The proposed mental health rating changes, and the SMC-S check you can do today
· Claim Situation
The situation
A Veteran rated for PTSD hears that VA is "changing mental health ratings" and wonders whether to wait. Two separate things are getting mixed together: a rating schedule change that VA has proposed but not finalized, and a payment level (SMC-S) that already exists under current law.
How mental health is rated now
Under the current General Rating Formula (38 CFR 4.130), PTSD, depression, anxiety and other mental disorders are rated on one scale of occupational and social impairment: 0, 10, 30, 50, 70 or 100%. The 100% level requires total occupational and social impairment, which is why many Veterans sit at 70% for years.
All mental health diagnoses are rated together as one disability, not separately.
What VA has proposed
VA proposed a new mental health rating framework in 2022 that would look at several areas of functioning (such as thinking, relationships, completing tasks, getting around, and self-care) instead of one overall scale, would provide more than one route to 100%, and would set a 10% minimum for a service-connected mental disorder. As of this writing it is still a proposal, not the rule VA uses to decide claims. The final version could differ.
Will a new schedule lower my rating?
VA's rules say a readjustment of the rating schedule is not, by itself, grounds to reduce an existing rating; see 38 CFR 3.951. Reductions require evidence of actual improvement and their own procedures.
SMC-S: check this under the current rules
Special monthly compensation at the "S" rate, under 38 CFR 3.350(i), is paid above the 100% rate when a Veteran has:
- one service-connected disability rated 100%, plus additional, separate service-connected disabilities that independently combine to 60% or more; or
- one disability rated 100% and is permanently housebound (substantially confined to home) because of service-connected disabilities.
"100% combined" is not the same thing. Several conditions that combine to 100% do not meet the first route unless one condition alone is rated 100%. And because mental health diagnoses are rated as one, a second mental health diagnosis can't supply the separate 60%. That has to come from other conditions, such as back, knees, migraines or sleep apnea. VA has also recognized that a TDIU award based on a single disability can count toward SMC-S in some cases; ask your representative.
Current amounts are on the VA SMC rates page.
What to do now
- Read your rating decision code sheet. Is any single condition at 100%? What do your other conditions combine to on their own? Use VA's combined ratings table (38 CFR 4.25).
- If you appear to meet SMC-S and it isn't on your award, ask a VSO or accredited representative to raise it with VA.
- If your mental health has worsened, don't wait for a final rule. A claim filed now is decided under the rules in effect now.
- Tell your providers how symptoms affect work, relationships and daily tasks, with specifics, so it is in your records.
- Ask a spouse, friend or coworker for a short statement describing what they actually see.
- Describe your condition accurately: neither your worst day as every day, nor hiding the bad days.
If you are in crisis, call the Veterans Crisis Line: dial 988, then press 1.
Get free help
You never have to pay to file an initial VA claim. Free help: a VSO such as DAV, VFW or the American Legion, or a VA-accredited representative.
Educational only, not legal or medical advice. We are not VA-accredited. No one can promise an outcome; VA decides each claim on its own evidence. Rules and rates change; check the linked VA and eCFR sources.