Pyramiding in VA Claims

Pyramiding is the VA term for rating the same disability – or the same manifestation (i.e. symptom) of a disability – twice. A veteran’s symptoms may not always line up with the set of symptoms VA lists for each diagnosis in their rating guide.  They might experience the same, or overlapping, symptoms as a result of two separate conditions. The image depicts a diagnostic code and its symptoms, showing what pyramiding versus not pyramiding would look like for PTSD and TBI.

To be considered pyramiding, one of the symptoms was factored into the rating of PTSD and factored into the rating of TBI. The same symptom would have been considered twice, under two separate diagnostic codes. To avoid pyramiding in situations where symptoms overlap like this, VA will consider the symptom when determining the rating for one of these conditions and will NOT factor it in when rating the other condition.