Diagnostic Code 9305 · 38 CFR §4.130
Vascular neurocognitive disorder (formerly called vascular dementia or multi-infarct dementia) is cognitive decline caused by cerebrovascular disease — reduced or blocked blood flow to the brain. This can result from strokes, transient ischemic attacks, or chronic small-vessel disease. Veterans are at elevated risk because of service-connected hypertension, cardiovascular disease, diabetes, and exposure to environmental toxins that damage blood vessels. Cognitive symptoms may appear gradually or in a stepwise pattern after vascular events and typically include difficulty with attention, processing speed, executive function, and memory. The VA rates this condition under the General Rating Formula for Mental Disorders at 38 CFR 4.130.
| Rating | Criteria |
|---|---|
| 0% | A diagnosis exists but cognitive symptoms do not impair occupational or social functioning. |
| 10% | Mild cognitive decline that decreases work efficiency only during periods of significant stress. |
| 30% | Occasional decrease in work efficiency due to mild memory loss, slowed processing, difficulty concentrating, or depressed mood. |
| 50% | Reduced reliability and productivity due to moderate cognitive decline affecting task completion, judgment, complex instructions, and relationships. |
| 70% | Deficiencies in most areas due to significant cognitive impairment. May include disorientation, inability to manage finances or medications independently, and near-continuous anxiety or depression about cognitive decline. |
| 100% | Total occupational and social impairment with severe cognitive decline, disorientation to time or place, inability to perform daily activities, severe memory loss, and need for constant supervision. |
A neuropsychological evaluation documenting cognitive decline is the strongest evidence. Brain imaging (MRI or CT) showing vascular changes — white matter lesions, lacunar infarcts, or evidence of prior strokes — supports the diagnosis. Medical records documenting the underlying vascular condition (hypertension, stroke history, cardiovascular disease) and its connection to military service establish nexus. If the vascular disease is secondary to a service-connected condition, that link must be documented. Buddy statements describing observed cognitive decline in daily functioning are valuable.
DC 9304 covers neurocognitive disorder from traumatic brain injury. DC 9305 covers neurocognitive disorder from vascular disease specifically. DC 9310 covers unspecified causes. The rating criteria are identical for all — the distinction helps clarify the underlying cause for nexus purposes.
Yes. If service-connected hypertension has caused cerebrovascular damage leading to cognitive decline, DC 9305 applies as a secondary claim. You need medical evidence — brain imaging and a nexus opinion — connecting the cognitive impairment to the vascular disease.