Veterans might think a diagnosis of “unspecified mental disorder” won’t count in their fight for PTSD disability benefits. The reality is often the opposite. Diagnoses of unspecified mental disorders can be the spark that ignites your PTSD or other VA disability rating for the full compensation you’ve earned for your service.
We want to stress that a mental disorder, diagnosed and coded as unspecified, does not imply that your symptoms are not severe or that you are not struggling. It does mean that your mental health practitioner cannot make a more specific diagnosis based on available information.
Unspecified mental disorders can disrupt your life extensively. In this post, we share how diagnoses of unspecified disorders may result in new disability claims, increased ratings, or additional evidence when appealing a denied claim.
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What Does “Unspecified Mental Disorder” Mean?
The official guide for diagnosing mental health conditions in the U.S. is the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The VA follows DSM-5 for all veterans’ mental health diagnoses for disability rating purposes and veteran’s mental health care benefits.
DSM-5 devotes a chapter to “Other Mental Disorders,” in which other specified and unspecified mental disorders are addressed.
According to DSM-5, the diagnostic use of unspecified and other specified mental disorders each applies to two situations.
The two “unspecified” scenarios are:
- Unspecified Mental Disorder
- Unspecified Mental Disorder Due to Another Medical Condition
The two “other” scenarios are:
- Other Specified Mental Disorder
- Other Specified Mental Disorder Due to Another Medical Condition
In each case, there is significant distress or impairment in critical areas of life, such as work, home, and social.
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What is the difference between “other specified” versus “unspecified” mental disorders?
- Unspecified is reserved for etiological (causative) ambiguity or conditions that don’t align with anything in a particular diagnostic category.
- Other specified is used for diagnoses included in DSM-5 that are missing some criteria necessary for a specific diagnosis.
When is an unspecified mental disorder diagnosis used?
1. Unspecified Mental Disorder
This category applies when there is ambiguity. The patient’s symptoms are in character with a mental disorder and cause considerable hardship or disablement in social, vocational, or other crucial areas of functioning; however, the full criteria for any mental disorder are not met. It may be unclear what is causing the mix of symptoms; pieces of the puzzle may be missing, and further assessment may be necessary.
An unspecified mental diagnosis may apply when the examiner has determined that your mental condition falls within a particular group of disorders. Still, it’s unclear which diagnosis in that group best suits your impairment. Clinicians often need to observe how symptoms progress before making a more specific diagnosis. “Unspecified” is a starting point to establish a diagnosis, leaving the door open for a more thorough or precise diagnosis later.
This is why an “unspecified” mental disorder diagnosis does not generally include detailed information, and the clinician does not explain why the criteria for a particular diagnosis are unmet.
2. Unspecified mental disorder due to another medical condition:
In this category, the person shows symptoms characteristic of a mental disorder that is due to another condition, and those symptoms cause considerable hardship or disablement in social, vocational, or other crucial areas of functioning. However, these symptoms do not meet the full criteria for any specific mental disorder attributable to another medical condition.
History behind the unspecified mental disorder classification
Unspecified seems a vague term for a pivotal matter such as diagnosing and grading disorders of the mind and behavior.
The term “unspecified” is an offshoot from past DSM editions, which instead used the one-size-fits-all designation of Not Otherwise Specified (NOS). This is still part of many veterans’ medical histories, for example, being diagnosed with “service-connected PTSD and major depressive disorder NOS.”
Why Is This Important?
The VA bases disability ratings on your ability to earn and maintain a sufficient living. Disability evaluations determine the ability of your body as a whole to function under the ordinary conditions of daily life, including employment.
To evaluate your mental disorder, the VA must consider the frequency, severity, and duration of:
- your psychiatric symptoms,
- the length of remissions, and
- your capacity for adjustment during periods of remission.
The more long-lasting and frequent your symptoms, the higher the rating may be.
Common Examples of Unspecified Mental Disorders in Veterans’ Disability Claims
- Adjustment Disorders, Unspecified
- Major Depressive Disorder, Unspecified
- Unspecified Depressive Disorder
- Unspecified Anxiety Disorder
- Unspecified Alcohol-Related Disorder
- Unspecified Obsessive-Compulsive and Related Disorder
- Unspecified Trauma- and Stressor-Related Disorder
- Unspecified Insomnia Disorder
How Can I Claim Disability Benefits for Unspecified Mental Disorder Due to PTSD?
The VA bases its decision on all the evidence of record that affects your occupational and social impairment − rather than on just one examiner’s evaluation of the level of disability at the moment of your examination. This includes your C-file, service records, medical records, employment records, and lay statements.
There are various paths to claiming VA benefits for “other specified” or “unspecified” mental disorders:
- original claim
- increased claim
- new claim
- secondary service-connected claim
- supplemental claim
- appeal a low VA rating decision or a denial
For example – symptoms of an unspecified mental disorder may be used as evidence of an increase in the severity of your current service-connected PTSD disability rating.
Perhaps the VA has assigned a 50% VA rating for your PTSD with unspecified mental disorder. Over time, the unspecified mental disorder has progressed and is now diagnosed as unspecified anxiety disorder with panic attacks. You suffer new problems with anger, interpersonal conflict, sleep issues, frequent panic attacks, and nightmares. You may be able to contend that, over an extended time frame, your service-connected PTSD with unspecified anxiety disorder symptoms more closely approximates the 70 percent disability rating and possibly qualifies for TDIU benefits. You would file an increased claim for a higher disability rating and more financial support.
How Our PTSD Lawyers Can Help
An accredited veteran’s claims attorney assisting you in these matters is highly beneficial. Our VA claims attorneys have a proven process for increasing your VA rating score. We know the evidence needed to win your VA claim and where to find it. Learn more about our work and how we help veterans get the disability benefits they deserve.
First and foremost, you want to document all possible unspecified mental disorder symptoms.
The VA looks for and uses specific terminology and aspects regarding each veteran’s disability claim. Providing the VA with a comprehensive, running record of your symptoms is an excellent start.
For instance, focus on recording the frequency, severity, and effects of all of your mental health symptoms.
If suicidal thoughts or violent ideations have developed, write them down with dates and details. If you suffer panic attacks, obsessive-compulsive behavior, anxiety, depressed mood, memory loss, unprovoked irritability, or other mental health symptoms, we can help you capture them.
Are you able to adjust during periods of remission? Can your spouse and family attest to your sleep problems and anger issues? We help you document when each symptom started and when and how your PTSD, along with all unspecified mental disorder symptoms, has affected your job performance, daily hygiene, social life, and ability to maintain relationships.
Has VA Denied Your PTSD Claim or Undervalued Your Unspecified Mental Disorder Symptoms?
We at Marc Whitehead & Associates have decades of experience with veterans’ PTSD disability claims and appeals. Our firm has helped thousands of veterans get the maximum disability benefits they deserve.
Our accredited veterans’ attorneys represent VA compensation claims at all levels: Regional Offices, the Board of Veteran’s Appeals, the U.S. Court of Appeals for Veterans Claims, the Federal Circuit, and the Supreme Court. We prepare you for every step and will represent you at your hearings whenever necessary.
We consider it an honor to fight for the benefits our veterans and their families deserve. If you need help today, call 866-477-2533 for a free case evaluation.