Rating by Analogy in VA Disability Claims

The VA has hundreds of diagnostic codes that recognize disabilities that were caused by military service. The codes run the gamut from physical injuries to cancers, heart problems or lung problems stemming from chemical exposures, traumatic brain injury from IEDs, and PTSD or other mental health conditions from the stressors of war. Typically, if it is something that can affect the human body, the VA should have a code for it. But what if the VA does not have a diagnostic code for your specific service-caused condition? If this is the case, the VA will use a rating by analogy to rate the condition.

Rating By Analogy

The VA does not have a code for every single possible disability. It would be a herculean task for any one organization to document every possible thing that can go wrong with a person’s body or mind. So, for situations where a disability is not listed in the ratings schedule, the “analogous ratings” rule applies.  When the veteran has an unlisted condition caused by service, the rater should rate the condition under a closely related disease or injury.

The VA is supposed to consider three factors when deciding on analogous ratings:

  1. the function affected by the conditions
  2. the location of the conditions
  3. whether the symptoms are similar

Once the VA decides to assign an analogous code, it evaluates the veteran’s injury as if it were the analogous condition. That means if your symptoms are close to the rating percentage in the analogous code, you will get rated at that percentage.

Examples of rating by analogy include balance disorders which also cause dizziness and tinnitus. This could be rated as labyrinthitis or injury of blood vessels to the brain. Lymph disease may be rated as Hodgkin’s disease. Runner’s knee may be rated as arthritis. Sternoclavicular separation may be rated as limitation of motion of the arm. Psychiatric disorders not listed in the VA’s ratings schedule may also be rated. Ratings by analogy is an often-confusing concept, especially for those unfamiliar with the VA’s rating system. Not only is the system confusing, but there are also exceptions to the rules.

Exceptions

Some conditions may not be rated by analogy. Conditions actually listed in the rating schedule may not be rated by analogy. This makes sense, as the analogous rating system is meant to compensate veterans when their disability is not listed at all. This means that a veteran cannot take advantage when a different diagnostic code would give a higher rating. However, if the veteran’s disability is actually more similar to a different diagnostic code, they may be able to get a new diagnosis.

VA Disability Lawyers

Understanding what the VA is trying to say can be difficult. Veterans applying for disability benefits who have been denied or rated too low often contact our team, saying they are overwhelmed by the process or just confused. If you or somebody you know needs assistance appealing an in unfavorable VA rating, contact our team of dedicated VA appeals attorneys today to schedule a free, confidential consultation.