Connecting Depersonalization/derealization disorder to Military Service
Mental health conditions are common among veterans transitioning from military service to civilian life. Combat deployments, operational stress, military sexual trauma (MST), moral injury, leadership pressures, and the cumulative psychological weight of military service create conditions that frequently manifest as diagnosable psychiatric disorders. Depersonalization/derealization disorder can be service connected directly — caused by in-service events — or secondarily to a primary service-connected condition like PTSD, TBI, or physical injury. VA law requires the VA to consider mental health conditions liberally in light of the service member's overall military experience.
How VA Rates Depersonalization/derealization disorder
The VA rates Depersonalization/derealization disorder and most mental health conditions on a single general rating formula: 0%, 10%, 30%, 50%, 70%, or 100%. The rating is determined by the frequency, severity, and duration of symptoms, and their impact on occupational and social functioning. A 30% rating reflects intermittent symptoms that temporarily reduce work performance. A 50% rating reflects reduced reliability and productivity. A 70% rating reflects significant deficiencies in most areas of life. A 100% rating requires symptoms that are totally incapacitating, or complete occupational and social impairment.
Diagnostic Code: 9417 — Depersonalization/derealization disorderis evaluated under 38 CFR Part 4 using this code. Ratings are determined at your Compensation & Pension (C&P) exam and confirmed in your rating decision letter.
Evidence Required for Your Depersonalization/derealization disorder Claim
- DBQ (Disability Benefits Questionnaire) from a qualified mental health provider (psychiatrist or psychologist)
- Personal statement (VA Form 21-0781 for PTSD, or a personal lay statement for other conditions) describing stressors
- Buddy statements from service members corroborating stressor events or behavioral changes during service
- Service records documenting assignments, deployments, and any documented mental health treatment
- Private mental health treatment records — all therapy and medication management records
- Lay statement describing impact on your daily functioning, relationships, and employment
Frequently Asked Questions — Depersonalization/derealization disorder and VA Disability
What are the VA disability rating levels for Depersonalization/derealization disorder?
Depersonalization/derealization disorder and most mental health conditions are rated at 0%, 10%, 30%, 50%, 70%, or 100% under the VA's General Rating Formula for Mental Disorders. A 30% rating applies to occupational and social impairment with occasional decrease in efficiency. A 50% rating reflects reduced reliability and productivity. A 70% rating covers significant deficiencies in multiple life areas. A 100% rating requires total occupational and social impairment. The C&P exam DBQ, your treatment records, and how symptoms manifest during the exam all factor into the rating.
What evidence does VA need for a Depersonalization/derealization disorder claim?
Three elements are required: (1) a current diagnosis of depersonalization/derealization disorder from a qualified mental health provider, (2) an in-service stressor event or condition that contributed to the disorder (for PTSD: VA Form 21-0781; for other conditions: personal statement), and (3) a medical nexus connecting the diagnosis to service. The DBQ from your mental health provider is the most important single document — it directly maps your symptoms to VA rating criteria.
Can Depersonalization/derealization disorder be claimed secondary to a physical condition or PTSD?
Yes. Mental health conditions can be secondary to physically service-connected conditions (a veteran with chronic back pain developing depression), or to PTSD (PTSD frequently causes secondary anxiety, depression, substance use disorders, and relationship problems). A nexus letter from your mental health provider explaining the relationship between your primary service-connected condition and your depersonalization/derealization disorder is required for secondary claims.
What is the difference between Depersonalization/derealization disorder and PTSD for VA rating purposes?
Both are rated using the same General Rating Formula for Mental Disorders (0%–100%). The diagnostic distinction matters because some conditions (like PTSD) have specific stressor evidence requirements (VA Form 21-0781), while others use a broader nexus process. Both can reach 100% and both qualify for TDIU (Total Disability Individual Unemployability) if they prevent gainful employment. Having both PTSD and depersonalization/derealization disorder as separate diagnoses can increase your combined rating.