Mental Disorders

DC 9521

Bulimia nervosa

Educational use only. Not legal or medical advice. Read 38 CFR §4.130 on eCFR
Diagnostic Code
9521
CFR Section
§4.130 — Mental Disorders

Rated Under Formula

This condition is rated using the Rating Formula for Eating Disorders general rating formula.

100%

Self-induced weight loss to less than 80 percent of expected minimum weight, with incapacitating episodes of at least six weeks total duration per year, and requiring hospitalization more than twice a year for parenteral nutrition or tube feeding.

60%

Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of six or more weeks total duration per year.

30%

Self-induced weight loss to less than 85 percent of expected minimum weight with incapacitating episodes of more than two but less than six weeks total duration per year.

10%

Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder and incapacitating episodes of up to two weeks total duration per year.

0%

Binge eating followed by self-induced vomiting or other measures to prevent weight gain, or resistance to weight gain even when below expected minimum weight, with diagnosis of an eating disorder but without incapacitating episodes.

What Raters Look For

Based on M21-1 adjudication criteria for Mental Disorders conditions. These are the factors a VA rater evaluates when assigning a rating percentage.

M21-1 III.iv.4.N
  • •Frequency, severity, and duration of psychiatric symptoms
  • •Impact on occupational functioning: ability to work, maintain employment, work with others
  • •Impact on social functioning: relationships, ability to leave home, social withdrawal
  • •Treatment history: outpatient therapy, psychiatric medications, hospitalizations
  • •Psychiatric hospitalizations — voluntary or involuntary, frequency and duration
  • •Suicidal ideation — whether passive or active, and any attempts
  • •Global Assessment of Functioning (GAF) score if documented in older records; WHODAS score in newer exams
  • •Specific symptoms from the General Rating Formula: depression, anxiety, panic, memory issues, sleep disturbance, anger, social avoidance
NoteThe General Rating Formula (38 CFR §4.130) applies to all mental disorders regardless of diagnosis. Raters focus on functional impairment, not diagnosis name. A detailed personal statement describing daily impact carries significant weight.