Veterans with post-traumatic stress disorder (PTSD) often meet the criteria for additional mental health disorders. Obsessive-compulsive disorder (OCD) is one of those further diagnoses. The two disorders share many symptoms.
VA statistics report that in the general population, nearly 1 in 4 people with PTSD also experience OCD. Co-occurrence among military personnel is even higher.
How does the VA rate a veteran living with service-connected PTSD and OCD?
It’s possible your service-connected PTSD has caused you to develop OCD symptoms. OCD can occur as a side effect of PTSD. An OCD diagnosis can also be secondary to your PTSD disability, or perhaps your military service has aggravated an existing obsessive-compulsive disorder. If any of these scenes are true for you, the VA may owe you additional compensation.
OCD symptoms may develop that are different from or in addition to your PTSD symptoms. OCD may also cause a worsening of existing symptoms, destroying your ability to engage in work and everyday activities.
A diagnosis of OCD may support your overall disability rating in other ways. Even if you only show symptoms of one disorder, it’s highly worthwhile to give us a call to discuss your options. Together, we can help ensure you get all the compensation you deserve.
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The VA rates both PTSD and OCD as mental disorders.
Veterans with mental disorders (aside from eating disorders) are eligible for one of six VA impairment ratings: 0%, 10%, 30%, 50%, 70%, or 100%. Visit VA’s current Schedule of Ratings – Mental Disorders for both PTSD and OCD.
- VA’s diagnostic code for OCD is 9404
- VA’s diagnostic code for PTSD is 9411
Your rating is based on how severe your symptoms are, how often you experience those symptoms, and how long the symptoms endure. You don’t need to meet every symptom listed in a specific rating to receive that rating.
How Does the VA Compensate PTSD and OCD Disabilities?
In 2024, the basic monthly compensation for either of these mental disorder ratings for a veteran with no dependents is:
- 0% rating: $0 per month
- 10% rating: $171.23 per month
- 30% rating: $524.31 per month
- 50% rating: $1,075.16 per month
- 70% rating: $1,813.28 per month
- 100% rating: $3,877.22 per month
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Do You Have Multiple Mental Health Conditions?
All mental health conditions, including PTSD and OCD, are evaluated using the same criteria; therefore, if you suffer from more than one condition, you will be given one combined disability rating.
Understanding Secondary Conditions
Post-traumatic stress disorder is often the root cause of further disabling conditions. These are referred to as secondary conditions, meaning they have manifested entirely due to or have been aggravated by your service-connected PTSD or other impairment.
Secondary conditions are crucial to a veteran’s compensation and well-being, as they portray the complete scope of their disability. Secondary claims recognize how a veteran’s health is directly connected to all injuries sustained during military service. Secondary conditions often result in a higher disability rating and further medical treatment.
Just as crucial as getting the highest possible benefits, identifying OCD as a secondary condition and its link to your service-connected PTSD will better enable you to obtain the most complete and proper health care and attention.
Understand Pyramiding
When both conditions are attributed to the veteran’s service, PTSD and OCD are rated on the same general scale for mental disorders. A veteran with both diagnoses is likely to experience some of the same symptoms caused by each disorder.
However, the VA will not assign a separate rating for the same symptoms, even if two separate diagnoses cause that symptom. This is VA’s pyramiding rule, where “The evaluation of the same disability under various diagnoses is to be avoided.”
For example, if PTSD and OCD cause the same symptoms, such as panic attacks and flattened effect, the VA will consider only the highest-rated condition.
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What Are Symptoms of OCD?
The main features of OCD are obsessions that produce anxiety, and specific, excessive, repetitive, or unrelated behaviors called compulsions that a person performs as a way to cancel anxious thoughts and feelings.
Obsessions in OCD
Obsessions are unwanted, intrusive, uncontrollable, and often distressful thoughts or urges that cause extreme anxiety.
Examples of Obsessions:
- Fear of coming into contact with perceived contaminated substances, such as germs or dirt.
- Fear of causing harm to yourself or someone else because you’re not careful enough or you’re going to act on a violent impulse.
- Unwanted thoughts or mental images
- Fear of making a mistake.
- Excessive concern with morality (“right or wrong”).
- Feelings of doubt or disgust.
- Excessive concern with your sexual orientation or gender identity.
- Need for order, neatness, symmetry, or perfection.
- Need for constant reassurance.
Compulsions in OCD
Compulsions are specific, excessive, repetitive, or unrelated rituals (hand washing or checking locks) or mental acts (counting things or repeating words) that you feel compelled to do that interfere with routine activities. Compulsions may be a reaction to subdue an obsession or a set of rigid rules you invent. Individuals with OCD feel they must indulge these compulsions, or their anxiety will get worse.
Examples of Compulsions:
- Arranging items in a particular way.
- Washing your hands again and again.
- Hoarding items that have no value.
- Repeatedly checking the home’s security, such as locks, windows, and doors.
- Continuously checking that you have not harmed anyone.
- Constantly seeking reassurance.
- Rituals related to numbers, such as counting or repeating a task a certain number of times.
- Saying specific words when doing different chores.
- Declining to shake hands or touch items that others handle, like pens or doorknobs.
These are just a few of the symptoms associated with OCD. Obsessions and compulsions can undermine a person to the point they can no longer earn a living and function in society.
A 2023 article in the National Library of Medicine reports, “As OCD has the possibility of hindering one’s social growth and development, the WHO lists OCD as one of the ten most disabling conditions by financial loss and a decrease in quality of life.”
How Is OCD Diagnosed?
The VA follows the diagnostic criteria in the APA’s Diagnostic and Statistical Manual of Mental Disorders(DSM-5). An OCD diagnosis requires the symptoms to be severe enough to interfere with your everyday functioning, cause considerable distress, and use up a significant amount of time.
OCD is not diagnosed with lab tests or CAT scans. OCD diagnosis requires a clinical interview and physical exam. In a psychological evaluation, you will discuss your thoughts, feelings, and behavior patterns. The doctor will assess the degree of distress and disability your OCD causes.
Trauma-related OCD
The role of trauma in veterans’ PTSD cases is well established, having been vigorously studied and defined for decades. More recently, obsessive-compulsive tendencies have been identified in people who have experienced a traumatic event.
Studies reveal clear connections between exposure to traumatic stressors and the development of OCD. This type of obsessive-compulsive disorder is referred to as “trauma-related OCD,” linking the trauma to the OCD.
“Insight” Specifiers
The latest edition of DSM-5 includes new “insight” specifiers that measure a patient’s level of awareness of their obsessive-compulsive disorder. Insight applies to the severity of OCD. It is a clinical factor considered in inpatient evaluation regarding the deteriorating course of the disorder and the person’s working status, educational level, and functionality.
OCD patients will present with:
- Good or fair insight (these insight specifiers point out the degree to which an OCD patient realizes his or her behaviors are irrational and untrue.
- Poor insight
- Absent insight (without insight – meaning the patient has complete conviction their obsessive-compulsive disorder beliefs are true.)
Severe cases with poor or absent insight are associated with greater disorder severity. These cases may bear a more delusional intensity. The insight specifier in severe cases may also justify a diagnosis of the appropriate OCD or related disorder rather than a diagnosis on the schizophrenia spectrum or other psychotic disorders.
Will Your PTSD and OCD Qualify for TDIU?
TDIU stands for Total Disability Due To Individual Unemployability. It is also referred to as Individual Unemployability (IU).
A veteran awarded TDIU receives the same compensation and additional benefits as a veteran with a 100% rating.
If your disability is rated less than a total 100% evaluation, but you cannot obtain or maintain substantial gainful employment, the VA allows you to apply for TDIU. This benefit is based on the severity of your unique disability case and its impact on your ability to stay gainfully employed.
Generally, you must have a single disability rated at 60% or a combined evaluation of 70% percent to be eligible for TDIU.
For example, if OCD is determined to be a side effect of your service-connected PTSD, the severity of your combined disabilities may enable you to reach a 70% VA rating. If you can prove you are unable to obtain and keep gainful employment, you may apply and qualify for TDIU.
Marc Whitehead & Associates handles TDIU cases across the U.S. and would be proud to assist you.
Make Sure You Get All the VA Benefits You Are Entitled To
Marc Whitehead & Associates are accredited veterans’ attorneys who have helped disabled veterans nationwide obtain the benefits they deserve. VA ratings for PTSD and OCD have a direct bearing on the disability compensation and other health benefits that you are eligible to receive. We understand how vital every passing day is until your disabilities are correctly rated and payment is obtained.
Let us help you understand your options at no cost. Together, we can determine how your OCD symptoms or diagnosis may support your PTSD claim for VA disability benefits.
If you have already received a rating decision from the VA, have been wrongly denied benefits, or are unsatisfied with the disability pay awarded, we can help you appeal.
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