Are you eligible to receive a VA Disability Rating for Somatic Symptom Disorder?
Somatic Symptom Disorder (SSD), previously called Chronic Pain Syndrome, means a veteran is having a considerable focus on his/her physical symptoms, such as pain, weakness, limitations, and shortness of breath.
This is typically tied to the daily chronic pain and life/healthlimitations related to a disabled veteran’s current service-connected disabilitiesrated at 0 percent or higher.
Thus, it is sometimes referred to as a “Lifestyle Impact Claim” although no such claim exists in CFR 38, Part 4, Schedule for Rating Disabilities.
The disabled veteran normally has excessive thoughts, feelings,and behaviors relating to these physical symptoms, which causes significant occupationaland social impairment in the veteran’s work, life, and/or social functioning.
These associated physical symptoms may then trigger a host ofmental health related symptoms, such as depression, anxiety, panic attacks,anger issues, insomnia, obsessive rituals, memory loss, among many others.
Excessive thoughts, feelings, or behaviors related to Somatic Symptom Disorder include at least one of the following in disabled veterans:
- Disproportionate and persistent thoughts about the seriousness of one’s physical symptoms and impairment.
- Persistently high level of anxiety about health or symptoms, which may or may not trigger other mental health related symptoms.
- Excessive time and energy devoted to these symptoms or health concerns, which can be characterized as “unhealthy.”
Table of Contents
- How to Diagnose Somatic Symptom Disorder in Veterans
- 100 VA Disability Rating for Somatic Symptom Disorder
- 70 VA Disability Rating for Somatic Symptom Disorder
- 50 VA Disability Rating for Somatic Symptom Disorder
- 30 VA Disability Rating for Somatic Symptom Disorder
- 10 VA Disability Rating for Somatic Symptom Disorder
- 0 VA Disability Rating for Somatic Symptom Disorder
- Need help with your Chronic Pain Syndrome VA Claim?
How to Diagnose Somatic Symptom Disorder in Veterans
Primary Care Physicians and/orPsychologists and Psychiatrists should be clear when diagnosing and characterizingdisabled veterans with Somatic Symptom Disorder and their corresponding severityof symptoms:
- With predominant pain (previously pain disorder): This specifier is for individuals whose somatic symptoms predominantly involve pain.
- Persistent: A persistent course is characterized by severe symptoms, marked impairment, and long duration (more than 6 months).
- Mild: Only one of the symptoms specified in Criterion B is fulfilled.
- Moderate: Two or more of the symptoms specified in Criterion B are fulfilled.
- Severe: Two or more of the symptoms specified in Criterion B are fulfilled, plus there are multiple somatic complaints (or one very severe somatic symptom).
A diagnosis of Somatic Symptom Disorder, which is widely recognized as a disabling condition, is accepted by VA as a disability for compensation purposes.
Because Somatic Symptom Disorder may also stem from an underlying disease such as multiple sclerosis or arthritis, and variations of somatic symptom disorder may be found throughout all body systems, the condition should be evaluated under the most appropriate diagnostic code (DC) based on the clinical picture demonstrated.
- The VA already recognizes conditions such as fibromyalgia and low back pain syndrome, which are forms of somatic symptom disorder, as disabilities for compensation purposes.
- Originally diagnosed as Chronic Pain Syndrome, the terminology was revised to Somatic Symptom Disorder in the Diagnostic and Statistical Manual of Mental Disorders, fifth version (DSM-5).
Important: Adequate medical evidence must be of record thatidentifies the specific manifestations of the disease present in order toaccurately evaluate the condition.
- Thismeans veterans need a medical diagnosis of Somatic Symptom Disorder.
- Theremust be a clear Nexus or logical link to a veteran’s current service-connecteddisabilities for secondary service connection.
- Theveteran must have current symptoms of Somatic Symptom Disorder that are causingoccupational and social impairment.
VA Disability Rating for Somatic Symptom Disorder
Somatic Symptom Disorder VA ratings are based upon the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (see §4.125 for availability information).
Rating agencies must be thoroughly familiar with this manual to properly implement the directives in §4.125 through §4.129 and to apply the general rating formula for mental disorders in §4.130.
Code 9421 specifies Somatic Symptom Disorder for VA Ratingpurposes, meaning, it’s characterized as a mental health claim, in which adisabled veteran’s level of occupational and social impairment determines the finalVA rating.
100 VA Disability Rating for Somatic Symptom Disorder
Total occupational and social impairment, due to such symptomsas: gross impairment in thought processes or communication; persistentdelusions or hallucinations; grossly inappropriate behavior; persistent dangerof hurting self or others; intermittent inability to perform activities ofdaily living (including maintenance of minimal personal hygiene);disorientation to time or place; memory loss for names of close relatives, ownoccupation, or own name.
70 VA Disability Rating for Somatic Symptom Disorder
Occupational and social impairment, with deficiencies inmost areas, such as work, school, family relations, judgment, thinking, ormood, due to such symptoms as: suicidal ideation; obsessional rituals whichinterfere with routine activities; speech intermittently illogical, obscure, orirrelevant; near-continuous panic or depression affecting the ability to functionindependently, appropriately and effectively; impaired impulse control (such asunprovoked irritability with periods of violence); spatial disorientation;neglect of personal appearance and hygiene; difficulty in adapting to stressfulcircumstances (including work or a work like setting); inability to establishand maintain effective relationships.
50 VA Disability Rating for Somatic Symptom Disorder
Occupational and social impairment with reduced reliabilityand productivity due to such symptoms as: flattened affect; circumstantial,circumlocutory, or stereotyped speech; panic attacks more than once a week;difficulty in understanding complex commands; impairment of short- andlong-term memory (e.g., retention of only highly learned material, forgettingto complete tasks); impaired judgment; impaired abstract thinking; disturbancesof motivation and mood; difficulty in establishing and maintaining effectivework and social relationships.
30 VA Disability Rating for Somatic Symptom Disorder
Occupational and social impairment with occasional decreasein work efficiency and intermittent periods of inability to performoccupational tasks (although generally functioning satisfactorily, with routinebehavior, self-care, and conversation normal), due to such symptoms as:depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often),chronic sleep impairment, mild memory loss (such as forgetting names,directions, recent events).
10 VA Disability Rating for Somatic Symptom Disorder
Occupational and social impairment due to mild or transientsymptoms which decrease work efficiency and ability to perform occupationaltasks only during periods of significant stress, or symptoms controlled bycontinuous medication.
0 VA Disability Rating for Somatic Symptom Disorder
A mental condition has been formally diagnosed, butsymptoms are not severe enough either to interfere with occupational and socialfunctioning or to require continuous medication.
How to File a VA Claim for Somatic Symptom Disorder
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About the Author
Founder & CEO
Brian Reeseis a VA benefits expert, author of the #1 Amazon Bestseller You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned, andfounder of VA Claims Insider–“The Most Trusted Name in Education-Based Resources for Veterans.”
His frustration with the8-step VA disability claims processled him to create“VA Claims Insider,”which provides U.S. military veterans with tips, strategies, and lessons learned for successfully submitting or re-submitting a winning VA disability compensation claim.
Brian isalso the CEOofMilitary Disability Made Easy, which is the world’s largest free searchable database for all things related to DoD disability and VA disability claims and has served more than 4,600,000 military members and veterans since its founding in 2013.
His eBook, the“9 Secrets Strategies for Winning Your VA Disability Claim”has been downloaded more than 300,000 times in the past three years and is the #1 rated free VA disability claims guide for veterans.
He is aformer active duty Air Force officerwith extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from theUnited States Air Force Academy, Colorado Springs, CO and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).