Neurocognitive Disorder Due to HIV or Other Infections — VA Disability Rating Criteria (DC 9301)
Diagnostic Code 9301 · 38 CFR §4.130
What Is It?
DC 9301 covers major or mild neurocognitive disorder caused by HIV disease or other infections. This includes cognitive decline resulting from HIV-associated neurocognitive disorder (HAND), neurosyphilis, Lyme neuroborreliosis, viral encephalitis, and other infectious processes affecting the central nervous system. For veterans, the usual route to service connection is an infection that began in service or a service-connected infection that went on to affect the brain. Neurocognitive disorders with other causes have their own codes in 38 CFR 4.130: DC 9304 for traumatic brain injury, DC 9305 for vascular neurocognitive disorder, DC 9312 for Alzheimer's disease, and DC 9326 for another medical condition or a substance or medication. The condition involves decline in cognitive functions such as memory, attention, executive function, language, or perceptual-motor ability. The VA rates it under the General Rating Formula for Mental Disorders.
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 neuropsychological evaluation documenting cognitive decline compared to prior functioning is the strongest evidence. A diagnosis identifying the underlying infection is important, because DC 9301 is the code for neurocognitive disorder due to HIV or other infections. Medical records linking the infection to military service, such as service treatment records showing the infection or treatment records for a service-connected infection, establish nexus. Brain imaging showing relevant changes can support the claim. Buddy statements from family describing cognitive decline in daily functioning are valuable.
C&P Exam Tips
Describe specific cognitive problems: memory difficulties, trouble finding words, difficulty planning or organizing tasks, getting lost in familiar places, trouble with previously routine tasks. Provide concrete examples of how these problems affect daily life. If you were previously able to manage finances, drive without getting lost, or follow conversations easily and can no longer do so, explain that. Describe the timeline of cognitive decline and its relationship to the underlying infection. If neuropsychological testing has been done, reference those findings.
How to File
File on VA Form 21-526EZ with DC 9301. Submit neuropsychological testing results, neurological evaluations, and records documenting the underlying infection. If the infection is already service-connected, say so on the claim. A nexus letter connecting the cognitive decline to the infection is often the key piece of evidence.
Common Mistakes
Not obtaining neuropsychological testing is a significant missed opportunity — these objective tests provide strong evidence of cognitive decline. Another mistake is attributing cognitive problems to normal aging without exploring service-connected causes. Not establishing the connection between the underlying infection and service weakens the claim. Filing under DC 9301 when the cause is not an infection is another error; vascular, traumatic, Alzheimer's, and other medical causes each have their own code. Failing to document the progression of cognitive decline over time makes it harder to demonstrate the severity.
Frequently Asked Questions
How is DC 9301 different from DC 9304?
DC 9304 is specifically for neurocognitive disorder caused by traumatic brain injury. DC 9301 is for neurocognitive disorder due to HIV or other infections. Vascular neurocognitive disorder has its own code (DC 9305), as do Alzheimer's disease (DC 9312) and another medical condition or a substance or medication (DC 9326). All of them are rated under the same General Rating Formula for Mental Disorders.
Can I file this secondary to a service-connected infection?
Yes. If a service-connected infection caused the neurocognitive disorder, it can be claimed under DC 9301 on a secondary basis. If the infection began in service but is not yet service-connected, claim the infection and the neurocognitive disorder together. You will need a diagnosis that names the infection as the cause and medical evidence linking the two. If the cognitive decline has a cause other than an infection, a different code in 38 CFR 4.130 applies.