Martinez-Bodon: Formal DSM-5 diagnosis required in order to be compensated for mental health disability

Martinez-Bodon v. McDonough, 28 F.4th 1241 (Fed. Cir. 2022)

HELD: VA REGULATIONS require a formal DSM-5 diagnosis in order to be compensated for a mental health disability.

Summary: Veteran had psychiatric symptoms, but no formal diagnosis. The Board denied service connection. Veteran argued that he didn’t need a diagnosis because Saunders v. Wilkie held that “pain that reaches the level of ‘functional impairment of earning capacity’ could constitute a ‘disability’ under 38 U.S.C. § 1110.”

The Court rejected this argument because the question in Saunders ”was whether conditions not on the rating schedule may still be considered for service connection purposes under § 1110.” VA regulations - 38 C.F.R. §§ 4.125, 4.130 - provide specific ratings for mental health conditions – so Saunders doesn’t apply. These regulations require a mental health diagnosis that conforms to the DSM-5.

Advocacy note: Make sure the record contains a formal DSM-5 diagnosis. Even if there are conflicting diagnoses. If the veteran doesn’t have a DSM-5 diagnosis, suggest that the veteran see a different practitioner. (You see 5 different psychologists, you’ll get 5 different diagnoses.)