What Is Somatic Symptom Disorder?

Somatic symptom disorder is a mental health condition that is most often diagnosed when a patient is exhibiting significant to extreme mental distress due to a physical symptom such as pain, shortness of breath, or other problems with bodily functioning. The focus on a physical problem may be a tangible diagnosed problem such as back pain, or it may be that the person experiencing symptoms believes that they are sick or experiencing pain even when no root cause can be identified by a medical professional. The key identifier of somatic symptom disorder is the characteristic of extreme or excessive thoughts, feelings, and behaviors related to the illness. The Cleveland Clinic estimates that somatic symptom disorder occurs in about 5 to 7 percent of the adult population, and that approximately 30 to 60 percent of people with somatic symptom disorder also have anxiety and or depression.

Additional symptoms that one may experience as a result of somatic symptom disorder includes:

  • Extreme anxiety related to one’s physical symptoms
  • Seeking out and undergoing multiple diagnostic tests with a healthcare provider but not believe the results, and or an inability to find reassurance in negative test results
  • Frequently switching healthcare providers
  • Frequently feeling concerned that mild symptoms are signs of serious conditions
  • Hyper fixation on physical condition leading to difficulty or inability to concentrate on other things
  • Constant worry and or irrational thoughts
  • Fearing that symptoms are serious, even if there is no evidence of injury or illness
  • Repeatedly checking one’s body for abnormalities
  • Inability to sleep due to worry regarding their physical symptoms

Somatic symptom disorder can easily be confused for illness-related anxiety disorder. The key difference between these conditions is that a person with illness-related anxiety disorder doesn’t experience physical symptoms such as pain. In contrast, those with somatic symptom disorder experience a physical symptom such as pain, fatigue or weakness, or shortness of breath, and they are constantly preoccupied with that symptom.

Obtaining Service Connection

As with all other conditions rated by the VA, a medical nexus opinion is needed that links the diagnosed condition to the veteran’s time in service. However, if a veteran has an already service-connected injury that is the cause of their somatic symptom disorder, they main be able to obtain secondary service connection for their mental health condition. For example, if a veteran is service connected for back pain, and that pain is the primary cause of the veterans somatic symptom disorder, then they are entitled to secondary service connection.

How The VA Rates Somatic Symptom Disorder

The VA evaluates all mental heath conditions under the same disability rating formula — 38 CFR § 4.130:

Diagnostic Code 9421: Somatic Symptom Disorder

  • 100 – Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name
  • 70 – Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work like setting); inability to establish and maintain effective relationships
  • 50 – Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships
  • 30 – Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events)
  • 10 – Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication
  • 0 – A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication

In order to be assigned the highest possible schedular disability rating for somatic symptom disorder, a veteran would have to exhibit total social and occupational impairment. It is also worth noting that a veteran may be entitled to a Total Disability Based on Unemployability (TDIU) rating if they are unable to maintain employment due to their condition. 

Contact The Veteran’s Law Office About Your Somatic Symptom Disorder Claim

If you or someone you know is a veteran seeking assistance with a somatic symptom disorder claim, please contact us today for a free case evaluation. Our team has extensive experience handling VA mental health claims and can help you get the compensation to which you are entitled.