Anxiety & Depression VA Claim Field Manual
Unlike PTSD, anxiety and depression claims don't require stressor documentation—you can file without proving a specific traumatic event. This playbook covers the most common path: secondary connection to chronic pain conditions like back, knee, or migraines.
Chronic pain and mental health feed each other. The VA recognizes this under 38 C.F.R. § 3.310—if your service-connected condition caused or aggravated anxiety or depression, you can claim it as secondary without proving an in-service stressor.
Whether you're filing secondary to back pain, knee conditions, or TBI, you need a diagnosis, a nexus linking the conditions, and evidence of occupational and social impairment. This playbook shows exactly how to build that case.
- No stressor required: unlike PTSD, anxiety and depression claims don't need VA Form 21-0781 or documented traumatic events—your diagnosis and nexus carry the claim.
- Use the right DBQ: VA Form 21-0960P-2 (Mental Disorders Other Than PTSD) is your form—not the PTSD DBQ. Have your provider complete it before the C&P exam.
- Map symptoms to 38 C.F.R. § 4.130: the same General Rating Formula applies—ratings from 0% to 100% depend on occupational and social impairment, not just diagnosis.
- Build the pain-depression nexus: if filing secondary, your provider must explain how chronic pain caused or worsened your mental health condition.
Key takeaways
- Lock your intent to file and gather treatment records showing a diagnosed anxiety or depressive disorder (DC 9400 or DC 9434).
- For secondary claims, secure a nexus letter explicitly connecting depression or anxiety to your service-connected chronic pain condition.
- Document occupational and social impairment using therapy notes, medication history, and lay statements that map to CFR § 4.130 rating levels.
Situation Brief
You have a diagnosis of generalized anxiety disorder, major depressive disorder, or both—and you can trace the symptoms to service or to a service-connected condition. Mental health conditions rated under 38 C.F.R. § 4.130 follow the same General Rating Formula as PTSD, but without the stressor burden. Success depends on diagnosis, nexus, and documented impairment.
Signals You Need This
- You have a clinical diagnosis of anxiety disorder (DC 9400), major depressive disorder (DC 9434), or a related condition from a licensed mental health provider.
- Your mental health symptoms began during service OR developed secondary to chronic pain, TBI, or another service-connected condition.
- You experience occupational difficulties (missed work, reduced productivity) or social impairment (isolation, relationship strain, irritability) that matches the CFR § 4.130 criteria.
Stay on Course
Decide your claim theory early: direct service connection (symptoms began in service) or secondary connection (caused by a service-connected condition). Most anxiety and depression claims succeed through the secondary route because chronic pain creates a documented medical link.
- Gather all mental health treatment records—therapy notes, psychiatry visits, medication history—going back to your earliest symptoms.
- For secondary claims, draft a nexus letter with your provider explaining the causal relationship between your primary condition and mental health.
- Collect lay statements from family, coworkers, or friends who observe your anxiety, mood changes, or functional limitations.
Keep symptom logs aligned with therapy visits so your narrative matches provider records during the C&P exam.
Prep Checklist
Stage your evidence before filing so the VA sees a complete picture of diagnosis, nexus, and impairment.
- File an Intent to File (VA Form 21-0966) to lock your effective date while you gather evidence.
- Obtain treatment records with a formal diagnosis of anxiety disorder (DC 9400) or major depressive disorder (DC 9434) using DSM-5 criteria.
- Have your treating provider complete VA Form 21-0960P-2 (Mental Disorders Other Than PTSD DBQ)—this is NOT the same as the PTSD DBQ.
- For secondary claims: secure a nexus letter from your provider stating the connection between your service-connected condition and your anxiety or depression.
- Gather buddy statements from family, friends, or coworkers describing observable behavior changes—isolation, irritability, missed events, mood swings.
- Collect employment records showing functional impact: performance reviews mentioning issues, FMLA records, accommodations, or termination documents.
Label every document with your name, file number, and the specific claim element it supports (diagnosis, nexus, or impairment).
Step-by-step playbook
- Lock in your intent date: Submit VA Form 21-0966 online or call the VA to establish your intent to file—this preserves your effective date for up to one year while you build evidence.
- Gather diagnosis and treatment evidence: Collect therapy notes, psychiatry records, and medication history. Ensure records include a formal DSM-5 diagnosis of anxiety or depression from a licensed provider.
- Build your claim theory: For secondary claims: get a nexus letter linking anxiety/depression to your service-connected condition. For direct claims: document in-service onset with STRs and continuity evidence.
- Prepare for the mental health C&P exam: Review CFR § 4.130 rating criteria, prepare examples of your worst days, and bring your symptom log. Don't minimize—describe occupational and social impairment honestly.
One rating for overlapping symptoms: under 38 C.F.R. § 4.14 (pyramiding rule), the VA assigns a single combined rating for mental health conditions with overlapping symptoms. If you have both anxiety and depression, you'll receive one rating based on overall impairment—not separate ratings for each.
Evidence Arsenal
Focus on three pillars: clinical diagnosis, nexus to service, and documented occupational/social impairment.
Documents to Gather
- Mental health treatment records: therapy session notes, psychiatry evaluations, medication management records, and hospitalization summaries if applicable.
- Completed DBQ: VA Form 21-0960P-2 (Mental Disorders Other Than PTSD) filled out by your treating provider.
- Nexus letter (for secondary claims): provider opinion explicitly linking your anxiety/depression to a service-connected condition, with supporting rationale.
- Employment records: performance reviews, disciplinary actions, FMLA usage, job loss documentation, or employer statements about functional limitations.
Templates & Tools
- Lay statement templates for describing mood changes, isolation, and daily impact.
- Claim Prep Checklist to track evidence uploads, deadlines, and VA correspondence.
- 38 C.F.R. § 4.130—the General Rating Formula so you can match your evidence to rating criteria.
- VA Disability Calculator to see how a mental health rating combines with existing ratings.
- Secondary Conditions Finder to identify conditions that may be secondary to your anxiety or depression.
Reminder: The VA rates mental health on occupational and social impairment—not just whether you have a diagnosis. Your evidence must show how symptoms affect work, relationships, and daily functioning to achieve an accurate rating.
Intel & Tools
Treat your mental health claim like a continuous mission—track symptoms, coordinate with providers, and debrief every exam.
- Weekly symptom logs: track panic attacks, depressive episodes, sleep disruption, and missed activities. Note triggers, duration, and impact. Upload summaries before exams or reviews.
- Therapy coordination: tell your therapist when you file so session notes capture occupational and social impairment. Ask them to use CFR § 4.130 language when it applies—phrases like "difficulty establishing and maintaining effective relationships" or "reduced reliability and productivity."
- C&P debrief: document the examiner's questions, demeanor, and duration immediately after the appointment. If the examiner minimizes symptoms or misses key impairments, submit a post-exam statement with corrections and supporting evidence.
Update your record whenever symptoms escalate, medication changes, or you start new treatment—these create dated evidence of ongoing impairment.
Next Actions & Support
Stay Organized
- Keep a binder with diagnosis records, nexus letters, lay statements, and employment documentation—organized by claim element.
- Set reminders to check VA.gov messages and respond to duty-to-assist requests within 48 hours.
- Log all VA calls and appointments with date, time, and outcome in your claim tracker.
More Routes
- Use the Claim Prep Checklist to track deadlines and evidence uploads.
- Denied or underrated? File a Supplemental Claim with new therapy evidence or a stronger nexus letter.
- Symptoms worsening? Document the decline and request a rating increase.
- Can't work? If mental health conditions prevent substantial employment, explore TDIU eligibility.
Resources
Anxiety & Depression Claim FAQs
Do I need a stressor statement for anxiety or depression claims?
Can I claim depression secondary to chronic pain?
What's the difference between PTSD and anxiety/depression claims?
What if I have both anxiety AND depression?
How do I prove occupational impairment for a higher rating?
Stay in the Mental Health Intel Loop
Short briefings when VA updates mental health rating criteria, DBQ requirements, or secondary connection guidance—no fluff. Written by a submariner who has run this gauntlet.
- Evidence refresh alerts when CFR updates or forms change.
- Templates, rebuttal scripts, and checklists aligned to this playbook.
- Sent by a fellow vet—no spam, unsubscribe anytime.