Other Specified Somatic Symptom and Related Disorder — VA Rating (DC 9422)
Diagnostic Code 9422 · 38 CFR §4.130
What Is It?
Other specified somatic symptom and related disorder is diagnosed when a veteran has symptoms characteristic of somatic symptom disorder or a related condition — significant distress or functional impairment related to physical symptoms — but does not fully meet criteria for a more specific diagnosis in that category. The clinician specifies why the full criteria are not met. For veterans, this may involve persistent health-related anxiety, excessive response to physical symptoms, or medically unexplained symptoms that developed during or after service. The condition recognizes that physical and psychological health are deeply interconnected. 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 diagnosis from a mental health professional is required. Treatment records from both physical and mental health providers showing a pattern of somatic complaints and psychological distress are important. Medical records demonstrating repeated evaluations for physical symptoms without proportionate medical findings help establish the pattern. Buddy statements from family describing the impact of health preoccupation on daily life are valuable.
C&P Exam Tips
Describe both the physical symptoms you experience and the psychological response to them — worry, preoccupation, repeated checking, avoidance of activities. Explain how this pattern affects daily functioning, work, and relationships. If you spend significant time seeking medical care, researching symptoms, or avoiding activity due to health concerns, describe those behaviors with specifics.
How to File
File on VA Form 21-526EZ with DC 9422. Submit both physical and mental health treatment records. If related to a service-connected condition or deployment exposure, describe that connection. A nexus letter from a mental health provider is recommended.
Common Mistakes
Not understanding that this is a mental health condition rated under the psychiatric formula — veterans sometimes file only for the physical symptoms. Another mistake is not documenting the psychological component with a mental health provider.
Frequently Asked Questions
How is this different from somatic symptom disorder (DC 9421)?
DC 9421 covers somatic symptom disorder when full diagnostic criteria are met. DC 9422 is used when symptoms are clinically significant but do not meet all criteria for a specific somatic diagnosis, and the clinician specifies why. Both are rated under the same formula.
Are my physical symptoms real?
Yes. The physical symptoms are genuine. The diagnosis recognizes that the psychological distress and behavioral response to those symptoms is itself clinically significant and warrants evaluation.