Rating Schedules and Why Combined Ratings Are Not Added
Two disabilities rated fifty and thirty percent do not produce eighty. The schedule measures what remains of a whole person, so each successive disability applies only to the capacity the previous ones left behind, and the rounding happens once at the end.
The rule in short
The schedule for rating disabilities in 38 CFR Part 4 assigns percentages representing average impairment in earning capacity, organized by body system and identified by diagnostic code. Multiple ratings are combined under the table in 38 CFR 4.25 rather than added: each rating applies to the efficiency remaining after the preceding one. Disabilities of paired extremities receive an additional bilateral factor, and the final combined value is rounded to the nearest ten percent.
The arithmetic of disability ratings surprises nearly everyone who encounters it. A veteran rated fifty percent for one condition and thirty percent for another is not rated eighty percent. The schedule does not add percentages, because the thing it measures is not additive.
What a percentage measures
The statute directs that the schedule be based on average impairment in earning capacity resulting from particular injuries and diseases in civil occupations, graded in ten percent increments. That framing does two things. It detaches the percentage from medical severity — a condition that is medically serious but rarely interferes with work may carry a low rating — and it makes the figure a statement about a population rather than about the individual veteran.
Ratings are assigned against written criteria rather than by judgment. Each criterion describes findings at a given level: a range of motion in degrees, a frequency of episodes, a described level of occupational and social impairment. Where the disability picture more nearly approximates the criteria for a higher rating, the higher rating is assigned; where it does not, the lower one is.
Diagnostic codes and analogous ratings
The schedule is organized by body system, and each listed condition carries a four-digit diagnostic code. The code identifies which criteria apply, and it appears on the rating decision beside the percentage. Two conditions in the same body system can carry very different criteria, so the code is the first thing to check when a rating seems wrong.
Conditions not listed are rated by analogy to a closely related listed condition, chosen for the affected anatomical location and the functions involved. Such ratings appear as hyphenated codes, and where a rating is built up from an unlisted condition the second half of the hyphenated code shows the criteria actually used. Disputes about analogous ratings turn on whether a more favorable analogue was available on the same findings.
Combination begins with the highest rating and proceeds downward. Applying the ratings in a different order can produce a different intermediate value, which is why the regulation fixes the sequence. Rounding to the nearest ten percent occurs only after every rating and the bilateral factor have been combined; rounding at each step inflates the result and is a common error in informal calculations.
The combined ratings table
The model is a whole person with a hundred percent of capacity. The first and highest rating removes its percentage. The second rating is then applied to what remains rather than to the whole. A fifty percent disability leaves fifty percent of capacity; a thirty percent disability applied to that fifty removes fifteen points, giving a combined value of sixty-five. A third disability rated twenty percent applies to the thirty-five that remain, adding seven points for a total of seventy-two.
Only at the end is the value rounded to the nearest ten percent. Sixty-five rounds to seventy; seventy-two rounds to seventy. That rounding rule explains why two veterans with visibly different combinations of conditions receive the same monthly payment, and why an additional low rating sometimes changes nothing at all.
| Step | Rating applied | Capacity before | Points removed | Combined value |
|---|---|---|---|---|
| First and highest | 50 percent | 100 | 50 | 50 |
| Second | 30 percent | 50 | 15 | 65 |
| Third | 20 percent | 35 | 7 | 72 |
| Fourth | 10 percent | 28 | 3 (rounded within the table) | 75 |
| Final rounding | — | — | — | 80 percent awarded |
The bilateral factor
Where partial disabilities affect both arms, both legs, or paired skeletal muscles, the schedule recognizes that the combined effect exceeds the sum of the parts — a person with one bad knee compensates with the other, and a person with two cannot. Those ratings are combined first, ten percent of the resulting value is added as the bilateral factor, and the total is then combined with the remaining ratings.
The factor applies only to the paired extremities themselves, and it is calculated before other disabilities enter the combination. A veteran with bilateral knee disabilities and an unrelated back condition receives the factor on the knees alone. Because the increment is modest but can carry a combined value across a rounding threshold, it is worth confirming that it was applied.
The limits of the schedule
Two situations exceed what the table can express. Where a disability presents an exceptional picture that the criteria do not contemplate — frequent hospitalization, marked interference with employment beyond what the rating reflects — the case may be referred for an extraschedular evaluation. And where service-connected disabilities prevent substantially gainful employment without reaching a hundred percent by combination, the veteran may be entitled to a total rating based on individual unemployability, paid at the hundred percent rate.
None of the arithmetic is reached until connection is established under one of the routes to service connection, and the findings that drive it come from examinations obtained through the agency's duty to assist. Where a percentage is disputed, the argument is usually that the examination failed to record a finding the criteria require, and it is pursued through the review lane best suited to the defect. The same schedule is applied, to a narrower set of conditions, by the military physical evaluation board.
Points to carry away
- A rating percentage represents average impairment in earning capacity, not a measure of medical severity.
- Each disability is identified by a diagnostic code, and analogous conditions are rated under a hyphenated code.
- Ratings are combined using a table that applies each rating to the efficiency remaining after the preceding one.
- Disabilities affecting both arms, both legs, or paired skeletal muscles attract an additional bilateral factor.
- The combined value is rounded to the nearest ten percent only at the end of the calculation.
- Rating the same impairment under two diagnostic codes is prohibited as pyramiding.
Questions readers ask
Why does a second rating add so little at high percentages?
Because there is less left to impair. A veteran already rated seventy percent retains thirty percent of the efficiency the schedule measures. A further thirty percent disability takes thirty percent of that thirty, or nine points, producing seventy-nine and a rounded eighty. The same thirty percent disability added to a ten percent rating would take twenty-seven points. The model never reaches a hundred by accumulation, which is one of the reasons a separate route exists for veterans who cannot work.
What is an analogous rating?
Where a condition is not listed in the schedule, it is rated by analogy to a closely related listed condition, using the anatomical location and the functions affected. The rating is written as a hyphenated code: the first four digits identify the unlisted condition's place in the schedule, and the second set identifies the criteria actually applied. Analogous ratings are common for newer diagnoses, and disputes about them usually concern whether a more favorable analogue was available.
Can two ratings be assigned for one injury?
Separate ratings are permitted where the manifestations are genuinely distinct — a knee with both instability and limitation of motion may be rated for each, because different criteria address different impairments. What is prohibited is rating the same disability under different diagnoses, or the same symptom twice under different codes. The line is drawn by asking whether the criteria overlap in what they measure, and it is a frequent subject of dispute on review.
Sources
- Cornell Legal Information Institute — 38 U.S.C. 1155, Authority for and Maintenance of Schedule of RatingsThe statutory basis for the schedule and its grading in ten percent increments.
- Cornell Legal Information Institute — 38 CFR Part 4, Schedule for Rating DisabilitiesThe full schedule, organized by body system with the diagnostic codes.
- Cornell Legal Information Institute — 38 CFR 4.25, Combined Ratings TableThe table and the rule that ratings are combined rather than added.
- Cornell Legal Information Institute — 38 CFR 4.26, Bilateral FactorThe additional allowance for disabilities of paired extremities.
- Cornell Legal Information Institute — 38 CFR 4.14, Avoidance of PyramidingThe prohibition on rating the same manifestation under multiple codes.
- Cornell Legal Information Institute — 38 CFR 4.7, Higher of Two EvaluationsThe rule assigning the higher rating where the picture more nearly approximates it.
- Cornell Legal Information Institute — 38 CFR 4.20, Analogous RatingsHow an unlisted condition is rated by analogy to a listed one.
Justice Partners Journal is a publication, not a law firm. This article states general rules and cites its sources; it is not advice about any particular case, and the law differs by state and changes over time.
