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 due to another medical condition, and substance/medication-induced major or mild neurocognitive disorder. Neurocognitive disorders with certain causes have their own codes in 38 CFR 4.130 (DC 9301 for HIV or other infections, DC 9304 for traumatic brain injury, DC 9305 for vascular disease, and DC 9312 for Alzheimer's disease), so DC 9326 is generally used for other medical causes and for decline caused by a substance or medication. Examples can include neurocognitive decline from Parkinson disease, Huntington disease, multiple sclerosis, or metabolic conditions, and decline brought on by a medication or a toxic substance. For veterans, service connection can come through a service-connected medical condition that went on to affect the brain, or through exposure to a toxic substance during service. 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, 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 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, and DC 9301 covers neurocognitive disorder due to HIV or other infections. Vascular neurocognitive disorder (DC 9305) and neurocognitive disorder due to Alzheimer's disease (DC 9312) have their own codes too. DC 9326 covers other medical causes, such as Parkinson disease or a metabolic condition, and neurocognitive disorder induced by a substance or medication; decline from a toxic exposure is generally coded here too. The rating criteria are the same for all.
Can I file this based on a toxic exposure during service?
Yes. If a toxic exposure during service caused or contributed to neurocognitive decline, DC 9326 generally applies, since it covers both neurocognitive disorder due to another medical condition and substance/medication-induced neurocognitive disorder. You need medical evidence linking the cognitive impairment to the specific exposure and documentation of the exposure itself.