The VA has always used the Diagnostic and
Statistical Manual of Mental Disorders (DSM) as reference, and recently the
manual’s newest edition, the 5th edition, was published.
In the 5th edition, many of the
terms used to describe mental disorders have been changed to reflect the most
commonly accepted terms used today in medicine. These changes are meant to
present “the most current classification of mental disorders with associated
criteria designed to facilitate more reliable diagnosis of these disorders.”
The legislation stated, “VHA clinicians, as
well as all mental health providers, have a professional duty as licensed
medical practitioners to use the most current medical guidelines, in this case
DSM-5. In addition, the Institute of Medicine has encouraged VBA to review the
VASRD to ensure that it relies on current medical science.”
To stay true to this manual, the VA updated
all their terms in the VASRD to reflect the new terms in the 5th
edition. For example, “somatization disorder” is now “somatic symptom
Additionally, the VA also removed the
mental disorder category titles, like “Anxiety Disorders”, “Psychotic Disorders”,
etc., from the VASRD. Not exactly sure why. They are rather useful. Because of
this, we’ve chosen to keep them on our site just because of how much easier
they make it to find specific conditions.
With the re-namings and such, the VA also
had to change some of the VASRD Codes.
Finally, DSM-5 has officially gotten rid of
the Global Assessment of Functioning (GAF) scores. These have never had a huge
impact on rating mental disorders, so this really doesn’t change anything, but
now they will no longer be used at all.
So, what does all this mean? Basically,
some of the mental disorder codes and names of conditions have changed, but the
Military Disability Ratings for mental disorders have NOT. So, although the
name the condition may have changed, the rating for it has not changed.
How does this affect you? If you already had
your ratings before August 4th, this does not affect you one bit. Your codes,
names, ratings, etc., will not change at all. If your VA Rating Decision was
not made or your PEB Process was not completed before August 4th, then once
your ratings are decided, they will automatically reflect these new changes.
Here is a list of all the Mental Disorder
codes and how they’ve changed. If a code was deleted or seriously altered,
we’ve also included instructions on how those conditions will now be coded.
You can click on the code number to take
you to our explanation of the code on our site.
Code 9440: Chronic Adjustment Disorder has
Code 9416: They got rid of “fugue” and
changed the condition name to “Dissociative amnesia and dissociative identity
disorder”. Fugue is still rated under this code, however. They just took it out
of the title.
Code 9417: Derealization disorders were added
in addition to Depersonalization disorders. All derealization disorders are now
rated under this code as well.
Code 9421: The title was changed from
“somatization disorder” to “somatic symptom disorder”. Somatization disorder is
still rated here, they just call it something different.
Code 9422: Was changed from Pain Disorder
to any somatic condition that has a definite title, like Pain Disorder, but
isn’t officially diagnosed as somatic symptom disorder.
Code 9423: This is pretty much the same as
before, but they changed the wording to mean any other somatic condition that
is not rated under code 9421 or 9422.
Code 9424: “Functional neurological symptom
disorder” was added to the title just to further define it. Doesn’t change
Code 9425: The term “hypochondriasis
disorder” was changed to “illness anxiety disorder”. All hypochondriasis is
still rated here.
Code 9431: Cyclothymic disorder has not
Code 9432: Bipolar disorder has not
Code 9433: Dysthymic disorder is now called
“persistent depressive disorder”. Dysthymic disorder is still rated here.
Code 9434: Major depressive disorder has
Code 9435: All “other mood disorders” are
still rated here, but they changed the word “mood” to “depressive”.
Code 9201: This code was changed to be the
single code for all Schizophrenia conditions.
Codes 9202-9205: All these were types of
schizophrenia. These codes have been permanently deleted. Now all schizophrenia
is rated under code 9201.
Code 9208: Delusional disorder has not
Code 9211: Schizoaffective disorder has not
Code 9210: “Unspecified schizophrenic
disorders” was added in addition to “all other psychotic disorders”. It’s
basically the exact same thing. Anything that doesn’t fit under another
psychotic code goes here.
Code 9300: Delirium has not changed.
Codes 9301-9310, 9312 and 9326: All these
codes previously used the term “dementia”. This has been changed to
“neurocognitive disorders” to make sure that the code is not just limited to
dementia. Dementia is, however, still rated under these codes.
Code 9327: Organic mental disorders was
deleted. All of these are now included under the term “neurocognitive
disorders” and can be rated under one of the previous codes.
Code 9400: Generalized anxiety disorder has
Code 9403: “Social anxiety disorder (social
phobia)” was added to this code for all phobias.
Code 9404: Obsessive-compulsive disorder
has not changed.
Code 9412: Panic disorder and agoraphobia
has not changed.
Code 9410: This was changed to “all other
specific anxiety disorders” to differentiate it from the new 9413. All other
anxiety disorders that have definite titles can be rated here.
Code 9413: This code used to be “neurosis”
but is now all other unspecific anxiety disorders. So if the anxiety disorder
does not have a definite title, it is rated here. All neuroses are now rated
either under code 9410 or 9413.
Code 9411: Post-traumatic stress disorder.
The code and name have not changed, but DSM-5 did change how PTSD is diagnosed.
The basic idea is that the previous requirements for diagnosing PTSD were too
restrictive. The new requirements should now allow more veterans to be
officially diagnosed with PTSD. For full details, see our PTSD page.
That’s it. Remember that the ratings for
all Mental Disorders have not changed. So even if your code changed, your Military Disability Rating will not.
All these changes are now on our Mental Disorders page, and the discussion on all the Mental Disorders before these
changes has been moved to the Historic VASRDs page.