Permanent and Total VA Disability Ratings for PTSD

Permanent and Total VA Disability Ratings for PTSD

What is Post Traumatic Stress Disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a mental health condition that develops in some people who have experienced a shocking, scary, or dangerous event. Symptoms of PTSD usually begin within three months of the traumatic incident, but sometimes begin years afterwards. To receive a diagnosis of PTSD, symptoms must last more than one month and be severe enough to interfere with relationships or work. Specific diagnostic criteria for PTSD is divided into different types of symptoms, including:

• Re-experiencing Symptoms. Includes flashbacks, nightmares, and intrusive thoughts.
• Avoidance Symptoms. Includes staying away from places, events, or objects that are reminders of the traumatic experience and avoiding thoughts or feelings related to the traumatic event.
• Arousal and Reactivity Symptoms. Includes being easily startled, feeling tense or on edge, having difficulty sleeping, and having angry outbursts.
• Cognition and Mood Symptoms. Includes trouble remembering key features of the traumatic event, negative thoughts about oneself or the world, distorted feelings like guilt or blame, and loss of interest in enjoyable activities.

PTSD can be short term or chronic depending on the individual and the circumstances. Regardless, the main treatments for people with PTSD are medications and psychotherapy, or both.

VA Disability Ratings for PTSD

To prove PTSD to the VA and establish a direct service connection, veterans must show (1) a current diagnosis of PTSD; (2) an in-service stressor; and (3) a medical link between the current diagnosed PTSD and the in-service stressor.

After service connection is established the VA will assign a disability rating. To determine this rating the VA uses the General Rating Formula for Mental Disorders. This rating scale ranges from 0 to 100 percent with in-between ratings of 10, 30, 50, and 70 percent.

There are two ways for a veteran to be considered totally disabled due to PTSD. The first is to receive a 100% VA disability rating. To qualify for a 100% disability rating for PTSD alone, or for PTSD combined with other service-connected mental health conditions, the veteran must meet the following criteria: 

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.

The second possibility is for the veteran to be deemed unemployable due to their service-connected medical condition. A veteran with a 70% VA disability rating for PTSD alone can be classified as totally disabled due to individual unemployability (TDIU) if their service-connected condition prevents them from engaging in substantial gainful activity. 

A veteran who suffers from service-connected PTSD may also be found totally disabled due to a combination of service-connected conditions, even if the PTSD alone isn’t sufficient to warrant a 100% VA disability rating or a TDIU classification. 

Both a 100% disability rating and a TDIU classification are considered total disability. But, not every total disability is considered permanent. 

Why Does It Matter if a Total Disability Rating is Permanent? 

Most benefits, such as the monthly monetary benefit and access to healthcare services, remain the same whether or not the total disability is considered permanent. But there are some advantages for a veteran whose total disability is deemed permanent. 

First, a veteran with a permanent disability rating isn’t subject to the periodic reviews most disabled veterans are. That not only eliminates the hassle of additional examinations and updating records, but also provides a greater sense of stability and predictability regarding benefits. While there are rare instances in which a permanent disability rating may be revoked, they typically involve fraud, serious error in the initial evaluation, or a re-evaluation triggered by the veteran. 

There are also some additional benefits available to dependents of a veteran with a permanent and total disability rating, including access to healthcare coverage and educational benefits.

What are Permanent and Total VA Disability Ratings?

Permanent and total disability, or P&T, refers to veterans whose disabilities are total (rated 100 percent disabling by the VA or with a TDIU classification) and permanent (zero or close to zero chance of improvement). Securing a permanent and total disability designation for PTSD alone is difficult for two reasons. First, most veterans suffering from service-connected PTSD don’t meet the high bar currently set for a 100% rating. Second, it can be more challenging to determine that a mental health condition is unlikely to ever improve than it is to make that call for certain physical impairments.

Permanent

The VA deems a disability “permanent” when it is reasonably certain that the level of impairment will continue for the rest of the veteran’s life. For this reason, the VA is allowed to take age into account when determining whether a disability is permanent.

Total

Veterans’ conditions are based on the VA’s Schedule of Rating Disabilities. The rating levels for each type of disability are based on how much the residuals of said disability impair their ability to function in life and at work. An 100 percent rating indicates that the disability is completely or totally disabling.

Update: Since 2022, there has been an effort underway to revise the General Rating Formula for mental disorders to allow for consideration of a wider range of symptoms and limitations. That change was widely expected to take place in 2025, and as of December of 2025 that has not yet occurred. However, the regulatory change is still in the pipeline. If enacted, most experts agree that it would be favorable for veterans suffering from PTSD and other mental health challenges, and could make it easier to attain higher VA disability ratings for those conditions.

How Does This Apply to PTSD?

A PTSD rating may become permanent and total if the VA determines that it meets the 100 percent criteria or if the veteran receives a TDIU classification and there a near-zero chance of improvement.

The rating criteria for a total disability rating for PTSD are:

• 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.

The VA should automatically consider whether a veteran’s PTSD qualifies for permanent and total status when adjudicating their claim. If the VA has awarded permanent and total status for PTSD it will most likely be indicated in the decision letter. However, if the VA fails to make that determination on its own, you can request a P&T determination.

Veterans Help Group has been supporting veterans in getting the benefits they deserve since 1995. If you or a loved one served, and suffer from PTSD, we are here to help.

Call Veterans Help Group at 855-855-8992 or complete our free veterans benefits case evaluation form.

FAQs: Permanent and Total VA Disability Ratings for PTSD

1. What does a Permanent and Total (P&T) rating for PTSD mean?
A P&T rating means the VA considers your PTSD service-connected, severe, and unlikely to improve. You are assigned a 100% disability rating with no future routine exams required.

2. How do I qualify for a P&T rating for PTSD?
You typically need medical evidence showing that your PTSD is severe, chronic, and substantially limits your daily life or ability to work. VA may review past claims, treatment records, and medical opinions.

3. What are the benefits of a P&T rating for PTSD?
A P&T rating ensures lifetime 100% disability compensation, eliminates periodic VA exams, and can make you eligible for additional benefits such as Dependents’ Educational Assistance or Special Monthly Compensation.

Read More About VA Disability:

• HOW TO INCREASE YOUR VA DISABILITY RATING FROM 80% TO 100%
• PTSD AND VETERANS: UNDERSTANDING THE 100% DISABILITY RATING REQUIREMENTS
• DIFFERENT TYPES OF 100% VA DISABILITY RATINGS
• THE DIFFERENCE BETWEEN 100% FOR UNEMPLOYABILITY AND 100% DISABILITY RATING
• 50% VA DISABILITY RATING EXPLAINED
• WHAT DOES IT MEAN TO HAVE A 100% VA DISABILITY RATING?
• WHAT BENEFITS DOES A 60% VA DISABILITY RATING GET?