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 with persistent severe neurological symptoms, gross impairment in communication or thought processes, persistent danger of hurting self or others, and inability to perform activities of daily living. |
| 70% | Deficiencies in most areas including work, family relations, judgment, thinking, or mood. Symptoms may include frequent debilitating episodes, suicidal ideation, near-continuous anxiety or depression, impaired impulse control, and difficulty adapting to stressful circumstances. |
| 50% | Reduced reliability and productivity due to unpredictable symptom episodes, difficulty concentrating, impaired judgment, disturbances of motivation and mood, and difficulty maintaining work and social relationships. |
| 30% | Occasional decrease in work efficiency with intermittent inability to perform tasks due to functional neurological symptoms, anxiety, depressed mood, or chronic sleep impairment. |
| 10% | Mild or transient symptoms that decrease work efficiency only during periods of significant stress, or symptoms controlled by medication or therapy. |
| 0% | A formal diagnosis exists but symptoms do not interfere with occupational or social functioning. |
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.