What secondary conditions are linked to Major Depressive Disorder?

Common secondary conditions for Major Depressive Disorder include Sleep Apnea, GERD, Hypertension, Migraines, IBS. Secondary service connection is established under 38 C.F.R. 3.310 when a condition is caused or aggravated by an already service-connected disability.

What happens during a C&P exam for Major Depressive Disorder?

Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation. Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.

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Major Depressive Disorder

Q: What are the VA rating percentages for Major Depressive Disorder?

Major Depressive Disorder (DC 9434) is rated at 0%, 10%, 30%, 50%, 70%, 100% under 38 CFR § 4.130, DC 9434. 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.

Q: What rates 0% for Major Depressive Disorder under 38 CFR § 4.130, DC 9434?

Under 38 CFR § 4.130, DC 9434 (DC 9434), a 0% rating for Major Depressive Disorder requires: 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.

Q: What rates 10% for Major Depressive Disorder under 38 CFR § 4.130, DC 9434?

Under 38 CFR § 4.130, DC 9434 (DC 9434), a 10% rating for Major Depressive Disorder requires: 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.

Q: What rates 30% for Major Depressive Disorder under 38 CFR § 4.130, DC 9434?

Under 38 CFR § 4.130, DC 9434 (DC 9434), a 30% rating for Major Depressive Disorder requires: 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).

Q: What rates 50% for Major Depressive Disorder under 38 CFR § 4.130, DC 9434?

Under 38 CFR § 4.130, DC 9434 (DC 9434), a 50% rating for Major Depressive Disorder requires: 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.

Q: What rates 70% for Major Depressive Disorder under 38 CFR § 4.130, DC 9434?

Under 38 CFR § 4.130, DC 9434 (DC 9434), a 70% rating for Major Depressive Disorder requires: 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.

Q: What rates 100% for Major Depressive Disorder under 38 CFR § 4.130, DC 9434?

Under 38 CFR § 4.130, DC 9434 (DC 9434), a 100% rating for Major Depressive Disorder requires: 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.

Q: What evidence do I need for a Major Depressive Disorder VA claim?

Key evidence for a Major Depressive Disorder claim includes: Service treatment records showing injury or complaints; Imaging (X-ray, MRI, CT); Range of motion measurements; Flare-up documentation per Sharp v. Shulkin; Buddy statements describing limitations. All evidence should document both the condition and its impact on daily functioning.

DC 943438 C.F.R. § 4.130

Diagnostic Code

DC 9434

38 C.F.R. § 4.130

Rating Range

0–100%

6 severity tiers

Source

Verified

38 C.F.R. § 4.130

Major Depressive Disorder is rated by the U.S. Department of Veterans Affairs under DC 9434 of 38 CFR § 4.130, DC 9434 across 6 severity tiers (0% / 10% / 30% / 50% / 70%…). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303. This condition is frequently rated as secondary to Sleep Apnea or GERD under 38 C.F.R. § 3.310.

Educational tool only. Not legal or medical advice. Not affiliated with the VA.

Overview

Major Depressive Disorder is a mood disorder defined in the DSM-5 by at least one two-week period of either depressed mood or loss of interest or pleasure (anhedonia), plus a total of five or more associated symptoms such as significant appetite or weight change, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness or excessive guilt, diminished concentration, and recurrent thoughts of death or suicidal ideation. The disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning and not be attributable to a substance or another medical condition. Course is often recurrent, and severity ranges from mild single episodes to severe, recurrent episodes with psychotic features.

Rating Criteria

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.

10%

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.

30%

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).

50%

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.

70%

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.

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.

03Key Evidence

—Service treatment records showing injury or complaints

—Imaging (X-ray, MRI, CT)

—Range of motion measurements

—Flare-up documentation per Sharp v. Shulkin

—Buddy statements describing limitations

—Prescription history

—Physical therapy records

—Employment impact documentation

04C&P Exam Tips

1Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.

2Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.

3Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.

4Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).

5If you use assistive devices (brace, cane), bring them.

6Describe daily activity impact: work, sleep, household tasks.

05Secondary Conditions

Sleep ApneaMODERATE

Weight gain from medications/inactivity and altered sleep patterns affect breathing during sleep

GERDMODERATE

Chronic stress and antidepressant medications increase stomach acid production and reflux

HypertensionMODERATE

Chronic stress hormones and reduced physical activity elevate blood pressure long-term

MigrainesMODERATE

Shared serotonin pathway dysfunction and chronic stress trigger migraine headaches

IBSMODERATE

Gut-brain axis dysfunction from chronic depression affects bowel function

FibromyalgiaMODERATE

Shared pathways of central sensitization cause widespread musculoskeletal pain

ObesityMODERATE

Appetite dysregulation, medication side effects, and reduced physical activity

Diabetes Type IIMODERATE

Metabolic changes from depression, medications, and lifestyle factors affect insulin sensitivity

Erectile DysfunctionMODERATE

Depression and SSRI medications affect sexual function and blood flow

Coronary Artery DiseaseMODERATE

Depression increases inflammation and cardiovascular risk

TinnitusMODERATE

Chronic stress and certain antidepressants can cause or worsen ringing in ears

Chronic Fatigue SyndromeMODERATE

Neurotransmitter imbalances cause persistent fatigue beyond mental symptoms

TMJ DisorderMODERATE

Chronic jaw clenching and bruxism from stress damages temporomandibular joint

Inside the Rating Decision

How Raters Evaluate Depression

Secondary Connection

Depression is frequently granted secondary to chronic pain conditions under 38 C.F.R. 3.310. In actual rating decisions, raters grant secondary service connection when medical evidence links chronic pain to mental health symptoms. All mental health conditions receive a single combined rating.

30% to 70% Progression

Rating decisions show a common pattern: initial grant at 30% (symptoms not severe enough to interfere with occupational functioning), followed by increase to 70% when symptoms worsen to include difficulty adapting to work, memory impairment, and flattened affect. The key evidence that drives the increase is typically a new C&P exam documenting worsened symptoms.

What This Means

If your depression is secondary to a service-connected condition like chronic back pain, ensure your treating provider documents the connection. The single-rating rule means your PTSD, depression, and anxiety symptoms all combine into one rating under whichever DC the rater selects.

Tools

Rating Calculator →Secondaries Explorer →C&P Exam Prep →PACT Act Scanner →2026 Rates →

Sources & Editorial

Rating criteria text quoted verbatim from 38 C.F.R. § 4.130 (Mental disorders). Source verified 2026-05-15 by ClaimRecon Editorial Team against the Cornell Law CFR mirror; eCFR.gov is the authoritative government source.

View § 4.130 on eCFR →Cornell Law mirror →Editorial Standards →Suggest a correction →

EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026

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