4.130—Schedule of ratings—mental disorders.
The nomenclature employed in this portion of the rating schedule is based upon the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, of the American Psychiatric Association (DSM-IV). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in § 4.125 through § 4.129 and to apply the general rating formula for mental disorders in § 4.130. The schedule for rating for mental disorders is set forth as follows:
| Rating | |
|---|---|
| Schizophrenia and Other Psychotic Disorders | |
| 9201Schizophrenia, disorganized type | |
| 9202Schizophrenia, catatonic type | |
| 9203Schizophrenia, paranoid type | |
| 9204Schizophrenia, undifferentiated type | |
| 9205Schizophrenia, residual type; other and unspecified types | |
| 9208Delusional disorder | |
| 9210Psychotic disorder, not otherwise specified (atypical psychosis) | |
| 9211Schizoaffective disorder | |
| Delirium, Dementia, and Amnestic and Other Cognitive Disorders | |
| 9300Delirium | |
| 9301Dementia due to infection (HIV infection, syphilis, or other systemic or intracranial infections) | |
| 9304Dementia due to head trauma | |
| 9305Vascular dementia | |
| 9310Dementia of unknown etiology | |
| 9312Dementia of the Alzheimer's type | |
| 9326Dementia due to other neurologic or general medical conditions (endocrine disorders, metabolic disorders, Pick's disease, brain tumors, etc.) or that are substance-induced (drugs, alcohol, poisons) | |
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| 9327Organic mental disorder, other (including personality change due to a general medical condition) | |
| Anxiety Disorders | |
| 9400Generalized anxiety disorder | |
| 9403Specific (simple) phobia; social phobia | |
| 9404Obsessive compulsive disorder | |
| 9410Other and unspecified neurosis | |
| 9411Posttraumatic stress disorder | |
| 9412Panic disorder and/or agoraphobia | |
| 9413Anxiety disorder, not otherwise specified | |
| Dissociative Disorders | |
| 9416Dissociative amnesia; dissociative fugue; dissociative identity disorder (multiple personality disorder) | |
| 9417Depersonalization disorder | |
| Somatoform Disorders | |
| 9421Somatization disorder | |
| 9422Pain disorder | |
| 9423Undifferentiated somatoform disorder | |
| 9424Conversion disorder | |
| 9425Hypochondriasis | |
| Mood Disorders | |
| 9431Cyclothymic disorder | |
| 9432Bipolar disorder | |
| 9433Dysthymic disorder | |
| 9434Major depressive disorder | |
| 9435Mood disorder, not otherwise specified | |
| Chronic Adjustment Disorder | |
| 9440Chronic adjustment disorder | |
| General Rating Formula for Mental Disorders: | |
| 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 | 100 |
| Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships | 70 |
| Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships | 50 |
| Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events) | 30 |
| Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication | 10 |
| A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication | 0 |
| Eating Disorders | |
| 9520Anorexia nervosa | |
| 9521Bulimia nervosa | |
| Rating Formula for Eating Disorders: | |
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| Self-induced weight loss to less than 80 percent of expected minimum weight, with incapacitating episodes of at least six weeks total duration per year, and requiring hospitalization more than twice a year for parenteral nutrition or tube feeding | 100 |
| Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of six or more weeks total duration per year | 60 |
| Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of more than two but less than six weeks total duration per year | 30 |
| Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder and incapacitating episodes of up to two weeks total duration per year | 10 |
| Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder but without incapacitating episodes | 0 |
| Note: An incapacitating episode is a period during which bed rest and treatment by a physician are required. | |