Conversion Disorder (Functional Neurological Symptom Disorder) — VA Rating (DC 9424)
Diagnostic Code 9424 · 38 CFR §4.130
What Is It?
Conversion disorder, now formally called functional neurological symptom disorder, involves neurological symptoms that cannot be explained by a medical or neurological condition. Symptoms may include weakness or paralysis, abnormal movement, seizure-like episodes (non-epileptic seizures), difficulty swallowing, speech problems, sensory loss, or vision changes. These symptoms are real and not intentionally produced — they represent a physical expression of psychological distress. For veterans, conversion disorder can develop after combat trauma, military sexual trauma, or other intense stressors. The VA rates it under the General Rating Formula for Mental Disorders, though neurological symptoms may also warrant evaluation under other criteria.
Rating Criteria
| Rating | Criteria |
|---|---|
| 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. |
| 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. |
| 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. |
| 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). |
| 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. |
| 0% | 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. |
Evidence Needed
A diagnosis from a neurologist who has ruled out structural causes for the symptoms is an important starting point. A psychiatric evaluation establishing the conversion disorder diagnosis is required. Neurological testing (EMG, EEG, MRI) showing no structural explanation supports the diagnosis. Treatment records documenting symptom patterns and functional impact are essential. Buddy statements describing the frequency and severity of symptoms in daily life add important context.
C&P Exam Tips
Symptoms may not be present during the exam. Keep a symptom log documenting episodes — what happened, duration, triggers, and functional impact. If you have non-epileptic seizures, bring witness statements or video if available. Describe the full range of neurological symptoms and how they limit daily activities, work, and relationships. Explain the connection between stressful situations and symptom flare-ups. Be prepared for both a neurological evaluation and a mental health evaluation.
How to File
File on VA Form 21-526EZ with DC 9424. Submit both neurological records (showing symptoms are not explained by structural disease) and mental health records (establishing the psychological component). If neurological symptoms like non-epileptic seizures cause additional impairment, discuss with your VSO whether separate neurological evaluation may be warranted. A nexus letter addressing both aspects is recommended.
Common Mistakes
A major mistake is having the condition dismissed as faking. Conversion disorder involves real symptoms — they are not fabricated. Having thorough neurological workups that rule out organic causes while confirming real functional impairment is essential. Another mistake is only pursuing a neurological claim without addressing the mental health component, or vice versa. Not documenting episodes when they occur makes it harder to demonstrate frequency and severity.
Frequently Asked Questions
Are conversion disorder symptoms real?
Yes. The symptoms are real and cause genuine impairment. They are not intentionally produced. The condition involves the nervous system expressing psychological distress as physical symptoms. Modern neuroscience has identified functional brain changes in people with this condition.
Can I be rated for both the neurological symptoms and the mental health aspect?
Potentially. The mental health component is rated under DC 9424. If functional neurological symptoms cause additional impairment beyond what the mental health rating captures, separate evaluation under neurological criteria may be appropriate. The VA cannot rate the same symptoms twice.