Rating Logic
The VA pyramiding rule (38 CFR 4.14) prevents a veteran from receiving multiple disability ratings for the same exact symptom or functional impairment, even if it is caused by multiple conditions.
This page explains a concept. It is not the current, authoritative list. Confirm details directly with VA before relying on anything here.
Pyramiding is the evaluation of the same disability or the same manifestation under various diagnoses. Under 38 CFR 4.14, VA regulations explicitly prohibit this practice. A veteran cannot be compensated more than once for the same functional loss or symptom, regardless of how many separate medical diagnoses cause it.
When a veteran has multiple conditions that produce identical symptoms, for example, two different respiratory conditions that both cause shortness of breath, VA will generally assign a single rating that reflects the overall severity of that symptom, rather than adding two separate ratings together. If the conditions affect distinct body parts or have completely separate symptoms, they may be rated separately.
The pyramiding rule does not prevent separate ratings when conditions affect the same body system but produce separate and distinct symptoms. For example, a veteran may receive separate ratings for a knee condition if there is distinct documentation of limited range of motion, instability, and painful motion, provided each rating addresses a separate functional impairment.
Explore published rating criteria, evidence requirements, and diagnostic codes for related conditions.
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Jump to the regulatory criteria section to evaluate the baseline requirements.
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See how multiple disability ratings combine under 38 CFR §4.25.