Trichotillomania (Hair-Pulling Disorder)

DC 9413Mental Disorders38 CFR 4.130, DC 9413 — General Rating Formula for Mental Disorders

A condition involving recurrent, compulsive pulling out of one's own hair, resulting in hair loss and significant distress. Often triggered or worsened by stress and anxiety, it is classified as an obsessive-compulsive related disorder.

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 9413

Rating range

0% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.130, DC 9413 — 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

⚠Not documenting the extent of hair loss and its impact on self-esteem and social functioning — photographs and dermatological records help demonstrate severity.
⚠Failing to connect hair-pulling behavior to service-related stress or a service-connected mental health condition — establishing this nexus is critical for service connection.
⚠Not reporting the time spent on pulling rituals and the distress caused by the urge to pull — the compulsive nature of the behavior and the inability to stop are key to showing severity.
⚠Not filing for secondary conditions — trichotillomania commonly co-occurs with anxiety, depression, and skin infections from repeated pulling.

Related DBQ Forms

DBQ Mental Disorders (other than PTSD and Eating Disorders)

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Trichotillomania (Hair-Pulling Disorder)

How the VA rates this condition

Diagnostic code

DC 9413

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

⚠Not documenting the extent of hair loss and its impact on self-esteem and social functioning — photographs and dermatological records help demonstrate severity.

⚠Failing to connect hair-pulling behavior to service-related stress or a service-connected mental health condition — establishing this nexus is critical for service connection.

⚠Not reporting the time spent on pulling rituals and the distress caused by the urge to pull — the compulsive nature of the behavior and the inability to stop are key to showing severity.

⚠Not filing for secondary conditions — trichotillomania commonly co-occurs with anxiety, depression, and skin infections from repeated pulling.