What does your VA disability rating mean?

What does your VA disability rating mean?

What is a disability rating?

Once VA adjudicators confirm that your disability is service connected, VA will assign a disability rating. For example, your service-connected hearing loss might be rated “20 percent disabling.” Disability ratings are given in multiples of 10.

After rating your disability or disabilities, VA sends you a Rating Decision letter that includes the rating(s) for each service-connected disability you have and your combined rating. VA calculates your combined rating according to a formula discussed later on in this post, under the section titled “Multiple Disabilities & Combined Ratings.” Your combined rating is used to determine how much compensation you will receive each month.

The VA Rating Schedule

VA has developed a Schedule of Rating Disabilities (Rating Schedule) that guides adjudicators through rating different disabilities. The Rating Schedule is detailed under 38 C.F.R., Part 4.

The disability ratings represent the “average impairment in earning capacity resulting from the given disability or disease and its residual conditions.” That is, VA adjudicators will want to know how your disability affects your ability to work or perform basic life tasks like bathing or driving.

During the disability rating process, VA is less focused on the severity of the original, in-service injury and more focused on the residual conditions i.e. the remaining limitations resulting from the injury that still impact your life.

Disability ratings may change over time. VA may decrease your disability rating after their initial Rating Decision if they determine that your disability has improved. Similarly, they may increase your rating if it has worsened. In both cases, there must be evidence (like a C&P Exam or medical treatment notes) that show improvement or decline.

Diagnostic Codes

The VA Rating Schedule contains groups affecting different parts of the body. Sections include, for example, the Musculoskeletal System, the Respiratory System, and Impairment of Auditory Acuity.

Each group contains a list of disabilities or diseases, each with its own diagnostic code. Generally, each diagnostic code specifies the symptoms that are required for each level of disability rating.

Even if your disability residuals could possibly be rated under more than one diagnostic code, you can only get rated (and paid) under one code. If two or more codes apply, VA must choose the diagnostic code that will give the highest rating.

Multiple Disabilities & Combined Ratings

If you have more than one service-connected disability, VA will calculate a combined rating to determine how much you will be paid each month.

To calculate a combined rating, VA does not simply add your individual disability ratings together. Rather, rating specialists use a Combined Ratings Table that applies a formula. The number calculated using the Table is then rounded to the nearest multiple of 10. And that number is your combined rating.

Here’s the basic idea: Say you have a disability rated at 40 percent and one rated at 30 percent. Again, this does not mean that your combined rating would be 70 percent. Using the Combined Ratings Table, you would locate the row labeled 40 (the highest rating first) and then move along the row until you’re in line with the column labeled 30. There, the Table tells you the combined rating is 58. You’d then round up to 60 and get 60 percent as your final combined rating.

If you have more than 2 disabilities, you can continue combining until all of your disabilities are included. For example, say you have a disability rated at 40 percent, one rated at 30 percent, and one rated at 20 percent. Starting with the highest disability rating and continuing in descending order, you would combine 40 and 30 using the table. The Table tells you this is 58 (see above). Then, before rounding up, you would combine 58 and 20 – locating the row labeled 58 and moving along the row until you’re in line with the column labeled 20. The Table tells you the combined rating is 66. You’d then round up to a 70 percent final combined rating.

The Bilateral Factor

Bilateral means affecting both sides. The Bilateral Factor adds 10 percent to the rating of a disability that results from “disease or injury of both arms, or of both legs, or of other paired skeletal muscles.”

To be eligible for the bilateral factor, your disability or disabilities must affect the functioning of

  • Two upper limbs OR two lower limbs (but not one from the upper body and one from the lower); AND,
  • those extremities must be on opposite sides of the body (left and right).

For example, if you had a left elbow disability and a right hand disability, the Bilateral Factor is applicable. If, however, you had a left elbow injury and a right knee injury, the Bilateral Factor would not be applied because, though your disabilities are on both sides of your body, they are not both from the upper body or both from the lower body.

If the Bilateral Factor is applicable, VA should calculate your combined rating with the added 10 percent.

Symptom Overlap with a Non-Service-Connected Condition

If you have both a service-connected disability and a non-service-connected disability and it is very difficult to determine which condition is causing your symptoms, the VA is required to apply the “benefit of the doubt” rule. Essentially, if VA can’t tell which disability is causing the symptoms, they have to assume that your service-connected disability is causing the symptoms, not your non-service-connected disability.

For example, say you’re service-connected for PTSD and you also have non-service-connected Major Depressive Disorder. If VA is unable to tell which disorder is causing certain symptoms (for example, anxiety), they must attribute those symptoms to PTSD.

Staged Ratings

If VA grants your claim, you will typically be awarded retroactive benefits for the time period during which your claim was pending.  Especially if your claim has taken years to process, your symptoms may have worsened during that time. If so, you can ask VA to look at the medical evidence and assign you a higher rating for the period when your symptoms worsened. This is called “staged rating.”

If VA agrees that the medical evidence shows that your symptoms have worsened to the point where you meet the criteria for a higher disability rating, they will award you the appropriate (increased) retroactive benefits for that period.

Be warned, however, that VA may decrease your rating if the medical evidence shows an improvement in symptoms during a certain period.

Rating Residuals Separately

Since VA is concerned with the residuals when rating disabilities, it is sometimes possible to receive more than one rating for different residuals stemming from a single injury or disease.

Residuals, remember, are the limitations resulting from the injury or disease that still impact your life. Say, for example, you are service connected for arthritis in your low back that results in pain and limitation of motion and you experience numbness in your left leg as a result of your back condition. You can potentially get a disability rating for both the chronic low back pain and for the numbness in your leg (generally known as “radiculopathy”).

The rules that govern when you can rate residuals separately are complex and often specific to the type of disability. It may be wise to get the help of a veterans disability attorney if you think you may be eligible for separate ratings for your disability residuals. Eligibility is more likely if the symptoms of the residuals do not overlap.

Category: Veterans Law