Dissociative Amnesia / Dissociative Identity Disorder — VA Rating (DC 9416)
Diagnostic Code 9416 · 38 CFR §4.130
What Is It?
DC 9416 covers dissociative amnesia and dissociative identity disorder (formerly known as multiple personality disorder). These conditions involve disruptions in consciousness, memory, identity, or perception. Veterans may develop dissociative disorders as a response to severe trauma experienced during military service, particularly combat trauma or military sexual trauma. Dissociative amnesia involves inability to recall important personal information, usually related to a traumatic event. Dissociative identity disorder involves two or more distinct personality states that alternately influence behavior, accompanied by gaps in memory. The VA rates these under the General Rating Formula for Mental Disorders at 38 CFR 4.130.
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 formal diagnosis from a psychiatrist or psychologist specializing in dissociative conditions is critical. Treatment records documenting dissociative episodes — amnesia events, identity switches, or depersonalization — are essential. Neuropsychological testing can help establish the diagnosis and rule out other causes. Buddy statements from family or friends who have witnessed dissociative episodes are particularly valuable because the veteran may not remember them. Records showing the in-service trauma that triggered the condition help establish nexus.
C&P Exam Tips
Dissociative disorders can be difficult to demonstrate in a single exam appointment because episodes may not occur on demand. Before the exam, keep a log of dissociative episodes including what happened, how long they lasted, and what others reported. Bring a family member or friend who has witnessed episodes if possible. Be honest about memory gaps and any periods of lost time. If you experience depersonalization or derealization, describe what those experiences feel like concretely. Explain how the condition affects your ability to work, drive, maintain relationships, and handle daily responsibilities.
How to File
File on VA Form 21-526EZ listing DC 9416. If filing as secondary to PTSD, include the primary claim number and a medical opinion connecting the conditions. Submit all psychiatric treatment records, neuropsychological evaluations, and therapy notes. Buddy statements from people who have witnessed dissociative episodes are especially important since you may not remember the episodes yourself. A detailed nexus letter from a treating provider is strongly recommended.
Common Mistakes
The biggest mistake is not having adequate documentation of episodes, since the veteran often has no memory of them. Without buddy statements or therapist observations, the claim may appear unsupported. Another common issue is having the condition misdiagnosed as PTSD alone without recognizing the dissociative component. Veterans sometimes do not report all symptoms because they are embarrassed by memory gaps or identity disruptions.
Frequently Asked Questions
Can I be rated for both dissociative disorder and PTSD?
VA generally evaluates co-occurring mental disorders such as these together under a single evaluation. That is VA practice rather than a rule the schedule prints: 38 CFR 4.130 puts DC 9201 through DC 9440 on one General Rating Formula, and 38 CFR 4.14 says the evaluation of the same manifestation under different diagnoses is to be avoided. Having both diagnoses can support a higher overall rating because the combined symptoms typically demonstrate greater functional impairment.
What if I do not remember my dissociative episodes?
This is common and expected with dissociative disorders. Buddy statements from witnesses, therapist session notes, and emergency room visit records serve as evidence. Keeping a journal between episodes can help document patterns.
Is dissociative identity disorder rated differently from dissociative amnesia?
Both fall under DC 9416 and use the same rating criteria. The severity of functional impairment determines the rating, not which specific dissociative condition you have.