Top 10 VA Disability Claims: Ratings, Filing, and Denials

The most common VA disability claims are tinnitus, knee injuries, hearing loss, PTSD, and back or spinal conditions, followed by depression and anxiety, sleep apnea, migraines, sciatica, and gastrointestinal disorders. As of 2022 data, more than 2.7 million veterans were receiving compensation for tinnitus alone, about 1.66 million for knee injuries, 1.43 million for hearing loss, 1.34 million for PTSD, and 1.33 million for spinal injuries.¹ Each of these conditions carries its own rating rules, evidence expectations, and common reasons for denial, and the details make a real difference in whether a claim is approved and at what level.

How VA Ratings Are Built

The VA assigns ratings in 10% increments from 0% to 100% based on how much a condition impairs a veteran’s ability to earn a living. When a veteran has more than one service-connected condition, the ratings are not added. They are combined using a table that accounts for remaining “whole person” capacity: ratings are ordered highest to lowest, combined sequentially, and rounded to the nearest 10%.² Two separate 10% ratings produce a combined rating of 19%, which rounds to 20%.

When disabilities affect both sides of the body, such as both knees, the VA applies a “bilateral factor.” The paired ratings are combined normally, then 10% of that combined value is added before the result folds into the overall calculation.³ A 2023 rule added an exception: if the bilateral factor would actually produce a lower overall rating, the VA must exclude those disabilities from the bilateral calculation so the veteran gets the more favorable result.⁴

Tinnitus

Tinnitus is a persistent ringing, buzzing, or clicking in the ears, and it is the single most commonly claimed VA disability. Over 3.2 million veterans receive compensation for it.⁵ Its prevalence comes from the noise exposure that runs through military life. Gunfire can exceed 155 decibels, and aircraft, heavy equipment, and blast events add cumulative damage.⁶

The VA assigns a flat 10% rating for tinnitus under Diagnostic Code 6260, whether one or both ears are affected.⁵ That 10% is the maximum schedular rating for the condition on its own.⁷ Service connection requires a current diagnosis, evidence of an in-service noise exposure event, and a nexus letter linking the two. Because no objective clinical test can disprove tinnitus, it is widely considered one of the more straightforward claims to establish.

Hearing Loss

Hearing loss ranks among the top three most commonly claimed conditions and is closely tied to tinnitus. The VA rates it under 38 CFR § 4.85 using two tests performed by a licensed audiologist: a puretone audiometry test measuring hearing thresholds at specific frequencies, and a controlled speech discrimination test using the Maryland CNC word list.⁸

Each ear is assigned a Roman numeral designation from I through XI based on the combination of its puretone average and speech discrimination score. The two designations are then matched on a third table to produce the percentage rating. If only one ear is service-connected, the other is treated as normal hearing (Roman numeral I) for rating purposes.⁸ The clinical precision of this process means hearing loss ratings often come in lower than veterans expect.

Knee Conditions

Knee injuries affect roughly 1.66 million veterans receiving VA compensation. The VA evaluates knee disabilities under 38 CFR § 4.71a, and a single knee can receive more than one rating if it has distinct manifestations. Limited flexion, limited extension, and instability can each be rated separately.

The main diagnostic codes and their ranges:

Limitation of flexion (DC 5260) is rated 0% to 30% depending on how far the knee bends. A 10% rating applies when flexion is limited to 45 degrees; 30% requires limitation to 15 degrees.
Limitation of extension (DC 5261) is rated 0% to 50% based on inability to straighten the knee. A 10% rating corresponds to extension limited to 10 degrees; the maximum 50% requires limitation to 45 degrees.
Instability (DC 5257) is rated 10%, 20%, or 30% based on severity of recurrent subluxation or lateral instability.
Total knee replacement (DC 5055) is automatically rated 100% for four months post-surgery, with a minimum permanent rating of 30% after.

Even with full range of motion, a veteran should receive a minimum 10% rating if painful motion is demonstrated, and the VA must consider functional loss from pain, flare-ups, and interference with daily activities. If arthritis is confirmed by X-ray, Diagnostic Code 5003 typically supports a 10% or 20% rating.⁹ Veterans with bilateral knee conditions benefit from the bilateral factor.

PTSD

Post-traumatic stress disorder accounts for more than 1.34 million veterans receiving compensation. It is rated under the General Rating Formula for Mental Disorders at 38 CFR § 4.130, which measures levels of occupational and social impairment rather than specific symptom checklists.

0%: diagnosed, but symptoms do not interfere with functioning or require medication.
10%: mild or transient symptoms that reduce efficiency only during significant stress, or symptoms controlled by continuous medication.
30%: occasional decrease in work efficiency, with symptoms like depressed mood, anxiety, chronic sleep problems, or mild memory loss.
50%: reduced reliability and productivity, with symptoms such as flattened affect, frequent panic attacks, or impaired memory.
70%: deficiencies in most areas of life, with symptoms like suicidal ideation, obsessional rituals, near-continuous panic or depression, or inability to maintain relationships.
100%: total occupational and social impairment, with persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger to self or others, or disorientation.

To establish service connection, a veteran must show a qualifying stressor (exposure to actual or threatened death, serious injury, or sexual violation) and a diagnosis meeting DSM-5 criteria. The evaluation must be conducted by a board-certified psychiatrist or a licensed doctorate-level psychologist.¹⁰ The stressor can be established through direct experience, witnessing the event, learning it happened to a close family member, or repeated professional exposure to traumatic details.¹¹

Back and Spinal Conditions

Spinal injuries round out the top five, with roughly 1.33 million veterans receiving compensation. Back conditions are rated primarily on limitation of motion and can generate secondary claims for radiculopathy, which is rated separately under the peripheral nerve codes.

Sciatica is the most common form of radiculopathy affecting the lower extremities. Under Diagnostic Code 8520, it is rated based on the severity of sciatic nerve paralysis:

10% for mild incomplete paralysis.
20% for moderate incomplete paralysis.
40% for moderately severe incomplete paralysis.
60% for severe incomplete paralysis with marked muscular atrophy.
80% for complete paralysis, where the foot dangles and drops with no active movement below the knee.

When the impairment is wholly sensory, meaning numbness and tingling without motor involvement, the rating is capped at the mild or moderate level.¹² Because radiculopathy often affects both legs, the bilateral factor applies. A single back injury can produce three separate ratings: the spine itself and both legs.

Depression and Anxiety

Depression and generalized anxiety disorder use the same General Rating Formula for Mental Disorders that governs PTSD, with the identical 0% to 100% impairment scale. Major depressive disorder falls under Diagnostic Code 9434, and generalized anxiety disorder is coded at 9400.¹¹ These conditions are frequently filed as secondary claims. A veteran with chronic pain from a service-connected knee or back injury, for example, may develop depression as a result. When approved secondary, the mental health rating combines with existing ratings and can push a veteran into a higher bracket.

Sleep Apnea

Obstructive sleep apnea is rated under Diagnostic Code 6847. Under current criteria:

0%: documented but asymptomatic.
30%: persistent daytime hypersomnolence.
50%: requires a breathing assistance device such as a CPAP machine.
100%: chronic respiratory failure with carbon dioxide retention, cor pulmonale, or the need for a tracheostomy.

Those criteria are under active review. The VA proposed a rule that would eliminate the automatic 50% rating for CPAP use and instead base ratings on how symptomatic the condition remains after treatment.¹³ Under the proposed framework, a veteran who is asymptomatic on CPAP would receive 0%, one with incomplete relief would receive 10%, and higher ratings would be reserved for cases where treatment is ineffective or cannot be used.¹⁴ After pushback from lawmakers and veterans service organizations, the VA paused implementation and said no immediate changes to existing benefits were being enacted during the review. Existing ratings are generally protected unless there is evidence of actual medical improvement.

Migraines

Migraine headaches are rated under Diagnostic Code 8100 based on the frequency and severity of “characteristic prostrating attacks,” which are episodes causing extreme exhaustion or powerlessness:

0%: service-connected but not meeting compensable criteria.
10%: prostrating attacks averaging once every two months.
30%: prostrating attacks averaging once a month.
50%: very frequent, completely prostrating and prolonged attacks capable of producing severe economic inadaptability.

At the 50% level, the attacks do not need to have actually made the veteran unemployable; they only need to be capable of producing a severe inability to function economically.¹⁵ Migraines are also commonly claimed as secondary to traumatic brain injuries or PTSD medications.

Gastrointestinal Conditions

GERD and irritable bowel syndrome are frequently claimed both as primary conditions and as secondary effects of PTSD, anxiety, or medications used for other service-connected disabilities. GERD is typically rated under Diagnostic Code 7346 (hiatal hernia), at 10%, 30%, or 60% based on epigastric distress, regurgitation, pain, and weight loss. IBS is rated under Diagnostic Code 7319 at 0%, 10%, or 30%. The VA does not combine GERD and IBS ratings; a single evaluation is assigned based on whichever condition predominates.¹⁶

In May 2024, the VA updated the rating schedule for 55 digestive conditions. Changes included a standalone diagnostic code for celiac disease (rated up to 80%, up from 30%), an adjustment ensuring every IBS evaluation is compensable, and a new 10% minimum for mild or moderate hemorrhoids that previously received 0%.¹⁷ Existing ratings were not reduced; veterans can apply for an increase if they believe the new criteria favor them.

PACT Act Presumptive Conditions

The Sergeant First Class Heath Robinson PACT Act, signed in 2022, expanded the universe of claimable conditions by establishing presumptive service connections for veterans exposed to burn pits, Agent Orange, radiation, and other toxic substances. “Presumptive” means the VA assumes military service caused the condition, so the veteran does not need to independently prove the link. They only need to show they served in a qualifying location during a qualifying period.¹⁸

The Act added presumptive respiratory conditions including asthma diagnosed after service, chronic bronchitis, COPD, chronic rhinitis, chronic sinusitis, and interstitial lung disease. It also established presumptive connections for more than a dozen cancer types, including brain, gastrointestinal, respiratory, reproductive, and pancreatic cancers, and added hypertension as a presumptive condition for veterans exposed to Agent Orange.¹⁹

As of May 2024, the overall grant rate for PACT Act claims was 75%. Among frequently claimed conditions, hypertensive vascular disease had a 71% grant rate across more than 342,000 claims, and allergic rhinitis had a 79% grant rate across more than 232,000 claims.²⁰ Veterans whose prior claims were denied for conditions now covered under the PACT Act can file a Supplemental Claim for a new review.

Secondary Conditions

A secondary condition is a disability caused or worsened by an already service-connected condition, even if it has no direct link to military service itself. Common examples include arthritis in the hip or ankle from a gait altered by an injured knee, sleep apnea tied to PTSD, gastrointestinal problems from medications prescribed for a service-connected condition, and depression from chronic pain.²¹

To establish a secondary claim, the veteran needs medical evidence linking the primary and secondary conditions. A nexus letter from a physician stating how the primary condition led to or aggravated the secondary one is the most effective tool. Once approved, the secondary condition gets its own rating and combines with existing ratings, which can move a veteran closer to Total Disability Individual Unemployability (TDIU), the 100% compensation rate for veterans who cannot maintain substantially gainful employment because of their service-connected conditions.²¹

Filing the Claim

Veterans file using VA Form 21-526EZ, submitted online at va.gov, by mail, in person at a regional office, or by fax.²² Before filing the full application, you can submit an Intent to File, which sets a potential effective date. If the claim is later approved, retroactive pay may reach back to the ITF date rather than the date the completed application arrived. An ITF gives you one year to file the formal claim.²³ For online filers, the effective date is set automatically when the application is started, so a separate ITF is unnecessary.

After filing, the claim moves through initial review, evidence gathering, evidence review, rating, and final decision. The VA may schedule a Compensation and Pension exam; missing that exam can result in denial. As of early 2026, average processing time was about 76 to 77 days.²⁴

Why Claims Get Denied

The three most frequent reasons the VA denies claims are that medical evidence does not show a current clinical diagnosis, that the condition was not incurred in or caused by military service, and that the evidence does not meet the requirements for presumptive service connection.²⁰ Many of these denials are avoidable.

Waiting to file until every piece of evidence is gathered is a common and costly error. Filing early preserves an earlier effective date, and the VA allows up to a year for supplemental documentation.²² Relying only on the C&P exam without obtaining an independent nexus letter is another frequent problem. A letter from a private provider stating the condition is “at least as likely as not” connected to service can be the difference between approval and denial. Submitting large volumes of irrelevant medical records can also bury the pertinent evidence and slow the process.

Perhaps the most consequential mistake is walking away from a denial. Veterans who disagree with a decision have three review options under the Appeals Modernization Act: a Supplemental Claim with new evidence, a Higher-Level Review, or a Notice of Disagreement to the Board of Veterans’ Appeals. Failing to act within the required timeframe forfeits the original effective date. Veterans service organizations, accredited claims agents, and attorneys who specialize in VA law can assist with both initial filings and appeals, often at no upfront cost.

1
Hill & Ponton. Top VA Disability Claims
2
U.S. Department of Veterans Affairs. About VA Disability Ratings
3
Cornell Law Institute. 38 CFR § 4.26 – Bilateral Factor
4
Federal Register. Exceptions to Applying the Bilateral Factor in VA Disability Calculations
5
Hill & Ponton. Tinnitus Claimed Disability VA
6
Veterans Guide. Hearing Loss and Tinnitus
7
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision A22022950
8
eCFR. 38 CFR § 4.85 – Evaluation of Hearing Impairment
9
CCK Law. VA Disability Benefits for Knee Pain
10
U.S. Department of Veterans Affairs. PTSD Review Disability Benefits Questionnaire
11
Cornell Law Institute. 38 CFR § 4.130 – Schedule of Ratings, Mental Disorders
12
eCFR. 38 CFR § 4.124a – Schedule of Ratings, Neurological Conditions
13
Military.com. VA Rewriting Big Pieces of Disability Rating Playbook
14
CCK Law. Sleep Apnea VA Disability
15
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision A22005658
16
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision 23005521
17
VA News. VA Updates Disability Rating Schedule for Digestive System
18
U.S. Department of Veterans Affairs. The PACT Act and Your VA Benefits
19
U.S. Department of Veterans Affairs. Specific Environmental Hazards and VA Disability
20
U.S. Department of Veterans Affairs. VA PACT Act Performance Dashboard
21
Veterans Guide. Secondary Conditions
22
U.S. Department of Veterans Affairs. How to File a VA Disability Claim
23
U.S. Department of Veterans Affairs. Your Intent to File a VA Claim
24
U.S. Department of Veterans Affairs. After You File Your VA Disability Claim