VA Disability Ratings Explained: From Claim to Combined Rating

What a VA disability rating actually represents

A VA disability rating is a percentage — from 0% to 100% in increments of 10 — that expresses the average earning impairment caused by a service-connected condition. The concept dates to World War I, when Congress created the first veterans' compensation system to replace wages lost to injury in service. Today, the rating system is codified in Title 38 of the United States Code and the implementing regulations in Title 38 of the Code of Federal Regulations.

The rating is not a clinical measure of how sick you are. It is an economic one. A 70% rating for PTSD does not mean you are "70% mentally ill" — it means the VA has determined that the average veteran with your level of PTSD symptomatology experiences a 70% reduction in employability. This distinction matters because two veterans with the same diagnosis can receive very different ratings based on how their symptoms actually affect their daily functioning.

The VA assigns a separate rating for each service-connected condition. A veteran might have a 70% rating for post-traumatic stress disorder, a 20% rating for a lumbar spine injury, a 10% rating for tinnitus, and a 10% rating for a knee condition. The veteran's combined rating — the one that determines monthly compensation — is not the simple sum of these numbers. Instead, the VA applies a specific formula, codified at 38 CFR § 4.25, that produces a single percentage between 0% and 100%.

The five-step claims process

Before any rating is assigned, a claim must travel through five distinct stages. Understanding these stages helps set realistic expectations for the timeline, which typically runs four to nine months for an initial decision but can stretch much longer for complex claims.

1. Claim received. The VA logs your claim (Form 21-526EZ for veterans) and sends an acknowledgment letter. This letter establishes your effective date — the date from which any retroactive benefits will be paid.
2. Initial review. A Veterans Service Representative determines whether your claim is administratively complete: signature, identifying information, and any dependent information. If anything is missing, the claim is returned for correction.
3. Evidence gathering. The VA requests your service treatment records, service personnel records, and any private medical records you identified. The VA is also required to assist you in obtaining these records, though this duty is limited to records that are reasonably obtainable.
4. Examination. If the existing evidence is insufficient to rate your condition, the VA schedules a Compensation & Pension (C&P) examination. The examiner — who may be a VA physician or a contracted provider — completes a Disability Benefits Questionnaire (DBQ) that mirrors the rating criteria for your condition.
5. Rating decision. A Rating Veterans Service Representative (RVSR) reviews the evidence, applies the diagnostic code from 38 CFR Part 4, and issues a Rating Decision (Form 21-4345). The decision specifies the condition, the percentage assigned, the effective date, and the rationale.

How individual ratings are assigned

Each body system has its own section in the VA Schedule for Rating Disabilities (38 CFR Part 4). The musculoskeletal system is in § 4.40–4.73, the mental health system is in § 4.125–4.130, and so on. Within each section, conditions are assigned a diagnostic code (DC) that points to a specific rating table. The table lists the percentage the VA will assign for various levels of severity, usually described in functional terms.

For example, DC 5055 (post-traumatic stress disorder) uses the following general framework: 0% if symptoms are present but do not interfere with occupational or social functioning; 10% if symptoms are mild, with only occasional impairment; 30% if symptoms are mild to moderate, with intermittent occupational impairment; 50% if symptoms are moderate, with reliable occupational impairment; 70% if symptoms are severe, with deficiencies in most areas; and 100% if symptoms are total, with gross impairment in thought processes.

The percentages in the rating tables are not arbitrary. They derive from studies of how specific impairments affect average earning capacity. The VA periodically revises the schedule — most recently overhauling the mental health and musculoskeletal criteria in 2024 — but the underlying methodology has been stable for decades.

The combined-ratings table explained

The combined-ratings table is the source of more confusion than any other part of the VA system. The core principle is straightforward: a person can never be more than 100% disabled. Therefore, each additional disability rating is applied not to the original 100% of the body, but to whatever "healthy" portion remains after previous ratings have been applied.

The arithmetic works as follows. Sort your ratings from highest to lowest. Take the highest rating and combine it with the second-highest using this formula: combined = first + second × (100 − first) ÷ 100. Then combine that result with the third-highest rating using the same formula. Repeat until every rating has been folded in. The final figure is then rounded to the nearest 10%.

The bilateral factor

When a veteran has disabilities affecting both arms, both legs, or paired skeletal muscle groups, the VA applies an additional 10% to the combined value of those bilateral conditions before they are folded into the rest of the rating. The bilateral factor is codified at 38 CFR § 4.26 and exists because the combined effect of bilateral disabilities is greater than the sum of the parts — losing the use of one arm is difficult, but losing the use of both is exponentially more disabling.

For example, a veteran with 10% disability in the right knee and 10% in the left knee would combine those ratings first: 10% + 10% × (100 − 10) ÷ 100 = 19%. The bilateral factor adds 10% of 19%, or 1.9%, for a bilateral subtotal of 20.9%. This subtotal is then combined with any non-bilateral ratings using the standard formula.

Worked example: four conditions

Consider a veteran with the following ratings:

• PTSD — 70%
• Lumbar spine — 20%
• Tinnitus — 10%
• Right knee — 10%

Step 1 — Sort high to low: 70, 20, 10, 10.

Step 2 — Bilateral check: No bilateral conditions (only one knee). Skip.

Step 3 — Apply the combined formula:

• Combine 70 and 20: 70 + 20 × (100 − 70) ÷ 100 = 70 + 6 = 76.
• Combine 76 and 10: 76 + 10 × (100 − 76) ÷ 100 = 76 + 2.4 = 78.4.
• Combine 78.4 and 10: 78.4 + 10 × (100 − 78.4) ÷ 100 = 78.4 + 2.16 = 80.56.

Step 4 — Round to the nearest 10%: 80.56 rounds down to 80%.

At 2025 rates, an 80% combined rating with a spouse and one child pays $2,297.96 per month — about $27,576 per year, tax-free.

You can run this exact calculation on your own conditions using our VA Combined Disability Rating Calculator.

Common mistakes and how to avoid them

Most rating disputes come down to four avoidable mistakes. First, veterans often accept the examiner's DBQ without reviewing it for completeness — a DBQ that omits relevant symptoms can lock in a lower rating. Second, veterans sometimes fail to claim secondary conditions, such as depression secondary to chronic pain, which the VA will rate separately if service-connection is established. Third, veterans miss the one-year window to appeal an unfavorable decision, after which the decision becomes final. Fourth, veterans fail to file for increased ratings when their condition worsens, leaving money on the table for years.

If you receive a rating decision you disagree with, you have three lanes under the Appeals Modernization Act (effective February 2019): a Higher-Level Review by a senior adjudicator, a Supplemental Claim with new and relevant evidence, or a Board Appeal to the Board of Veterans' Appeals. Each lane has different timelines and trade-offs — see our VA appeals guide for the full comparison.

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Last reviewed July 8, 2026. This article is informational and does not constitute legal advice. For claim-specific guidance, consult a VA-accredited representative, VSO, or attorney.