Disabled veterans with physical symptoms like chronic pain, weakness, and shortness of breath may be eligible for a VA Disability Rating for Somatic Symptom Disorder (SSD). SSD causes significant impairment in occupational, social, and personal functioning due to excessive thoughts and behaviors related to physical symptoms. It may be considered if tied to a service-connected disability rated at 0% or higher. SSD can also trigger mental health-related symptoms like depression, anxiety, and insomnia. Seek medical attention and contact the VA to explore disability rating options if you exhibit disproportionate thoughts or persistent anxiety regarding physical symptoms.
WHAT IS SOMATIC SYMPTOM DISORDER?
Somatic symptom disorder is characterized by a hyper-focus on physical and health-related symptoms such as pain or fatigue that leads to significant emotional distress and impairment in functioning.
SYMPTOMS AND SIGNS OF THIS DISORDER MAY INCLUDE:
- Constant worry about potential illness
- Viewing normal physical sensations as an indication of severe physical illness
- Fear that symptoms are serious, even when there is no evidence
- Belief that physical sensations are threatening or harmful
- Feeling that medical treatment and evaluation have not been adequate
- Fear that physical activity may cause harm to the body
- Repeatedly checking the body for abnormalities
- Frequent healthcare visits that worsen or do not alleviate concerns
- Being unresponsive to medical treatment or unusually sensitive to medication side effects
- More severe impairment than expected from a medical condition.
DSM-5 Diagnosis
As per the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), at least one of the following symptoms must be present to indicate excessive thoughts, feelings, or behaviors associated with somatic symptoms or health concerns:
✓ Disproportionate and persistent thoughts about the seriousness of one’s symptoms;
✓ Persistently high level of anxiety about health or symptoms; or
✓ Excessive time and energy devoted to these symptoms or health concerns,
Importantly, somatic symptom disorder is typically specified based on the category that best describes the presentation of the condition (below):
- With predominant pain: This specifier is for individuals whose somatic symptoms predominantly involve pain
- Persistent: A persistent case is characterized by severe symptoms, marked impairment, and long duration (i.e., more than six months)
Finally, somatic symptom disorder is also characterized by its level of severity:
① Mild: only one of the symptoms specified above (“DSM-5 Diagnosis” section) is fulfilled
② Moderate: two or more of the symptoms specified above are fulfilled
③ Severe: two or more of the symptoms specified above are fulfilled, plus there are multiple somatic complaints (or one very severe somatic symptom)
How to Get Service Connection for Somatic Symptom Disorder
To get service connection for Somatic Symptom Disorder (SSD), a veteran must submit a claim to the Department of Veterans Affairs (VA) and provide medical evidence to establish that their SSD is related to their military service. The veteran should also be able to demonstrate that they experienced symptoms of SSD during their service or within a year of discharge. It’s essential to work with a mental health professional to obtain a proper diagnosis and evidence for your claim. The VA will review the evidence provided, and if the claim is approved, the veteran may be eligible for disability benefits
TYPES OF ANXIETY THAT ARE RECOGNIZED BY THE SOMATIC SYMPTOM DISORDER: VA DISABILITY RATING VA:
The VA Disability Rating for Somatic Symptom Disorder is determined by using the guidelines set forth in the DSM-5. To apply the appropriate rating, the rating agency must be familiar with the guidelines provided in §4.125 through §4.129 and apply the general rating formula for mental disorders in §4.130.
Somatic Symptom Disorder is classified under code 9421 for VA rating purposes, and the level of occupational and social impairment determines the final VA rating. The following ratings are assigned based on the severity of the symptoms:
70% VA DISABILITY RATING:
When the symptoms cause occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, and include symptoms such as suicidal ideation, obsessional rituals, near-continuous panic or depression, impaired impulse control, and difficulty in adapting to stressful circumstances.
50% VA DISABILITY RATING:
When the symptoms cause occupational and social impairment with reduced reliability and productivity, including symptoms such as flattened affect, circumstantial, circumlocutory, or stereotyped speech, panic attacks, and difficulty in understanding complex commands, among others.
30% VA DISABILITY RATING:
When the symptoms cause occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, including symptoms such as depressed mood, anxiety, suspiciousness, and chronic sleep impairment.
10% VA DISABILITY RATING:
When the symptoms cause occupational and social impairment due to mild or transient symptoms that decrease work efficiency and ability to perform occupational tasks only during periods of significant stress or symptoms controlled by continuous medication.
0% VA DISABILITY RATING:
When a mental condition has been formally diagnosed, but symptoms are not severe enough to interfere with occupational and social functioning or to require continuous medication.
It’s important to note that while PTSD is often associated with anxiety, it has its own diagnostic code and rating criteria. Additionally, even if you experience both anxiety and PTSD, you will only receive one rating for mental health conditions. If you are experiencing any of these symptoms, it’s important to seek help and speak with a mental health professional to get a proper diagnosis.
