Diagnostic Code 9327 · 38 CFR §4.130
DC 9327 is the broad catch-all code for mental disorders attributable to an identifiable medical condition or organic cause — what the DSM-5 calls "mental disorder due to another medical condition" or "unspecified neurocognitive disorder" when a specific code does not fit. 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), psychiatric features of HIV-associated neurocognitive disorder, 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.
| Rating | Criteria |
|---|---|
| 0% | A formal diagnosis is on record but symptoms are not severe enough to interfere with occupational and social functioning, and no continuous medication is required. |
| 10% | Mild symptoms (occasional decrease in work efficiency, transient symptoms during periods of stress) responding to continuous medication, or symptoms controlled to the point that work and social function are essentially normal. |
| 30% | Occupational and social impairment with occasional decrease in work efficiency and intermittent inability to perform tasks, with symptoms including mild memory loss, depressed mood, anxiety, suspiciousness, panic attacks weekly or less often, chronic sleep impairment. |
| 50% | Occupational and social impairment with reduced reliability and productivity, with symptoms including flattened affect, circumstantial or stereotyped speech, panic attacks more than weekly, impaired judgment, disturbances of motivation, difficulty maintaining effective work and social relationships. |
| 70% | Occupational and social impairment with deficiencies in most areas, with symptoms including suicidal ideation, obsessional rituals interfering with routine activities, intermittently illogical or obscure speech, near-continuous panic or depression, impaired impulse control, neglect of personal appearance and hygiene, inability to establish and maintain effective relationships. |
| 100% | Total occupational and social impairment with symptoms including gross impairment in thought processes or communication, persistent danger of harm to self or others, intermittent inability to perform activities of daily living, severe memory loss, disorientation to time or place. |
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.
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.
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 when the underlying condition is a TBI rated under DC 8045 — the DC 8045 framework already includes a mental health facet, so the rater applies whichever framework produces the higher single rating to avoid pyramiding.
A rating in continuous effect for five years or more is protected against reduction under 38 CFR §3.951 without strong evidence of sustained material improvement. If the underlying medical condition resolves or improves substantially and the psychiatric symptoms resolve with it, a reduction proposal is possible, but the protection rules and the typical persistence of organic mental symptoms even after the underlying condition is treated favor keeping the rating.