Depersonalization/Derealization Disorder — VA Rating (DC 9417)
Diagnostic Code 9417 · 38 CFR §4.130
What Is It?
Depersonalization/derealization disorder involves persistent or recurrent experiences of feeling detached from your own mind, body, or actions (depersonalization), or feeling that your surroundings are unreal, dreamlike, or distorted (derealization). Unlike psychotic conditions, the person maintains awareness that these experiences are not actually reality — they know something feels wrong, which itself causes significant distress. Veterans may develop this condition after combat trauma, military sexual trauma, blast exposure, or prolonged extreme stress during service. The episodes can be profoundly disorienting and interfere with the ability to engage with daily life, work, and relationships. The VA rates it under the General Rating Formula for Mental Disorders.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Total occupational and social impairment where persistent depersonalization or derealization makes you unable to function in any work or social capacity. The condition has completely severed your ability to engage with reality in a meaningful way. |
| 70% | Near-continuous feelings of detachment dominate daily life, causing deficiencies in work, relationships, judgment, and emotional engagement. The inability to feel present makes steady employment and meaningful connections extremely difficult. |
| 50% | Episodes are frequent enough to reduce reliability and productivity. Feeling detached from reality interferes with complex tasks, concentration, and maintaining effective work and personal relationships. |
| 30% | Periodic episodes cause occasional drops in work performance, difficulty concentrating, anxiety about when the next episode will occur, and mild disruption of daily routines. |
| 10% | Mild or transient episodes that decrease work efficiency only during stressful periods, or symptoms managed by medication. |
| 0% | A diagnosis exists but episodes are rare and do not impair occupational or social functioning. |
Evidence Needed
A diagnosis from a psychiatrist or psychologist documenting the depersonalization and/or derealization episodes is required. Treatment records showing ongoing therapy and any medication management are important. Because these symptoms can be difficult to describe and measure objectively, detailed clinical notes from providers who understand the condition are valuable. Buddy statements from family describing episodes where you appeared detached, confused, or unresponsive to surroundings help corroborate the condition. A nexus opinion linking the condition to service trauma or stress is needed.
C&P Exam Tips
Describe your episodes in concrete terms: what does it feel like when you are depersonalized — do you feel like you are watching yourself from outside, that your hands are not your own, that you are in a dream? For derealization, describe how surroundings feel unreal — objects look distorted, sounds seem muffled, environments feel like a movie set. Explain how often episodes occur, how long they last, and what triggers them. Describe the functional impact: difficulty driving because the road feels unreal, trouble at work because you feel disconnected, strained relationships because you cannot feel emotionally present.
How to File
File on VA Form 21-526EZ with DC 9417. Submit psychiatric treatment records, therapy notes, and medication records. If the condition developed after military trauma, describe the connection clearly. If filing as secondary to PTSD or TBI, include the primary claim number and a medical opinion linking the conditions. Buddy statements describing observed episodes of detachment are particularly helpful.
Common Mistakes
Many veterans struggle to describe depersonalization and derealization experiences and end up not reporting them at all, or describing them so vaguely that the examiner does not grasp the severity. Practice describing your experiences in specific, concrete language before the exam. Another mistake is not connecting the condition to a triggering trauma or service event. Veterans sometimes have this condition misdiagnosed as anxiety or depression without the dissociative component being recognized.
Frequently Asked Questions
Is depersonalization/derealization the same as psychosis?
No. In depersonalization/derealization, you maintain awareness that your experiences are distorted — you know something feels wrong. In psychosis, the person may believe the distorted perceptions are real. This distinction matters clinically but does not change the rating criteria, which focus on functional impairment.
Can this condition be secondary to PTSD?
Yes. Depersonalization and derealization commonly develop alongside PTSD as dissociative responses to trauma. If you are already service-connected for PTSD, you can file a secondary claim with a nexus opinion linking the conditions.