Bipolar disorder is a serious mental health condition affecting many veterans, yet it is often misunderstood or misdiagnosed within the VA system. Whether diagnosed during service or years later, many veterans share the same uncertainty about VA recognition.
This article explains bipolar disorder and VA disability compensation, including service connection, VA ratings, common claim mistakes, and ways to strengthen your case.
Table of Contents
Understanding Bipolar Disorder
Bipolar disorder is a chronic mental health condition marked by extreme mood changes beyond normal emotional shifts. These changes include depressive and manic or hypomanic episodes that can disrupt daily life, relationships, and work.
There are several recognized types of bipolar disorder. Bipolar I disorder involves full manic episodes that may require hospitalization and can include impulsive or risky behavior. Bipolar II disorder includes hypomanic episodes that are less severe than full mania but still disruptive, combined with major depressive episodes. Cyclothymic disorder is a milder form, involving ongoing mood fluctuations over a longer period of time.
Symptoms vary by person, but manic or hypomanic episodes often include high energy, racing thoughts, little sleep, impulsivity, and risky behavior. Depressive episodes may involve fatigue, hopelessness, loss of interest, poor concentration, sleep or appetite changes, and suicidal thoughts.
For veterans, bipolar disorder is frequently misdiagnosed as depression, anxiety, or PTSD. This happens because many symptoms overlap, particularly in cases where manic episodes are mild or not well documented. As a result, bipolar disorder may go unrecognized for years.
Bipolar Disorder and Military Service
Military service can place extraordinary stress on mental health. High pressure environments, irregular sleep, traumatic events, and prolonged stress can all contribute to the onset or worsening of mood disorders.
Bipolar disorder may develop during active duty, but it can also emerge or be properly diagnosed after service. The VA recognizes this reality and does not require a diagnosis during service in order for a condition to be considered service connected.
Direct Service Connection for Bipolar Disorder
A direct service connection means that bipolar disorder began during active duty or that clear symptoms appeared while you were in uniform. This does not always require a formal diagnosis at the time.
Direct service connection may include documented mental health treatment during service that was later identified as bipolar disorder. Some veterans were misdiagnosed with personality or adjustment disorders and received a correct bipolar diagnosis years later.
Service connection may also be supported when in service stressors, such as combat or trauma, triggered the first manic or depressive episode. Even with a post service diagnosis, service records, evaluations, and medical opinions can help show symptoms began during active duty.
Secondary Service Connection and Bipolar Disorder
Bipolar disorder can also be service connected on a secondary basis. Secondary service connection means that a condition was caused or worsened by another disability that is already service connected.
Common conditions that may lead to secondary service connection for bipolar disorder include PTSD, depression, traumatic brain injury, and chronic pain. PTSD and depression are especially relevant because symptoms often overlap and may evolve over time into a bipolar diagnosis. Traumatic brain injuries have been linked in medical literature to mood instability and bipolar spectrum disorders. Chronic pain conditions can also contribute to long term mood dysregulation and emotional stress.
For example, a veteran may already be service connected for PTSD. Over time, a psychiatrist may determine that the original symptoms were part of a broader mood disorder and update the diagnosis to bipolar disorder. In this scenario, bipolar disorder may be considered secondarily service connected.
It is important to understand that the VA generally assigns only one mental health rating. If symptoms overlap between PTSD, depression, and bipolar disorder, the VA will usually combine them under a single rating rather than assigning separate evaluations. This is due to VA rules against pyramiding, which prevent multiple ratings for the same symptoms. An accredited representative such as a VSO, claims agent, or attorney can help you understand how this applies to your specific case.
Medical Evidence and Bipolar Disorder in Veterans
Medical research strongly supports the link between military service related conditions and bipolar disorder. Studies show that veterans with PTSD or traumatic brain injuries are at a significantly higher risk of developing bipolar spectrum disorders. Research also confirms that bipolar disorder is frequently misdiagnosed in veterans due to overlapping symptoms, particularly when manic episodes are subtle.
The VA recognizes bipolar disorder as a ratable mental health condition and does not require combat exposure to qualify. If your claim is denied because the VA determines the condition is not related to service, you still have options. A second medical opinion or a detailed medical nexus letter may help overturn an unfavorable decision.
How the VA Rates Bipolar Disorder
The VA rates bipolar disorder using the same general rating formula applied to all mental health conditions under 38 CFR 4.130. Ratings are based on the severity of symptoms and how they affect occupational and social functioning.
A zero percent rating may be assigned if symptoms are present but do not interfere with work or relationships. Ratings from 10 to 30 percent generally reflect mild to moderate symptoms with occasional impairment. A 50 percent rating is assigned when symptoms cause reduced reliability and productivity, affecting mood, memory, judgment, and work performance.
A 70 percent rating reflects major difficulty in work and relationships, frequent depression or panic, and impaired functioning. A 100 percent rating is reserved for total occupational and social impairment, including inability to work, severe isolation, or persistent danger to oneself or others.
You do not need to experience full manic episodes or require hospitalization to qualify for a higher rating. What matters most is how symptoms affect your daily life, work, and relationships. Mental health rating criteria may change in the future, so it is always important to verify the most current standards.
What to Expect at a C and P Exam
If you file a bipolar disorder claim, the VA will likely schedule a Compensation and Pension exam with a VA or contracted provider.
During the exam, you will discuss mood swings, sleep, behavior, work history, and how symptoms affect daily life.
It is critical to be honest and thorough. Do not minimize symptoms, even if you are having a good day. Be prepared to describe your worst episodes, not just how you feel at the moment. The examiner’s report plays a major role in determining your rating.
Strengthening Your Bipolar Disorder Claim
There are several steps you can take to support your VA disability claim for bipolar disorder. Obtaining a formal diagnosis from a psychiatrist or psychologist is essential. Reviewing service records for signs of mood changes, disciplinary issues, or behavioral problems can help establish service connection.
A medical nexus letter from a qualified provider can be especially valuable. This letter should explain how your bipolar disorder is linked to your military service or to another service connected condition. Documenting how symptoms affect your work, relationships, and daily life through journaling or statements can also strengthen your case.
If you are already service connected for another mental health condition, bipolar disorder may be a progression or misdiagnosis.
The VA usually assigns the diagnosis that leads to the highest rating when supported by evidence.
Final Thoughts on Bipolar Disorder and VA Disability
Bipolar disorder is a serious but manageable condition. With proper treatment and support, many veterans live productive and fulfilling lives. The VA does recognize bipolar disorder for disability compensation purposes, and veterans have the right to file claims when symptoms began in service, were triggered by trauma, or were misdiagnosed for years.
A prior denial does not mean the end of the road. Veterans can seek help from a VSO, obtain a new psychological evaluation, and pursue an appeal with accredited representation. Understanding the process and building strong medical evidence can make a meaningful difference in the outcome of your claim with the Department of Veterans Affairs.
Also read: Military Police VA Disability Claims
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
Our purpose is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.
Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
