Persistent Depressive Disorder (Dysthymia)
Persistent Depressive Disorder, also known as Dysthymia, is rated under Diagnostic Code 9433 using the General Rating Formula for Mental Disorders. It falls under the VA's mood disorder category. The same rating criteria and single-rating rule apply as all other mental health conditions.
VA Rating Levels
A mental health condition has been formally diagnosed, but symptoms are not severe enough to interfere with occupational or social functioning, and continuous medication is not required.
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.
Occasional decrease in work efficiency with intermittent periods of inability to perform occupational tasks, though generally functioning satisfactorily with normal routine behavior, self-care, and conversation. Symptoms include depressed mood, anxiety, suspiciousness, panic attacks weekly or less often, chronic sleep impairment, and mild memory loss such as forgetting names, directions, or recent events.
Reduced reliability and productivity due to symptoms such as flattened affect, circumstantial or stereotyped speech, panic attacks more than once a week, difficulty understanding complex commands, impaired short-term and long-term memory, impaired judgment, impaired abstract thinking, disturbances of motivation and mood, and difficulty establishing and maintaining effective work and social relationships.
Deficiencies in most areas including work, school, family relations, judgment, thinking, or mood. Symptoms include suicidal ideation, obsessional rituals that interfere with routine activities, intermittently illogical or irrelevant speech, near-continuous panic or depression affecting the ability to function independently and effectively, 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 work settings, and inability to establish and maintain effective relationships.
Total occupational and social impairment with symptoms such as 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, and memory loss for names of close relatives, own occupation, or own name.
Exam Tips & Key Evidence
- →Persistent depressive disorder uses the same rating schedule as PTSD and major depression, so your diagnosis name doesn't set a ceiling on your rating.
- →The VA only allows one mental health rating total. All symptoms from every diagnosis are combined into one evaluation.
- →Conditions like erectile dysfunction, IBS, GERD, sleep apnea, and TMJ are commonly granted as secondary to depression.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.130, Diagnostic Code 9433