidence requirements?

• Can I submit new evidence?
• Do I need to submit new evidence?

How likely am I to achieve a favorable outcome?

• Given my particular circumstances, are some options more promising than others?
• What would I need to establish for each option to succeed?
• How well does my existing evidence support that outcome?
• What additional evidence, if any, might materially improve my chances?

What deadlines and effective dates should I consider?

• What deadlines do I need to factor in?
• What effective date might apply under each option?

What time, effort, and expense might be involved?

• Filling out forms?
• Writing a statement?
• Attending a hearing?
• Requesting lay statements?
• Paying for an independent medical examination (IME) or independent medical opinion (IMO)?

What are the potential risks?

• Might I have to undergo another C&P exam?
  
  • For this disability?
  • For my other service-connected disabilities?
• Could pursuing this option put any of my existing ratings at risk of reduction?
  
  • For this disability?
  • For my other service-connected disabilities?

What protections against reduction apply?

• For my current mental health rating?
• For my other service-connected ratings?‍

If I don't like the outcome, what options, if any, would I still have?

• Could I challenge the decision or submit additional evidence?
• What deadlines, costs, risks, and potential effective-date consequences would those options involve?

These are the questions I would bring to my accredited Veterans Service Officer (VSO). I'd want their guidance and expertise before committing to any approach.

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Given What I Know – and Don't Know – Is Pursuing a Higher Rating Worthwhile?

By this point, I'd have a better understanding of whether my rating might be too low, how confident I am in that assessment, and what options and risks I need to consider.

This is when I would need to sit down and weigh each of the options.

• How confident am I in the evidence supporting a higher rating?
• Given my answers above, what do I know about my likelihood of success?
• Could pursuing one option limit the options available to me later, particularly if I disagree with the outcome?
• What could I potentially gain financially? What might I lose?
• What might this process cost me in terms of my mental health, time, energy, and work?

These considerations would influence whether I pursue a higher rating. They would also influence which option I choose, and how much I'd be willing to invest upfront – to increase my confidence in the decision, to strengthen the evidence supporting my claim, or both.