Understanding the VA Combined Ratings Table

Have you ever received a backpay award that was a lot less than you thought it was going to be?

Have you ever believed you would receive a backpay award for an Agent Orange condition like coronary artery disease or diabetes, but nothing ever came and your monthly award didn’t change?

Don’t worry. Your math isn’t wrong. The VA just does things differently.

A very common question for veterans with several service-connected conditions is why their VA overall rating seems so low when compared to the ratings they have been assigned.

The answer is due to the VA’s Combined Ratings Table, found at 38 C.F.R. § 4.25.

Understanding VA Math for Multiple Disabilities

Basic math won’t work if you are trying to determine how much money you can expect in VA disability benefits. The VA doesn’t simply add up disability percentages, as you might expect.

Calculations are relatively simple for a veteran with only one disability. He or she applies for benefits and gets a rating based on that one condition. But if you are like so many veterans, you are living with multiple disabilities stemming from your time in service – and that’s where the rating process gets trickier.

The VA uses a distinct methodology to determine a combined rating for veterans with multiple disabilities. The scale does not use simple addition. For example, a 50 percent disability for sleep apnea, plus 30 percent for lower back pain, plus 10 percent caused by a traumatic brain injury does not equal a 90 percent combined disability rating. Instead, it’s 70 percent.

How could that be?

The VA begins the evaluation process assuming every veteran is 100 percent healthy. It then rates his or her disabilities in order of severity.

Here’s how it works for the above example:

  • Using VA math, the veteran with sleep apnea is 50 percent disabled and 50 percent non-disabled based on that one condition.
  • Then, it calculates how the 30 percent lower back pain disability affects the non-disabled 50 percent of this veteran. (30 percent x 50 percent = 15 percent). In other words, the VA doesn’t apply the 30 percent disability to the veteran’s total non-impacted percentage. Instead, it applies it to the remaining 50 percent after factoring in the sleep apnea rating.
  • The VA adds 50 percent plus 15 percent to determine that the veteran is 65 percent disabled by sleep apnea and back pain.
  • This means that the veteran is 35 percent non-disabled.
  • Next, it calculates how the remaining 10 percent disability affects the non-disabled 35 percent of this veteran. (10 percent x 35 percent = 3.5 percent).
  • The VA adds 65 percent plus 3.5 percent to determine that the veteran is 68.5 percent disabled.
  • Rounded up to the nearest 10 percent, the final combined disability rating is 70 percent.  

How the Combined Ratings Table Works    

For someone who has never seen the VA Combined Ratings Table, it just looks like a grid of random numbers. But for a veteran who is counting on compensation to make ends meet, it is important to understand how to navigate the table.

The theory behind the Combined Ratings Table is that it considers each disability rating as limiting the veteran’s ability to work. A good analogy to this is to consider each veterans’ “ability to work” as a pie (or pizza, if you prefer). With no disability ratings, the VA views a veteran as having full capacity to work. Should a veteran receive a disability rating, for instance 50%, the VA views the veteran as having a 50% remaining “ability to work.”

100% – 50% = 50%

If we take that same veteran, and the VA grants an additional 30% disability for sleep apnea, then the Combined Ratings Table comes in to play. In this case, the VA removes the highest-rated disability from the “ability to work” pie first. So, as above, the veteran only has a 50% “ability to work” remaining.

The VA would then remove 30% more ability to work based on the remaining “ability to work”, or in this case, remove 30% from the remaining 50% “ability to work” pie. To find the percentage to add, you must multiply the additional disability by your ability to work. In this case, the Veteran is 50% able to work.

30% x 50% = 15%

So, take the 50% initial rating and add 15% for sleep apnea. The Veteran is left with a total rating of 65%. Since the VA rates in 10% increments, the overall rating would round up to 70%.

Each additional disability that is service connected is subject to this type of ‘diminished return’ as it removes a smaller and smaller piece of the remaining “ability to work” pie.

While this can be extremely frustrating seeing newly connected disabilities failing to change your overall rating, it does not always mean that seeking service connection for those disabilities won’t be helpful in the long run.

How to Use the Combined Ratings Table

The combined ratings table is often confusing.

Let’s use the disability ratings from the above example:

  • 50 percent sleep apnea
  • 30 percent back pain
  • 10 percent TBI

Using the table:

  • Find the degree of the greatest disability (50 percent from sleep apnea) in the left column.
  • Find the degree of the next highest ranked disability (30 percent from back pain) in the top row.
  • The percentage in the space where the selected row and column intersect (65) represents the combined value for the two disabilities.
  • Repeat this process, now starting with the combined value of 65, for the third disability. Match 65 in the left column with 10 percent (for the TBI) in the top row to get 69.
  • Round the final combined value of 69 to the nearest 10 to get a combined disability rating of 70 percent.

The Bilateral Factor

If you have service-connected disabilities for both arms, both legs, or paired skeletal muscles, consider the bilateral factor when calculating your combined rating. Under this rule, a veteran adds 10 percent to his or her combined rating for the bilateral disabilities. The disabilities do not have to mirror each other exactly. They do have to affect the same extremities, though (all upper extremity conditions, or all lower limb disabilities).

Let’s assume the following disability ratings:

  • 20 percent left wrist condition
  • 10 percent right elbow condition

Accounting for the bilateral factor:

  • Consulting the VA Combined Ratings Table, you would have a combined rating of 28.
  • Add 10 percent to this rating. (28 + 2.8 = 30.8)
  • The new rating would be rounded to 31 percent to combine with the other disabilities or rounded down to 30 if standing alone.

If you need help understanding the VA Combined Ratings Table or believe the VA hasn’t rated you correctly, please contact us online for a free consultation or call us now.