Diagnostic Code 9300 · 38 CFR §4.130
Delirium is an acute disturbance in attention, awareness, and cognition that develops over a short period and fluctuates in severity. It is caused by an underlying medical condition, substance intoxication or withdrawal, medication effects, or multiple combined factors. For veterans, delirium may occur as a result of traumatic brain injury, toxic exposures, combat injuries requiring surgery, or medication reactions during service. While delirium itself is typically temporary, it can cause lasting cognitive impairment — particularly in cases of prolonged or repeated episodes. When residual cognitive or psychological symptoms persist, they may be rated under DC 9300 using the General Rating Formula for Mental Disorders.
| Rating | Criteria |
|---|---|
| 0% | History of delirium but no residual symptoms affecting functioning. |
| 10% | Mild residual cognitive symptoms that decrease work efficiency only during significant stress. |
| 30% | Occasional decrease in work efficiency due to residual cognitive impairment, mild memory loss, difficulty concentrating, or anxiety about recurrence. |
| 50% | Reduced reliability due to persistent cognitive deficits, difficulty understanding complex commands, impaired judgment, and difficulty maintaining relationships. |
| 70% | Deficiencies in most areas due to significant residual cognitive impairment. May include disorientation, near-continuous confusion or anxiety, and inability to function independently. |
| 100% | Total occupational and social impairment with severe residual cognitive deficits, disorientation, inability to perform daily activities, and need for constant supervision. |
Medical records documenting the delirium episode during service or caused by a service-connected condition are essential. These may include hospital records showing altered mental status, ICU records, or surgical records noting post-operative delirium. Follow-up neuropsychological testing showing residual cognitive impairment strengthens the claim. A nexus opinion connecting the delirium to service or a service-connected condition is required. Buddy statements from family describing cognitive or behavioral changes after the episode add context.
Yes, if the episode left residual cognitive or psychological impairment. The rating is based on your current symptoms, not the acute episode itself. You need documentation of the original episode and evidence of persistent effects.
Delirium is an acute confused state caused by a medical condition, while TBI is caused by physical trauma to the head. They can overlap — a TBI can cause delirium. If both apply, work with your VSO to determine the best rating approach to avoid pyramiding.