VA Schedule for Rating Disabilities: Percentages and Reductions

The VA Schedule for Rating Disabilities is the federal regulation, codified at 38 CFR Part 4, that converts a veteran’s service-connected medical conditions into percentage-based disability ratings and, from there, into monthly compensation. Every ratable condition is assigned a four-digit diagnostic code with specific medical criteria for each rating level, and when a veteran has more than one condition, a set formula combines those percentages into a single overall rating.¹

How the Schedule Is Organized

The schedule divides the body into fifteen systems, and each system contains its own diagnostic codes and rating instructions. The categories are the musculoskeletal system, the organs of special sense, impairment of auditory acuity, infectious diseases and immune and nutritional disorders, the respiratory system, the cardiovascular system, the digestive system, the genitourinary system, gynecological conditions and disorders of the breast, the hematologic and lymphatic systems, the skin, the endocrine system, neurological conditions and convulsive disorders, mental disorders, and dental and oral conditions.

Each section sets its own method for measuring severity. Respiratory ratings rely heavily on pulmonary function tests. Musculoskeletal ratings turn on range-of-motion measurements and functional loss. Finding your rating starts with identifying which system your diagnosis falls under, then locating the diagnostic code inside that section.¹

How a Single Condition Gets a Percentage

Diagnostic codes run from 5000 to 9999, and each lays out specific medical benchmarks tied to particular percentages. A knee injury rating is driven by measurable degrees of flexion and extension. Other codes depend on lab results, the frequency of flare-ups over a defined period, or whether continuous medication is needed. The percentage that results is meant to reflect the average loss of earning capacity the condition would cause in civilian work.¹

Not every code offers the full 0% through 100% range. Many jump between fixed levels such as 0%, 10%, 30%, and 50%. When symptoms fall between two levels, the adjudicator assigns the one that most closely reflects the veteran’s functional impairment. Notes attached to each code often specify which tests are required or how to interpret particular symptoms, and those annotations can expand or limit how the code applies.

The Benefit of the Doubt Rule

Under 38 CFR 4.3, when the evidence for and against a particular rating level is roughly equal, the VA must resolve that doubt in the veteran’s favor.² If your records show symptoms that could reasonably support either a 30% or a 50% rating, the VA should assign the 50%. In practice this doesn’t always happen, and a decision that acknowledges your symptoms but assigns the lower rating despite close evidence may be a candidate for appeal on that basis alone.

How Multiple Ratings Combine

When you have more than one service-connected condition, the VA does not add percentages together. It uses the “whole person theory,” which starts from the premise that you begin with a 100% efficient body. Each disability is applied against the remaining efficiency, not the original total.³

Here is how that plays out. If your first condition is rated at 20%, you’re considered 80% efficient. A second 20% rating is then applied to that remaining 80%, adding 16% rather than another full 20%. Your combined value becomes 36%, not 40%. Each additional condition chips away at a shrinking pool of remaining efficiency, which is why several moderate ratings rarely add up to 100%.

After everything is combined, the VA rounds to the nearest 10%. Values ending in 1 through 4 round down; 5 through 9 round up. A combined value of 74% becomes 70%. A 75% becomes 80%. That rounding step can mean hundreds of dollars per month, so a single percentage point on one condition can change the final combined rating.³

The Bilateral Factor

Veterans with compensable disabilities affecting both sides of the body get an additional boost. When conditions affect both arms, both legs, or paired skeletal muscles, the VA first combines those bilateral ratings using the standard method, then adds 10% of that combined value before combining it with the remaining disabilities.⁴

If all four extremities are affected, the VA combines all four ratings by severity and applies the 10% factor to the combined figure. The regulation includes a safeguard: if pulling a disability out of the bilateral calculation and combining it separately produces a higher overall rating, the VA must use whichever method benefits you most.⁴

The Rule Against Pyramiding

The VA prohibits rating the same symptoms under more than one diagnostic code. This is known as the anti-pyramiding rule under 38 CFR 4.14.⁵ If a back injury causes both limited motion and nerve pain radiating down one leg, those are two different symptoms and can be rated separately. Counting the same limitation of motion under both a spinal code and a general musculoskeletal code would be pyramiding and is not allowed.

The line between prohibited double-counting and legitimate separate ratings is where many claims get complicated. Injuries to muscles, nerves, and joints in the same extremity often overlap. If you received a single rating for a condition that produces genuinely distinct impairments, it may be worth examining whether separate codes should have been used.

What a 0% Rating Actually Gives You

A 0% rating means the VA recognizes your condition as service-connected but the symptoms don’t currently meet the threshold for monthly payments. That designation still carries real value.⁶

The most immediate benefit is access to VA healthcare for that specific condition. Veterans with service-connected disabilities may also qualify for a clothing allowance if they use a prosthetic device, orthopedic brace, or wheelchair that wears out clothing, or if prescribed medication for a service-connected skin condition damages garments.⁷

The larger benefit is that a 0% rating locks in your service connection. If the condition worsens years later, you only need to show that current symptoms meet the criteria for a compensable percentage. You skip the far harder step of proving the condition originated in or was aggravated by service.

When Ratings Can and Cannot Be Reduced

The VA can reduce a rating if evidence shows improvement, but the longer a rating has been in place, the harder that becomes. Three thresholds matter.

The Five-Year Rule

Once a rating has been in effect for five years, it is considered stabilized. The VA can still reduce it, but must show sustained improvement, meaning a consistent reduction in symptoms over time and under the ordinary conditions of daily life. A single reexamination showing improvement is not enough.

The Ten- and Twenty-Year Rules

After ten years, the VA cannot sever service connection for a disability entirely unless it proves the original grant was based on fraud. The rating percentage can still be adjusted, but the link to service is locked in. After twenty continuous years, the VA cannot reduce your rating below the lowest level it has held during that period. Again, fraud is the only exception.

Due Process Before Any Reduction

Before reducing any rating, the VA must issue a proposed reduction and give you 60 days to submit evidence in response. If you provide medical evidence within that window that justifies reexamination, the VA must order one before making a final decision. The actual reduction takes effect only on the first day of the month following another 60-day period after you are notified of the final decision. That first 60-day response window is the critical deadline.

Permanent and Total Status

Veterans whose disabilities are reasonably certain to continue for life may receive a Permanent and Total designation. The regulation defines this as an impairment sufficient to prevent substantially gainful employment, with permanence meaning the condition is reasonably certain to last the rest of the veteran’s life. Qualifying conditions include the permanent loss or loss of use of both hands, both feet, one hand and one foot, or the sight of both eyes. Long-standing totally incapacitating conditions may also qualify when the chance of improvement is remote, and the veteran’s age can be considered.⁸ Permanent and Total status generally shields veterans from future routine reexaminations.

Reaching 100% Beyond the Schedule

A schedular 100% rating is assigned when medical evidence meets the specific criteria for total disability under a diagnostic code, or when the combined rating calculation reaches 100%. Two other paths exist for veterans whose schedular numbers fall short of that mark.

Individual Unemployability

Total Disability based on Individual Unemployability (TDIU) pays at the 100% rate for veterans who cannot work because of service-connected disabilities but whose schedular rating is lower. You may qualify with one condition rated at 60% or higher, or a combined rating of 70% or higher with at least one condition rated at 40%.⁹

TDIU is not automatic. You must show that your service-connected disabilities actually prevent substantially gainful employment. The question is not whether you can do any job at all, but whether you can hold employment that provides more than a marginal income. The VA can also grant TDIU on an extraschedular basis in exceptional cases, even when the percentage requirements aren’t met.

Extraschedular Ratings

When a disability is so unusual or severe that the standard diagnostic criteria don’t adequately capture the impairment, the Director of Compensation Service can approve an extraschedular rating. The governing standard requires that applying the regular schedule would be impractical because the disability involves factors like marked interference with employment or frequent hospitalization beyond what the assigned rating contemplates.¹⁰ These require referral above the regional office and are not common, but they exist because a standardized schedule will underrate some veterans.

Special Monthly Compensation

Special Monthly Compensation (SMC) provides additional payments on top of regular compensation for veterans with specific severe disabilities. It operates on lettered levels from K through S, each with its own eligibility criteria and payment amount.

SMC-K, the most commonly awarded level, pays an additional $139.87 per month and applies to specific losses such as the anatomical loss or loss of use of a creative organ, one hand, one foot, or the sight of one eye. Veterans can receive up to three simultaneous SMC-K awards for different qualifying losses. Higher levels compensate increasingly severe combinations of disability. For 2026, monthly rates for a veteran without dependents range from $4,900.83 at SMC-L to $11,271.67 at SMC-R.2. SMC-S, the housebound rate at $4,408.53 per month, applies to veterans substantially confined to their home due to service-connected disabilities.¹¹

1
eCFR. 38 CFR Part 4 – Schedule for Rating Disabilities
2
eCFR. 38 CFR 4.3 – Resolution of Reasonable Doubt
3
U.S. Department of Veterans Affairs. About Disability Ratings
4
eCFR. 38 CFR 4.26 – Bilateral Factor
5
eCFR. 38 CFR 4.14 – Avoidance of Pyramiding
6
U.S. Department of Veterans Affairs. Non-compensable Disability
7
Office of the Law Revision Counsel. 38 US Code 1162 – Clothing Allowance
8
eCFR. 38 CFR 3.340 – Total and Permanent Total Ratings and Unemployability
9
U.S. Department of Veterans Affairs. Individual Unemployability If You Can’t Work
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eCFR. 38 CFR 3.321 – General Rating Considerations
11
U.S. Department of Veterans Affairs. Special Monthly Compensation Rates