Neurocognitive Disorder Due to Another Medical Condition — VA Rating (DC 9326)
Diagnostic Code 9326 · 38 CFR §4.130
What Is It?
DC 9326 covers major or mild neurocognitive disorder caused by a medical condition other than traumatic brain injury, HIV/infections, vascular disease, or Alzheimer disease (which each have their own DCs). Examples include neurocognitive decline from Parkinson disease, Huntington disease, prion disease, toxic substance exposure, metabolic conditions, or multiple sclerosis. For veterans, toxic exposures during service — burn pits, Agent Orange, industrial solvents, depleted uranium — are among the most common service-connected causes. The VA rates this condition under the General Rating Formula for Mental Disorders at 38 CFR 4.130.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Total occupational and social impairment with severe cognitive decline, disorientation to time or place, inability to perform daily activities, memory loss for personal information, and need for constant supervision. |
| 70% | Deficiencies in most areas due to significant cognitive decline. May include disorientation, inability to manage finances or medications independently, near-continuous anxiety or depression, and neglect of self-care. |
| 50% | Reduced reliability and productivity due to moderate cognitive decline affecting complex task completion, judgment, and ability to maintain effective relationships. |
| 30% | Occasional decrease in work efficiency due to mild memory loss, difficulty concentrating, depressed mood about cognitive decline, or sleep problems. |
| 10% | Mild cognitive decline that decreases work efficiency only during periods of significant stress, or symptoms managed by compensatory strategies. |
| 0% | A diagnosis exists but cognitive symptoms do not impair occupational or social functioning. |
Evidence Needed
A neuropsychological evaluation documenting cognitive decline compared to prior functioning is the strongest evidence. A diagnosis identifying the underlying medical cause is important — for example, toxic exposure records paired with neurological findings. Medical records linking the physiological cause to military service establish nexus. Brain imaging showing relevant changes can support the claim. Buddy statements from family describing cognitive decline in daily functioning are valuable. Employment records showing declining work performance add corroboration.
C&P Exam Tips
Describe specific cognitive problems: memory difficulties, trouble finding words, difficulty planning tasks, getting confused in familiar places, struggling with previously routine activities. Give concrete examples of how these problems affect daily life. If you were previously able to manage finances, follow conversations, or complete work tasks and now struggle, explain that timeline. Describe the relationship between the underlying medical condition and the cognitive decline. If neuropsychological testing has been completed, reference those findings.
How to File
File on VA Form 21-526EZ with DC 9326. Submit neuropsychological testing results, neurological evaluations, and records documenting the underlying medical cause. If the cause is a service-connected condition, include that claim number. If related to toxic exposure, submit deployment records, unit histories, and any toxic exposure registry enrollment. A nexus letter connecting cognitive decline to the service-connected condition is essential.
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 specific connection between the underlying medical condition and service weakens the claim. If the underlying condition has its own DC (like TBI under 9304), filing under the wrong code can create confusion.
Frequently Asked Questions
How is DC 9326 different from DC 9304 or DC 9301?
DC 9304 is specifically for neurocognitive disorder due to TBI. DC 9301 covers neurocognitive disorder from HIV or other infections. DC 9326 covers all other medical causes — toxic exposures, Parkinson disease, metabolic conditions, and similar. The rating criteria are the same for all.
Can I file this secondary to toxic exposure?
Yes. If toxic exposure during service caused or contributed to neurocognitive decline, DC 9326 applies. You need medical evidence linking the cognitive impairment to the specific exposure and documentation of the exposure itself.