Body system: Mental DisordersRegulation: 38 CFR § 4.130DBQ: DBQ PSYCH Eating Disorders
Anorexia nervosa is an eating disorder characterized by self-induced weight loss, intense fear of weight gain, distorted body image, and restrictive eating, sometimes combined with binge-purge behavior. The VA rates DC 9520 under the Rating Formula for Eating Disorders (38 CFR § 4.130), NOT the General Rating Formula for Mental Disorders. The 5-tier ladder: 100% (weight <80% of expected minimum + incapacitating episodes >= 6 weeks/year + hospitalization >2x/year for parenteral nutrition or tube feeding), 60% (weight <85% + incapacitating episodes >= 6 weeks/year), 30% (weight <85% + incapacitating episodes 2-6 weeks/year), 10% (binge-purge or weight-gain resistance below minimum + incapacitating episodes up to 2 weeks/year), 0% (binge-purge or weight-gain resistance below minimum + diagnosis but no incapacitating episodes). "Incapacitating episode" means a period during which bed rest and treatment by a physician are required.
Rating levels
- 100% — You qualify for 100% if all three are met: (1) self-induced weight loss has dropped you below 80% of your expected minimum healthy weight, (2) you have had incapacitating episodes totaling at least 6 weeks in the past year (an incapacitating episode is a period during which bed rest and treatment by a physician are required), AND (3) you have required hospitalization more than twice in the past year specifically for parenteral nutrition (IV feeding) or tube feeding. All three thresholds must be met; falling below any one drops you to 60% or lower.
- 60% — You qualify for 60% if both are met: (1) self-induced weight loss has dropped you below 85% of your expected minimum healthy weight, AND (2) you have had incapacitating episodes totaling 6 or more weeks in the past year. Unlike the 100% tier, no hospitalization for tube feeding or IV nutrition is required at this level.
- 30% — You qualify for 30% if both are met: (1) self-induced weight loss has dropped you below 85% of your expected minimum healthy weight, AND (2) you have had incapacitating episodes totaling more than 2 weeks but less than 6 weeks in the past year.
- 10% — You qualify for 10% if you have either binge eating followed by self-induced vomiting (or other measures to prevent weight gain such as laxatives, diuretics, or excessive exercise) OR resistance to weight gain even when below your expected minimum weight, AND you have a formal diagnosis of an eating disorder, AND incapacitating episodes totaling up to 2 weeks in the past year. The 10% tier covers bulimic-pattern or purging-pattern eating disorder with limited but documented incapacitation.
- 0% — You qualify for 0% (non-compensable but service-connected) if you have either binge eating followed by self-induced vomiting (or other measures to prevent weight gain) OR resistance to weight gain even when below your expected minimum weight, AND you have a formal diagnosis of an eating disorder, but you have NOT had any incapacitating episodes (periods requiring physician-ordered bed rest) in the past year. The diagnosis is recognized as service-connected but does not currently rise to a compensable level.