Diagnostic Code 9417 · 38 CFR §4.130
Depersonalization/derealization disorder involves persistent or recurrent experiences of feeling detached from your own mind, body, or actions (depersonalization), or feeling that your surroundings are unreal, dreamlike, or distorted (derealization). Unlike psychotic conditions, the person maintains awareness that these experiences are not actually reality — they know something feels wrong, which itself causes significant distress. Veterans may develop this condition after combat trauma, military sexual trauma, blast exposure, or prolonged extreme stress during service. The episodes can be profoundly disorienting and interfere with the ability to engage with daily life, work, and relationships. The VA rates it under the General Rating Formula for Mental Disorders.
| Rating | Criteria |
|---|---|
| 0% | A diagnosis exists but episodes are rare and do not impair occupational or social functioning. |
| 10% | Mild or transient episodes that decrease work efficiency only during stressful periods, or symptoms managed by medication. |
| 30% | Periodic episodes cause occasional drops in work performance, difficulty concentrating, anxiety about when the next episode will occur, and mild disruption of daily routines. |
| 50% | Episodes are frequent enough to reduce reliability and productivity. Feeling detached from reality interferes with complex tasks, concentration, and maintaining effective work and personal relationships. |
| 70% | Near-continuous feelings of detachment dominate daily life, causing deficiencies in work, relationships, judgment, and emotional engagement. The inability to feel present makes steady employment and meaningful connections extremely difficult. |
| 100% | Total occupational and social impairment where persistent depersonalization or derealization makes you unable to function in any work or social capacity. The condition has completely severed your ability to engage with reality in a meaningful way. |
A diagnosis from a psychiatrist or psychologist documenting the depersonalization and/or derealization episodes is required. Treatment records showing ongoing therapy and any medication management are important. Because these symptoms can be difficult to describe and measure objectively, detailed clinical notes from providers who understand the condition are valuable. Buddy statements from family describing episodes where you appeared detached, confused, or unresponsive to surroundings help corroborate the condition. A nexus opinion linking the condition to service trauma or stress is needed.
No. In depersonalization/derealization, you maintain awareness that your experiences are distorted — you know something feels wrong. In psychosis, the person may believe the distorted perceptions are real. This distinction matters clinically but does not change the rating criteria, which focus on functional impairment.
Yes. Depersonalization and derealization commonly develop alongside PTSD as dissociative responses to trauma. If you are already service-connected for PTSD, you can file a secondary claim with a nexus opinion linking the conditions.