General Rating Rules

VA disability ratings measure the average impairment in earning capacity that results from a service-connected condition — not the severity of pain, not the medical complexity, and not how much the condition affects your personal life. A rating of 30% means the VA estimates that, on average across all Veterans with that condition at that severity, the condition reduces earning capacity by 30%.

When the evidence for and against a claim is in "approximate balance" — meaning it could reasonably go either way — the VA must resolve the question in the Veteran's favor. This applies to both service connection decisions and rating level decisions. The Veteran does not need to prove their case beyond a reasonable doubt; they need only show that it is at least as likely as not.

When a condition reasonably fits two different rating levels, the VA must assign the higher rating. For example, if a condition could be rated either 30% or 50% based on the documented symptoms, the rater must assign 50%. This rule applies when the evidence does not clearly support one level over the other.

If a VA examination report is unclear, inconsistent, or incomplete, the VA must return it to the examiner for clarification rather than deny the claim based on the deficient report. The Veteran should not be penalized for a poorly written C&P exam. If an examiner fails to address a claimed condition or provides only a conclusory opinion without rationale, the report may be legally inadequate.

The same disability cannot be rated twice under different diagnostic codes. If two diagnostic codes describe the same clinical picture, only one rating applies — the one most favorable to the Veteran. However, if two conditions are genuinely separate (different etiology, different symptoms, different body structures), both can be rated independently even if they overlap anatomically.

Raters must consider the Veteran's condition in the context of their entire medical picture and occupational history — not just the isolated test results. A condition that would be minor for most people may be more disabling for a Veteran whose occupation requires the specific function that is impaired. Functional impairment in the context of the Veteran's life and work is what matters.

The VA must consider all evidence of record — VA records, private treatment records, military records, lay statements, buddy statements, personal statements, and IMOs (Independent Medical Opinions). No single piece of evidence automatically outweighs another. A treating physician's opinion carries weight, but so does a well-documented lay statement from the Veteran or a family member.

Multiple ratings are not simply added together. The VA uses a "whole person" method: start with 100% (a whole, unimpaired person). Apply the highest rating first — this leaves a remainder. Apply the next rating to that remainder, and so on. The result is rounded to the nearest 10%. Example: 50% + 30% does not equal 80%. It equals 50% + 15% (30% of the remaining 50%) = 65%, rounded to 70%.

When a Veteran has service-connected disabilities affecting both paired extremities (both arms, both legs, or both arms and legs), a 10% factor is added to the combined value of those bilateral disabilities before they are combined with any remaining disabilities. This recognizes that losing function on both sides of the body is more than twice as disabling as losing one side.

A joint or muscle condition is not rated solely on range of motion measurements. Pain on motion, weakened movement, excess fatigability, incoordination, and instability are all forms of functional loss that must be considered — even when the measured range of motion appears near-normal. The VA must account for functional loss from pain even if the Veteran can technically move the joint to the normal endpoint.

For joint conditions, raters must consider tenderness, swelling, heat, and the occurrence and frequency of flare-ups. A Veteran's own statement about how often flare-ups occur, how severe they are, and what activities trigger them is competent lay evidence. The rater cannot dismiss flare-up history simply because no flare-up occurred during the C&P exam.

A Veteran who cannot maintain substantially gainful employment due to service-connected conditions may be entitled to compensation at the 100% rate — even if their combined schedular rating is below 100%. The basic eligibility thresholds are: one condition rated at 60% or higher, OR two or more conditions with a combined rating of 70% or higher where at least one is 40% or higher. Marginal employment (below the federal poverty threshold) does not count as substantially gainful employment.

Separate from TDIU, a Veteran may reach a 100% schedular rating two ways: a single condition rated at 100% on the schedule, or multiple conditions whose combined rating (under §4.25) reaches 95% or higher, which rounds to 100%. Some conditions — like certain cancers, active TB, certain heart conditions — have 100% ratings built into the schedule. A schedular 100% is permanent until the condition improves; TDIU can be severed if the Veteran returns to substantially gainful employment.

Once a rating has been in place for a certain amount of time, the VA faces a higher burden to reduce it. After 5 years, the VA must show sustained improvement under ordinary conditions of life, not just a single better exam. After 10 years, the VA cannot sever service connection entirely (except for fraud). After 20 years, the rating cannot be reduced below its lowest level during that 20-year period — it is effectively protected at that floor.

A disability that has been continuously rated at or above a certain level for 20 or more years is considered a "continuous rating" and cannot be reduced below that level. This is the strongest protection available. Example: if you have been rated 30% for a knee condition for 20 years, that 30% floor is permanent barring proof of fraud.

The VA may schedule reexaminations when it has reason to believe a condition has improved. However, it may NOT schedule a reexamination if the disability is static (unlikely to improve), is the result of an irreversible condition, or is a disability of a Veteran over age 55. Routine "check-in" exams to look for improvement are not authorized once a rating has stabilized.

A Veteran (and anyone who observed the Veteran) is competent to testify about observable symptoms — pain, limited motion, difficulty sleeping, emotional symptoms, functional inability. Lay evidence does not require medical training. A statement that says "I cannot stand for more than 10 minutes without severe pain" is competent evidence of that fact. Lay evidence alone, combined with a plausible nexus, can establish service connection.

Before denying a claim or assigning a final rating, the VA must make a reasonable effort to help the Veteran gather evidence — ordering C&P exams, requesting military records, and attempting to obtain private treatment records when the Veteran identifies them. If the VA fails to fulfill this duty and then denies the claim, the denial can be challenged on that basis.