Organic Mental Disorder, Other — VA Disability Rating (DC 9327 Retired)
Diagnostic Code 9327 · 38 CFR §4.130
What Is It?
DC 9327 is the broad catch-all code for mental disorders attributable to an identifiable medical condition or organic cause when no more specific code fits. It captures presentations where psychiatric symptoms (mood changes, personality changes, anxiety, psychotic features, cognitive impairment) develop as a direct consequence of a documented medical or neurological condition rather than from a primary psychiatric diagnosis. Examples include personality and behavioral changes after frontal lobe injury, mood symptoms from endocrine disorders (Cushing, hypothyroidism, hyperthyroidism), post-encephalitic mood and behavioral changes, and chronic medical illness producing depression and anxiety with documented organic contribution. For veterans, the typical pathway is service-connected medical condition producing secondary psychiatric symptoms; the underlying medical condition is the primary claim and DC 9327 captures the psychiatric residual. The rating flows through the General Rating Formula for Mental Disorders under 38 CFR §4.130, the same framework used for PTSD, depression, and the schizophrenia subtypes. One thing to know before filing: DC 9327 no longer appears as a live code. Current §4.130 prints the entry as '9327 [Removed]', alongside the four schizophrenia subtype codes 9202 through 9205, which were removed the same way. A new claim is diagnosed and coded under whichever current code fits — for example, DC 9326 for neurocognitive disorder due to another medical condition, or DC 9301 where the cause is HIV or another infection — while an evaluation already running under DC 9327 keeps it, because 38 CFR §3.951(a) provides that a readjustment to the rating schedule is not by itself grounds for reduction unless medical evidence establishes actual improvement. The criteria below are the General Rating Formula for Mental Disorders as § 4.130 prints it today.
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 psychiatric or neurology diagnosis specifying the organic mental disorder and identifying the underlying medical condition is the anchor. Medical records documenting the underlying condition (TBI, encephalitis, endocrine disorder, HIV, autoimmune disease, etc.) establish the organic basis. Neuropsychological testing characterizes the cognitive component. Treatment records covering psychotropic medications and any specialist follow-up demonstrate the management burden. Service treatment records or post-service records establishing the underlying medical condition as service-connected or related to service support the nexus.
C&P Exam Tips
Bring the psychiatric diagnosis, the underlying medical condition records, neuropsychological testing if performed, and the treatment history. The exam follows the General Rating Formula like other mental-health conditions, so the examiner should ask about specific symptom clusters at each tier. Describe how the underlying medical condition produces the psychiatric symptoms (the mechanism) and how the symptoms have changed over time as the underlying condition has progressed or responded to treatment. Mention any cognitive symptoms — memory, executive function, processing speed — explicitly because they often distinguish DC 9327 from primary psychiatric conditions.
How to File
File VA Form 21-526EZ listing the mental disorder alongside the underlying medical condition under its appropriate code. A new claim is coded under a current § 4.130 code; DC 9327 itself applies only to an evaluation already assigned under it. Attach the psychiatric diagnosis, medical records establishing the underlying organic cause, neuropsychological testing if performed, and the treatment history. When the cognitive component is dominant, a neurocognitive diagnosis such as DC 9326 (another medical condition) may fit the picture better.
Common Mistakes
- Claiming the psychiatric residual without claiming the underlying medical condition separately, when the underlying condition has its own rating ceiling that could substantially exceed the mental health rating.
- Missing the cognitive evaluation when neuropsychological testing would support a different mental health code or the TBI residuals code.
- Treating organic mental disorder as a primary psychiatric diagnosis instead of as a secondary manifestation of the underlying medical condition.
- Letting the rating sit at 30% when the documented functional impairment supports the 50% or 70% level.
Frequently Asked Questions
How is DC 9327 different from PTSD or depression?
PTSD (DC 9411) and major depression (DC 9434) are primary psychiatric diagnoses with their own etiologies — trauma exposure for PTSD, mood disorder for depression. DC 9327 captures psychiatric symptoms caused by an underlying medical condition rather than by primary psychiatric pathology. The clinical picture may look similar, but the rating frameworks are the same (General Rating Formula for Mental Disorders) and the service-connection theory differs: PTSD requires a service-connected stressor, depression requires direct or aggravation pathway, and DC 9327 typically runs through secondary service connection to the underlying medical condition.
Can I rate both DC 9327 and the underlying medical condition?
Yes — they are separate diagnoses with separate impacts. The underlying medical condition (TBI, endocrine disorder, autoimmune disease) is rated under its own code for its physical manifestations. DC 9327 captures the psychiatric residuals. The combined rating reflects both impacts. The exception is a TBI rated under DC 8045: where its manifestations and the mental disorder's cannot be clearly separated, Note (1) to DC 8045 has the rater assign a single evaluation under whichever set of criteria allows the better assessment of overall impaired functioning.
Does the rating drop if the underlying condition improves?
It can, but three separate protections sit in the way and they are routinely confused with each other. 38 CFR §3.344(a) and (b) restrict reduction of a rating that has continued at the same level for a long period, which §3.344(c) defines as five years or more, and they expressly do not apply to disabilities that have not stabilized and are likely to improve. 38 CFR §3.951(b) bars reduction below an evaluation that has been continuously in effect for twenty years or more except on a showing that the rating was based on fraud. And §3.951(a) provides that a readjustment to the rating schedule itself — such as the removal of DC 9327 — is not grounds for reduction unless medical evidence establishes that the disability has actually improved. Separately, 38 CFR §3.105(e) requires notice and an opportunity to respond before any reduction takes effect.