How to Get a VA Rating Increase Without a New Diagnosis in 2026

One of the most common misconceptions about VA rating increases is that you need a new diagnosis or a new medical condition to qualify for a higher rating. This is simply not true. The VA rates functional impairment, not diagnoses. If your existing service-connected condition has gotten worse, causes more limitations, or affects your life more severely than your current rating reflects, you can file for an increase -- even if your diagnosis has not changed at all.

Your PTSD is still PTSD. Your arthritis is still arthritis. Your back injury is still a back injury. But if the symptoms are worse, the limitations are greater, and your ability to function has declined, your rating should go up.

Why You Do Not Need a New Diagnosis

The VA rating system is built around functional impairment, not diagnoses. Each condition has a diagnostic code with multiple rating levels -- 0%, 10%, 20%, 30%, and so on up to 100%. Each level corresponds to a specific degree of severity and functional limitation.

As your condition progresses through these severity levels, your rating should increase. The diagnosis stays the same; what changes is how much the condition limits your ability to work, maintain relationships, care for yourself, and live your daily life.

Real-World Examples

PTSD worsening: You were rated 30% when you had weekly nightmares and some social anxiety but could hold a full-time job. Now you have nightmares most nights, daily panic attacks, complete social isolation, and you cannot maintain employment. Same diagnosis, dramatically different functional impact. Your rating should reflect the current severity.

Arthritis progression: You were rated 10% when you had occasional knee pain and some stiffness. Years later, you have chronic pain, severely limited range of motion, and need a cane to walk. The arthritis diagnosis has not changed, but your functional impairment has increased substantially.

Back injury escalation: You were rated 20% when you had moderate back pain with some limitation of motion. Now you experience constant severe pain, cannot lift anything, require frequent bed rest, and your range of motion has dramatically decreased. Same injury, worse symptoms, higher rating warranted.

Common Scenarios for Increases Without New Diagnoses

Gradual Worsening Over Time

This is the most straightforward path. Degenerative conditions like arthritis, disc disease, and neuropathy naturally worsen with age. Mental health conditions like PTSD and depression can intensify over years, especially with additional life stressors. If your condition has gradually become more severe, you should be filing periodic increase claims to keep your rating current.

Increased Functional Limitations

Sometimes symptoms feel similar, but your ability to function has declined:

• You were working full-time when you received your initial rating, but now you cannot work at all
• You could care for yourself independently before, but now need help with bathing, dressing, or household tasks
• You walked without assistance before, but now require a cane, walker, or wheelchair
• You had some social life when initially rated, but now you are completely isolated

These functional changes justify a higher rating even without any change in your underlying diagnosis.

Your Original Rating Was Too Low

Sometimes the issue is not worsening -- it is that you were underrated from the beginning. Many veterans minimize symptoms during their initial C&P exam due to military culture. If your condition has always been more severe than your rating reflects, you can file with evidence showing your true level of impairment.

How to Build Your Case

Step 1: Review the Rating Criteria

Find the diagnostic code for your condition (it is in your rating decision letter). Look up the criteria for your current rating and the next higher level in 38 CFR Part 4. Identify the specific symptoms, frequencies, and functional limitations required for the higher rating. This becomes your evidence roadmap.

Step 2: Document Functional Decline

Focus on what you cannot do, not just how you feel. The VA rates disability based on functional impairment.

For physical conditions, document:

• How far you can walk before pain stops you
• How long you can sit or stand before needing to change positions
• What household tasks you can no longer perform
• Whether you need assistive devices (canes, braces, walkers)
• How pain affects your sleep
• Whether you need help from family members for daily activities

For mental health conditions, document:

• Impact on work (absenteeism, declining performance, inability to handle stress)
• Social functioning (isolation, inability to maintain relationships, conflict)
• Self-care (neglecting hygiene during bad episodes, inability to maintain a routine)
• Frequency and severity of panic attacks, nightmares, or flashbacks
• Memory and concentration problems
• Suicidal ideation, if present

Step 3: Gather Before-and-After Evidence

The most persuasive evidence compares your condition at the time of your last rating with your condition now:

• Range of motion: Original C&P showed 90-degree knee flexion; current exam shows 40-degree flexion
• Medications: Originally on one low-dose medication; now on three medications at higher dosages
• Work status: Originally working full-time; now unable to work
• Treatment frequency: Originally seeing a doctor quarterly; now weekly or biweekly
• Symptom frequency: Originally had nightmares once a week; now nightly

Step 4: Get Supporting Lay Evidence

Write a detailed personal statement using the "then vs. now" structure:

"When I was rated 30% in 2020, I could still drive to the store, attend my son's games, and work a full shift. Now I cannot drive more than 10 minutes without severe pain. I have not attended any family events in over a year. I had to leave my job in 2024 because I missed too many days. On my worst days, my wife has to help me get out of bed."

Ask your spouse, family members, or close friends to write similar statements describing the changes they have observed.

Step 5: Obtain Medical Documentation

Get recent treatment records showing your current severity. If possible, obtain a medical opinion from a doctor who can review your history and explain why your condition -- while carrying the same diagnosis -- now meets the criteria for a higher rating. This opinion should directly reference the 38 CFR rating criteria.

When Test Results Do Not Show the Worsening

Many conditions that cause significant disability do not show clearly on diagnostic tests:

• Chronic pain -- MRIs might look unchanged even though your pain and limitations are significantly worse
• Mental health -- There is no blood test for PTSD severity
• Migraines -- Brain scans are typically normal even with debilitating migraines
• Fibromyalgia -- Lab work is normal by definition, but the disability is very real

In these situations, focus on functional evidence. Lay statements describing what you cannot do, employment records showing you had to quit, prescriptions for assistive devices, and treatment records documenting escalating interventions are all more relevant than test results.

Writing Your Claim Narrative

When filing, create a clear narrative in your personal statement. Here is an effective structure:

1. State your current rating and when it was assigned: "I am currently rated 30% for PTSD, effective March 2020."
2. Describe your condition then: "At the time, I experienced nightmares about once a week and some anxiety in crowded places, but I was able to maintain full-time employment."
3. Describe your condition now: "Since then, my symptoms have significantly worsened. I now experience nightmares 5-6 nights per week, daily panic attacks, and complete social isolation. I had to leave my job in 2024."
4. Reference the rating criteria: "According to 38 CFR 4.130, the 70% criteria includes occupational and social impairment with deficiencies in most areas. My current symptoms meet this criteria."
5. Point to your evidence: "This is documented in my attached VA treatment records, buddy statement from my spouse, and letter from my psychiatrist."

Key Takeaways

• You do not need a new diagnosis to get a rating increase
• The VA rates functional impairment, not diagnoses
• Focus your evidence on what you cannot do, not just how you feel
• Use the 38 CFR rating criteria as your evidence roadmap
• Before-and-after comparisons are the most persuasive evidence
• Lay evidence (personal statements, buddy statements) can be just as powerful as medical records
• Degenerative conditions should be re-evaluated periodically as they naturally worsen

Use the Veterans Benefits Finder to understand what additional benefits become available at higher rating levels. Even a small increase in your rating can unlock significant new benefits beyond monthly compensation.