The VA determines your disability rating by first confirming your condition is connected to military service, then measuring its severity against a standardized rating schedule that assigns a percentage from 0% to 100% in ten-point steps. A rating specialist compares the medical evidence in your file, most importantly the findings from a Compensation and Pension exam, against the specific criteria listed for your condition’s diagnostic code. If you have more than one service-connected disability, the VA uses a combining formula, not simple addition, to reach your overall rating.
Step One: Proving Service Connection
No rating happens until the VA agrees your disability is linked to your service. Federal law authorizes compensation for any disability resulting from injury or disease contracted during active service, and for pre-existing conditions that service made worse beyond their natural course.1Office of the Law Revision Counsel. 38 USC 1110 – Basic Entitlement There are four routes to establishing that link.
Direct Service Connection
The standard path requires three things: an in-service event, injury, exposure, or illness; a current diagnosed disability; and a medical opinion (a “nexus”) connecting the two. The VA reviews the whole record, including service treatment records, post-service medical records, and lay statements about your symptoms.2eCFR. 38 CFR 3.303 – Principles Relating to Service Connection A condition diagnosed after discharge still qualifies if the evidence shows it started during service.
Presumptive Service Connection
For certain conditions tied to qualifying service, the VA presumes the link and you skip the nexus fight entirely. The PACT Act expanded these presumptions significantly for toxic exposure, covering more than 20 conditions including several cancers and chronic respiratory illnesses for veterans who served in Afghanistan, Iraq, Syria, and other listed countries during specified periods.3Veterans Affairs. The PACT Act and Your VA Benefits
Secondary Service Connection
A condition caused or worsened by an already service-connected disability can itself be service-connected. A service-connected knee injury that alters your gait and causes hip problems is the textbook example. When the basis is aggravation rather than direct causation, the VA rates only the worsening above the baseline severity of the non-service-connected condition.4eCFR. 38 CFR 3.310 – Disabilities That Are Proximately Due to, or Aggravated by, Service-Connected Disease or Injury
Disability From VA Medical Care
If you suffer an additional disability because of VA hospital care, surgery, or treatment, and the cause was negligence or an unforeseeable event, you can receive compensation as though the disability were service-connected, even if the underlying treatment was for a non-service-connected condition.5Office of the Law Revision Counsel. 38 USC 1151 – Benefits for Persons Disabled by Treatment or Vocational Rehabilitation
Step Two: The Compensation and Pension Exam
After you file, the VA usually schedules a Compensation and Pension (C&P) exam. This appointment drives the rating more than anything else in your file. A VA-employed or VA-contracted clinician evaluates you using a Disability Benefits Questionnaire (DBQ) built for your specific condition, documenting diagnoses, reviewing treatment records, taking history, checking off applicable symptoms from a standardized list, and assessing how the condition affects work and daily function. Those findings feed directly into the rating decision.
Do not miss this appointment. For an original claim, the VA will decide based only on evidence already in the file, which usually means a lower rating or denial. For claims seeking an increase or a reopened claim, missing the exam results in automatic denial.6eCFR. 38 CFR 3.655 – Failure to Report for Department of Veterans Affairs Examination If something genuinely prevents you from attending, call 1-800-827-1000 to reschedule.
Step Three: Applying the Rating Schedule
With enough evidence gathered, a rating specialist assigns a percentage using the Schedule for Rating Disabilities, a regulatory framework that covers every body system. Each condition has a diagnostic code with tiered criteria, and the percentages are meant to represent the average loss in earning capacity the disability causes.7eCFR. 38 CFR Part 4 – Schedule for Rating Disabilities
Ratings run from 0% to 100% in increments of 10. A knee condition, for instance, might be 10% for slight limitation of motion, 20% for moderate, and 30% for severe, with each level defined by measurable criteria like range-of-motion degrees. The specialist matches your C&P findings and records against those criteria and picks the level that fits.
What a 0% Rating Means
A 0% rating is not a denial. It confirms service connection but says the condition currently doesn’t meet the threshold for a monthly payment. It still opens the door to VA healthcare, travel pay reimbursement for medical appointments, VA dental and vision care where otherwise eligible, and Veterans Affairs Life Insurance.8Veterans Affairs. Non-Compensable Disability If the condition later worsens, you can file for an increase without re-proving service connection.
The Anti-Pyramiding Rule
The same symptoms cannot be rated twice under different diagnostic codes. A knee injury causing both limited motion and instability can pick up separate ratings for each because those are distinct symptoms; two codes that would each compensate the identical symptom force the VA to pick one.9eCFR. 38 CFR 4.14 – Avoidance of Pyramiding Worth pushing back on when the VA lumps genuinely distinct symptoms under a single code.
Step Four: Combining Multiple Ratings
With more than one service-connected disability, the VA does not add percentages together. A 50% plus a 30% does not equal 80%. The combining formula treats each additional disability as reducing your remaining functional capacity, not the original whole.10eCFR. 38 CFR 4.25 – Combined Ratings Table
Arrange the ratings highest to lowest, starting from 100% efficiency. The highest disability reduces that first. The next disability reduces only what remains. Take a veteran with 50% and 30%: the 50% brings efficiency from 100 down to 50. The 30% then applies to that remaining 50 (30% of 50 is 15), producing a combined value of 65%. That 65 rounds to 70% because the VA rounds to the nearest number divisible by 10, and 5 rounds up.
For three or more, you repeat the process. A veteran rated 60%, 40%, and 20% combines 60 and 40 first (76 on the table), then combines 76 with 20 (81), then rounds to 80%. The rounding happens once, at the very end.
The Bilateral Factor
When disabilities affect both sides of the body in a paired way, like both knees, both shoulders, or paired muscle groups, the VA adds a bonus. The paired ratings are combined normally, then 10% of that combined value is added (not combined) to the total before any further calculations.11eCFR. 38 CFR 4.26 – Bilateral Factor Each paired disability has to be rated at least 10% for the factor to apply.
When the VA Rates Higher Than the Math
Total Disability Individual Unemployability
If service-connected disabilities keep you from substantially gainful employment, you can be paid at the 100% rate even without a 100% combined rating. Schedular TDIU requires either one disability rated 60% or higher, or two or more disabilities with at least one at 40% and a combined rating of 70% or higher.12Veterans Affairs. Individual Unemployability if You Can’t Work
Those thresholds are more flexible than they look. Disabilities from a common cause, affecting a single body system, or involving both arms or both legs (including the bilateral factor) can count as one for meeting them. Even outside the schedular criteria, the VA can grant TDIU on an extraschedular basis by referral to the Director of Compensation Service. The stated policy is that any veteran who cannot work because of service-connected disabilities should be rated totally disabled.13eCFR. 38 CFR 4.16 – Total Disability Ratings for Compensation Based on Unemployability of the Individual TDIU changes what you’re paid, not your combined rating on paper.
Special Monthly Compensation
Special Monthly Compensation (SMC) pays above the 100% rate for particularly severe disabilities. The common level covers loss or loss of use of one hand, one foot, or one eye, deafness in both ears, or loss of a creative organ. Higher tiers apply to more severe combinations, such as loss of use of both hands or both legs, or blindness in both eyes combined with a need for daily assistance. SMC has multiple tiers, designated “k” through “t,” each with its own criteria and amount.14eCFR. 38 CFR 3.350 – Special Monthly Compensation Ratings The VA is supposed to evaluate SMC automatically when the disabilities suggest eligibility, though in practice some veterans need to raise it.
Permanent and Total Status
A veteran rated 100%, either schedular or through TDIU, can be designated Permanent and Total (P&T) when the impairment is reasonably certain to last for life. Some conditions qualify automatically, including permanent loss of use of both hands, both feet, one hand and one foot, or the sight of both eyes, and being permanently bedridden. Long-standing, totally incapacitating diseases qualify when improvement is remote.15eCFR. 38 CFR 3.340 – Total and Permanent Total Ratings and Unemployability P&T ends future routine reexaminations and unlocks benefits like Dependents’ Educational Assistance.
When Your Payments Start
Rating decisions carry an effective date, which controls when payments begin and how much back pay you get. As a general rule, the effective date is whichever is later: the date the VA received your claim, or the date the evidence shows the disability arose.16Office of the Law Revision Counsel. 38 USC 5110 – Effective Dates
The main exception helps recently separated veterans. File your initial claim within one year of discharge, and the effective date is the day after separation rather than the filing date. For an increased-rating claim, the effective date can go back up to one year before you filed if evidence shows the worsening occurred during that window.
If you’re not ready to submit a full claim, filing an Intent to File (VA Form 21-0966) locks in the effective date and gives you a year to complete the application. As long as the VA gets the finished claim within that year, the Intent to File date controls.17eCFR. 38 CFR 3.155 – Intent to File a Claim You can submit it online through VA.gov (it’s created automatically when you start and save an application), by paper form, or by phone to a designated employee.18Veterans Affairs – VA.gov. Your Intent to File a VA Claim
Compensation is tax-free and adjusted annually. Current monthly rates run from $180.42 at 10% to $3,938.58 at 100% for a single veteran with no dependents, with additional amounts at 30% and above for spouses, children, and dependent parents.19U.S. Department of Veterans Affairs. Current Veterans Disability Compensation Rates
Keeping the Rating Once You Have It
The VA can’t quietly cut a rating. Before any reduction that would lower your payment, it must send a written proposal explaining the reasons, give you 60 days to submit evidence, and offer a predetermination hearing if you request one within 30 days. Payments continue at the current level until a final decision if you request that hearing.20eCFR. 38 CFR 3.105 – Reduction in Evaluation, Compensation
A rating in place for five years or more can’t be reduced unless the VA can show sustained improvement based on an exam at least as thorough as the one that established the rating. A single better-looking exam isn’t enough; the improvement must be reasonably certain to continue under normal life conditions.21eCFR. 38 CFR 3.344 – Stabilization of Disability Evaluations Fluctuating conditions, including many mental health and autoimmune diagnoses, get extra protection.
Routine reexaminations happen every two to five years after the initial exam, but not when the disability is static, when findings have been materially unchanged for five or more years, when the condition is permanent by nature, or generally when the veteran is over 55.22eCFR. 38 CFR 3.327 – Reexaminations P&T veterans are exempt from routine reexaminations entirely.
If the Rating Comes Back Too Low
Three review options exist. You can use them in any order, and using one doesn’t lock out the others.
A Supplemental Claim is the right tool when you have new and relevant evidence the VA hasn’t seen, such as a fresh medical opinion, updated treatment records, or a private nexus letter. The reviewer weighs the old and new evidence together.23Veterans Affairs – VA.gov. Choosing a Decision Review Option
A Higher-Level Review fits when you believe the VA made an error with the evidence already in the file. A senior reviewer looks at the same record for mistakes in how law and regulations were applied. No new evidence is accepted, but you can request an informal conference to point out errors.
An appeal to the Board of Veterans’ Appeals puts your case in front of a Veterans Law Judge. The Board offers three docket choices: Direct Review of existing evidence (goal of one year), Evidence Submission with 90 days to add records (goal of 1.5 years), and Hearing before the judge in person or virtually (goal of two years).24Veterans Affairs. Board Appeals
File a Supplemental Claim or Board Appeal within one year of the original decision and you preserve your earlier effective date, which can mean more retroactive pay if the review succeeds.16Office of the Law Revision Counsel. 38 USC 5110 – Effective Dates