Factitious Disorder

DC 9499-9421Mental Disorders38 CFR 4.130, DC 9499-9421 — General Rating Formula for Mental Disorders

A serious mental health condition where a person acts as if they have an illness by exaggerating or producing symptoms. Unlike malingering, the motivation is not financial gain but a deep psychological need to assume the sick role. The behavior is compulsive and driven by underlying mental health issues.

How the VA rates this condition

The VA rates this condition based on how much it affects your ability to work and carry out daily activities. The examiner will focus on the functional limitations your condition causes, not just the diagnosis itself.

Diagnostic code

DC 9499-9421

Rating range

0% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.130, DC 9499-9421 — General Rating Formula for Mental Disorders. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

Your condition causes total impairment in your ability to work and function socially. You may be a persistent danger to yourself or others, disoriented, or have severe memory loss.

What the VA looks for

Gross impairment in thought processes or communication
Persistent delusions or hallucinations
Grossly inappropriate behavior
Persistent danger of hurting self or others
Inability to perform activities of daily living
Disorientation to time or place
Memory loss for names of close relatives, own occupation, or own name

Common Pitfalls

⚠Factitious disorder being confused with malingering — in malingering, the goal is external gain (money, avoiding duty). Factitious disorder is a genuine mental illness where the person has a compulsive psychological need to be seen as sick. A mental health professional must clearly distinguish the two.
⚠Not documenting the underlying psychological drivers — factitious disorder often stems from severe trauma, attachment disorders, or personality disturbances. The underlying mental health condition should be thoroughly evaluated.
⚠Stigma preventing proper diagnosis and treatment — factitious disorder carries significant stigma even among medical professionals. Ensure the evaluating provider treats this as the recognized mental disorder it is under the DSM-5.
⚠Not connecting the condition to military service — the stress, isolation, and trauma of military service can trigger or worsen factitious disorder. A nexus opinion linking the condition to service stressors is necessary.

Related DBQ Forms

DBQ Mental Disorders (other than PTSD and Eating Disorders)

View evidence checklist →See secondary conditions →

Condition Rating Guides

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Factitious Disorder

How the VA rates this condition

Diagnostic code

DC 9499-9421

Rating range

0% – 100%

Rating levels

Rating Levels

Your condition causes total impairment in your ability to work and function socially. You may be a persistent danger to yourself or others, disoriented, or have severe memory loss.

What the VA looks for

Gross impairment in thought processes or communication
Persistent delusions or hallucinations
Grossly inappropriate behavior
Persistent danger of hurting self or others
Inability to perform activities of daily living
Disorientation to time or place
Memory loss for names of close relatives, own occupation, or own name

Common Pitfalls

⚠Factitious disorder being confused with malingering — in malingering, the goal is external gain (money, avoiding duty). Factitious disorder is a genuine mental illness where the person has a compulsive psychological need to be seen as sick. A mental health professional must clearly distinguish the two.

⚠Not documenting the underlying psychological drivers — factitious disorder often stems from severe trauma, attachment disorders, or personality disturbances. The underlying mental health condition should be thoroughly evaluated.

⚠Stigma preventing proper diagnosis and treatment — factitious disorder carries significant stigma even among medical professionals. Ensure the evaluating provider treats this as the recognized mental disorder it is under the DSM-5.

⚠Not connecting the condition to military service — the stress, isolation, and trauma of military service can trigger or worsen factitious disorder. A nexus opinion linking the condition to service stressors is necessary.