From 70% to 100%: Why VA Mental Health Rating Increases Can Be Difficult

As a Compensation and Pension (C&P) examiner, some of my least favorite exams are with veterans rated 70% who have requested an increase, but whose symptoms and impairment don’t support a 100% rating. The claims process and the C&P exam take a real toll on mental health, and I hate seeing veterans go through this process when the evidence doesn't appear likely to support a higher rating. In those moments, I wish someone had helped them make a more informed decision before they filed.

I understand the reasoning. If your mental health has significantly worsened since your last rating, it’s logical to think your rating should go up. But moving from 70% to 100% is different from seeking an increase at a lower rating. A 70% rating already reflects deficiencies in most areas of life, and 100% is the only step above it, reserved for total occupational and social impairment. That means your symptoms can become more numerous, frequent, or intense, and your functioning can decline considerably, without meeting the criteria for 100%. I see this in C&P exams: veterans whose mental health has genuinely worsened, but whose symptoms and impairment still appear more consistent with a 70% rating.

If you're rated 70% and are wondering whether your rating is too low, it helps to understand how high the bar for 100% is before you decide to file.

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What Does It Take to Increase a 70% Mental Health Rating to 100%?

The General Rating Formula for Mental Disorders lists symptoms for the 100% rating that reflect very severe impairment:

• 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

These symptoms are examples, not a checklist. You don’t need to have any particular one to qualify for 100%. The VA looks at the overall severity of your symptoms and how they affect your occupational and social functioning, but that impairment still has to be total. In my experience, symptoms like these are much less common than those associated with lower ratings.

For some perspective, the VA’s FY2025 Annual Benefits Report shows that only 13.3% of service-connected mental disorder disabilities were rated 100%. These numbers don’t show how often increases from 70% are granted, but they do show that 100% is the exception rather than the norm.

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Are There Other Options Worth Considering?

If you're at 70% and considering an increase to 100%, talk through your options with an accredited representative, such as a Veterans Service Officer (VSO), before you file.

In particular, ask whether Total Disability Based on Individual Unemployability (TDIU) might be an alternative worth pursuing. TDIU uses a different standard. Instead of requiring total occupational and social impairment under the General Rating Formula, the VA considers whether your service-connected disabilities prevent you from securing or maintaining substantially gainful employment. If the VA grants TDIU, your underlying disability rating remains the same, but your compensation increases to the 100% rate.

TDIU isn't necessarily easier to qualify for, but for veterans whose service-connected disabilities prevent substantially gainful employment, it may be a more appropriate option to consider.

Learn more about TDIU, eligibility requirements, and what the VA considers when evaluating your ability to work.

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