Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after an individual experiences or witnesses a terrifying event. The condition involves a distinct set of symptoms that persist for more than a month and significantly interfere with daily life. Because the severity of these symptoms varies widely, formal assessment is necessary to understand the condition’s impact. This assessment occurs in two distinct ways: a clinical evaluation used by healthcare providers for diagnosis and treatment planning, and an administrative evaluation used by government bodies to determine eligibility for disability compensation.
Clinical Tools Used to Measure Severity
Mental health professionals use standardized instruments to quantify the severity of a patient’s symptoms, which helps guide the course of treatment. These tools yield a numerical score that correlates to symptom frequency and intensity. One widely used self-report measure is the PTSD Checklist for DSM-5 (PCL-5). This 20-item questionnaire asks individuals to rate how much they have been bothered by specific symptoms over the past month, aligning directly with the diagnostic criteria.
The PCL-5 produces a total severity score ranging from 0 to 80, where higher scores indicate greater symptom burden. While the PCL-5 is effective for initial screening and monitoring progress during therapy, the “gold standard” for a formal diagnosis is the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). The CAPS-5 is a structured interview conducted by a trained clinician, which assesses both the frequency and intensity of all 20 PTSD symptoms over the past week to establish a definitive diagnosis and a precise measure of symptom severity.
Disability Rating Systems and Functional Impairment
For administrative purposes, such as determining compensation from the U.S. Department of Veterans Affairs (VA), a numerical rating is assigned to represent the degree of functional impairment. The VA rates PTSD on a scale of 0% to 100%, typically in increments of 10, 30, 50, 70, and 100 percent. These percentages reflect how the symptoms affect an individual’s occupational and social functioning, detailing the real-world consequences of the disorder.
A 30% rating is assigned when there is mild or transient occupational and social impairment; work efficiency and performance are only decreased during periods of significant stress. This level often includes symptoms like chronic sleep impairment, depressed mood, and panic attacks occurring weekly or less often.
A 50% rating indicates a more significant reduction in reliability and productivity, with symptoms such as frequent panic attacks occurring more than once a week, impaired judgment, and difficulty understanding complex commands.
The 70% rating describes a severe level of impairment, with deficiencies in most areas of life, including work, school, and family relations. Criteria at this level include symptoms like near-continuous panic or depression affecting independent function, suicidal ideation, and difficulty adapting to stressful circumstances.
The highest schedular rating, 100%, is reserved for total occupational and social impairment. This often involves gross impairment in thought processes, persistent delusions or hallucinations, or the inability to maintain personal appearance and hygiene. Veterans who do not meet the 100% schedular rating but are unable to maintain substantially gainful employment due to their service-connected PTSD may be eligible for Total Disability based on Individual Unemployability (IU), which provides compensation at the 100% rate.
Why Relying on an “Average” Rating is Problematic
Seeking an “average” disability rating for PTSD offers little predictive value for any individual claim. While statistical data may show that a particular percentage, such as 70%, is a common rating among veterans, this statistic is merely an aggregate of highly varied personal outcomes. The rating system is designed to be individualized, making the statistical mean irrelevant to a person’s unique presentation of the disorder.
An individual’s rating depends entirely on the documented evidence of their specific functional impairment, which can fluctuate over time and is affected by co-occurring conditions. Two people with the same diagnosis may receive vastly different ratings because their symptoms impact their ability to work and socialize in unequal measures. The focus should remain on thoroughly documenting personal evidence of the disorder’s impact, rather than using a statistical average as a benchmark for an expected outcome.