This section provides a general overview of how the VA diagnoses mental disorders, with a specific reference to the DSM V
Initial thoughts: Diagnosis of mental disorders
The VA places a significant emphasis on the diagnosis of psychiatric impairments and require that any diagnoses conform to the diagnostic and statistical manual (DSM) 5, which is the current guide used by mental health practitioners.
However, unless the appropriate conclusion is that there is no mental health diagnosis, in which case a veteran cannot obtain service connection as there is no “current condition” for which to obtain a nexus to service, the VA often puts too much emphasis on the diagnosis.
Specifically, any psychiatric diagnosis that is related to service should qualify for compensation under the table for rating mental disorders. It is important to not let VA evaluators or ratings specialists deny an otherwise viable claim because it does not meet with a specific diagnosis. For example, if a veteran does not meet all of the diagnostic criteria for PTSD, but there is a conceded stressor, and they meet the criteria for “other stressor induced disorder” under the DSM, this should still warrant service connection even though the diagnosis doesn’t match the four magic letters of “P” “T” “S” and “D.”
§ 4.125 Diagnosis of mental disorders.
(a) If the diagnosis of a mental disorder does not conform to DSM–5 or is not supported by the findings on the examination report, the rating agency shall return the report to the examiner to substantiate the diagnosis. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5), American Psychiatric Association (2013), is incorporated by reference into this section with the approval of the Director of the Federal Register under 5 U.S.C. 552(a) and 1 CFR part 51. To enforce any edition other than that specified in this section, the Department of Veterans Affairs must publish notice of change in the Federal Register and the material must be available to the public. All approved material is available from the American Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209–3901, 703–907–7300, http://www.dsm5.org. It is also available for inspection at the Office of Regulation Policy and Management, Department of Veterans Affairs, 810 Vermont Avenue NW., Room 1068, Washington, DC 20420. It is also available for inspection at the National Archives and Records Administration (NARA). For information on the availability of this information at NARA, call 202–741–6030 or go to *http://www.archives.gov/federal_register/code_of_federal_regulations/ibr_publications.html.*
(b) If the diagnosis of a mental disorder is changed, the rating agency shall determine whether the new diagnosis represents progression of the prior diagnosis, correction of an error in the prior diagnosis, or development of a new and separate condition. If it is not clear from the available records what the change of diagnosis represents, the rating agency shall return the report to the examiner for a determination.
(Authority: 38 U.S.C. 1155)
[61 FR 52700, Oct. 8, 1996, as amended at 79 FR 45099, Aug. 4, 2014]