Panic Disorder with Agoraphobia VA disability rating & claim guide

Yes. The VA rates Panic Disorder with Agoraphobia under VASRD diagnostic code 9412 (Mental Disorders). Panic disorder is marked by sudden episodes of intense fear, often leading to avoidance of public places.

Possible VA ratings for Panic Disorder with Agoraphobia are 100%, 70%, 50%, 30%, 10%, 0%. Examples: 100%: Total occupational and social impairment, due to such symptoms 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; memory loss for names of close relatives, own occupation, or own name; 70%: Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships; 50%: Occupational and social impairment with reduced reliability and 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- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.

Not for the same symptoms. Diagnostic codes 9201 through 9440, Panic Disorder with Agoraphobia among them, are all rated on one General Rating Formula for Mental Disorders, which grades how much symptoms impair work and social life. 38 CFR 4.126(a) says the rating rests on "all the evidence of record that bears on occupational and social impairment." 38 CFR 4.14 says: "The evaluation of the same disability under various diagnoses is to be avoided." So the same symptoms should not be rated twice, once under each diagnosis. These rules do not say when, if ever, a second mental disorder rating is given.

Vetrify estimates the typical rating awarded for Panic Disorder with Agoraphobia at around 50%, based on VA claims data and the rating schedule. An estimated 216,000 veterans are service-connected for Panic Disorder with Agoraphobia. Estimated approval outlook: Moderate – supported with documented panic frequency and functional limits.

Strong evidence for a Panic Disorder with Agoraphobia claim includes: Mental health treatment records describing how the condition affects work, school and relationships, since that is what the formula rates; A documented record of panic attack frequency, which the formula names at the 30 and 50 percent levels; Lay statements from a spouse, coworker or supervisor describing missed work, avoidance and functional limits; Medication and therapy history, including whether symptoms are controlled by continuous medication.

VA's Mental Disorders Disability Benefits Questionnaire (DBQ) is on its public list of DBQs. VA's page says: "You can use these forms to submit medical evidence from your health care providers."

Common pitfalls when filing for Panic Disorder with Agoraphobia: Treating the diagnosis as the rating - the percentage comes from the level of impairment, not from the diagnosis; Not documenting panic attack frequency, which the formula itself uses as an example at two levels; Filing without evidence connecting the condition to service or to an in-service stressor.

Conditions that can be service-connected as secondary to Panic Disorder with Agoraphobia, when a medical opinion links them, include: Irritable Bowel Syndrome. A secondary condition gets its own rating, which VA combines with the veteran's other ratings under 38 CFR 4.25.