The Rating Schedule
The Veterans Benefits Administration (VBA) uses the Schedule For Rating Disabilities in conjunction with M21-1 Adjudication Procedures Manual to determine what rating to award Veterans depending upon the severity of their disability and any other applicable policies and regulations.
The Rating Schedule
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The Veterans Benefits Administration (VBA) uses the Schedule For Rating Disabilities in conjunction with M21-1 Adjudication Procedures Manual to determine what rating to award Veterans depending upon the severity of their disability and any other applicable policies and regulations.
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IMPORTANT
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DO NOT misuse the schedule! To misrepresent the severity of your condition is a CRIME! Please use the schedule more as a means to understand what the VA is looking for. So you have a better understanding of how to explain your impairment or to simply learn how your condition is rated. Do NOT treat the schedule as a check list of things to say or do!
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Due to the sheer size of the schedule, this write up has been broken up into various systems and then broken down further into the various sub-components. While you are free to read the rating schedule and M21-1 yourself, you may find that these write ups are better organized and easier to understand.
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The following write ups are based upon the latest November 2021 rating schedule.
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Master Reference List
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If you would like to search the rating schedule by condition name click HERE.
Alternatively, you can search by VA Diagnostic Codes HERE.
Otherwise, feel free to navigate the schedule, using the following table.
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Rating Schedule Major Sections
Major Section
Description
Heart, blood, vein, and artery issues
Things the VA will not service connect/rate
Jaw, jaw joint, palates, and teeth.
Abdomen & peritoneum, cancers & tumors, esophagus, gallbladder, hepatitis, hernias, and intestines
Adrenal conditions, cancers & tumors, diabetes, parathyroid conditions, pituitary conditions, pluriglandular syndrome, and thyroid conditions
Breasts, cancers & tumors, endometriosis, fallopian tubes, fistulas, ovaries, uterus, vagina, vulva, and cervix
Cancers & tumors, renal conditions, penis & testis, tuberculosis, urinary conditions
Analogous and Equivalent Disabilities
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Due to the the sheer volume and duplication of symptoms that the human mind and body can have, it is impractical for the rating schedule to have a rating for every single disability by name. In such cases that the Veteran's disability/disease/condition is not mentioned by name in the rating schedule, it will be rated under the most comparable rating.
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Take for instance, there is only a rating for migraine type headaches in the schedule. If the Veteran has a diagnosis of headaches, the VA will rate under the migraine schedule.
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Convalescent Rating (Temporary 100% Rating)
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If the Veteran meets at least ONE of the following eligibility requirements following their hospital discharge they will be entitled to a temporary single rating of 100%.
Unless the rating schedule specifies, the temporary ratings can range from 1 to 3 months. If a medical professional determines the Veteran needs additional time the Veteran may get file to get extensions up to a total of 6 months. Veterans who may require further extensions can get up to another 6 months if approved by the Veterans Service Center Manager.
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Eligibility
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The surgery or procedure MUST be done on something that is service connected AND
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Surgery requires at least one month of convalescence;
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Surgery with severe postoperative residuals such as incompletely healed surgical wounds, stumps of recent amputations, therapeutic immobilization of one major joint or more, application of a body cast, the necessity for house confinement, or the necessity for continued use of a wheelchair or crutches (regular weight-bearing prohibited); OR
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Immobilization by cast, without surgery, of one major joint or more.
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After the convalescent period ends. The Veteran's disability will be Reevaluated. If the schedule dictates a minimum rating the Veteran will get that, unless the Veteran's level of disability rates higher.
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NOTES:
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Depending upon the Veteran's existing ratings they may become eligible for SMC S during their period of convalescence.
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If the rating schedule specifies a Veteran will get say 6, 12, etc. months of temporary 100% rate, the Veteran will get an additional month of 100%. So the Veteran will in effect have 7, 13, etc. months of temporary 100%.
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If the Veteran retroactively becomes service connected for something that made them eligible for a convalescent rating, they can file to get back pay - SO LONG AS the effective day is before or during the Veteran's convalescent time period.
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If the Veteran needs an extension of their temp 100% due to their condition taking longer to recover, the Veteran can request an extension of up to 3 months by providing the VA medical evidence from their doctor demonstrating the need.
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Filing for Temporary 100%
The Veteran can seek the aid of a VSO or file via a VA Form 21-536ez.
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NOTE:
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If the Veteran had the surgery at a VA facility, the VA should handle the claim for the Veteran. In this case the Veteran should not need to file themselves.
Hospitalizations (Temporary 100% Rating)
Veterans who are hospitalized at a VA hospital or at an approved hospital for 22 or more continuous days due to a service-connected condition will be paid at the 100% rate, going back to the day that they were admitted to the hospital.
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This 100% rating will be paid to the end of the month that the Veteran was discharged in*.
*Unless the hospitalization lasted at least six months due to a Mental disorder. In such case, the Veteran will continue to receive the 100% rating for six months, at which point the Veteran will receive a Reevaluation to determine their current level of disability.
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NOTE:
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Depending upon the Veteran's existing ratings they may become eligible for SMC S during their period of convalescence.
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Filing for Temporary 100%
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The Veteran can seek the aid of a VSO or file via a VA Form 21-536ez.
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NOTE:
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If the Veteran is hospitalized at a VA facility, the VA should handle the claim for the Veteran. In this case the Veteran should not need to file themselves.
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Extra Scheduler
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In exceptional or unusual circumstances in which the Veteran has factors such as marked interference with employment or frequent periods of hospitalization, the VA Director of Compensation Service may grant a rating that is higher than what is provided for in the rating schedule. Do know, these cases are exceptionally rare!
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Incarcerated Veterans
Veterans who are incarcerated in a Federal, State or local penal institution in excess of 60 days for conviction of a felony will have their disability compensation reduced.
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Reduced Pay
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Rated 20% or higher
Veteran will be paid according to 38 USC § 1114(a). At the time of this writing this is $123.
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Rated 10%/paid at 10%
Veteran will be paid half the rate of 10%.
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Apportionment
If the Veteran's spouse/dependents rely on the Veteran's disability compensation, they may appeal to have all or part of the money that was reduced from the Veteran's compensation paid to themselves. This appeal will be based upon a demonstrated need.
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NOTES:
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If the Veteran receives any SMCs they will not be paid.
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If the Veteran's conviction is overturned on appeal, the Veteran's disability pay minus any apportioned money will be returned to the Veteran.
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Protections
Veterans who have held their ratings for the following number of continuous years have the following legal protections. However, if there was fraud involved then there are NO protections given! Errors on the part of the VA are not fraud.
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5 years - Reductions
A Veteran's rating cannot be reduced based upon a single C&P exam or records review that has determined that the Veteran's disability has improved. In the event that the Veteran has shown improvement they will very likely be given another reevaluation. If the condition is still improved the Veteran will receive a Proposal for reduction.
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10 years - Service-Connection
A Veteran's service-connection for a disability cannot be severed, barring the aforementioned fraud or if it is clearly shown from military records that the Veteran did not have the requisite service period or character of discharge.
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The Veteran's erroneously service-connected condition is eligible for increases, if an increase is warranted.
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If the Veteran's erroneously service-connected condition causes other disabilities, they can be service-connected on a secondary basis.
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20 years - Total Protection
A Veteran's rating cannot be reduced.
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Example involving increase
*Condition A has been held for 10 years, no matter the rating percentage. However, the 5 year protection only applies to the 10% rating and not the newly increased rating of 30%.
**Only the 10% rating has the 20 year protection, as it has been held for 20 years.
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Other Protections
Protections that are not based on age of award.
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Amputation
In the event that a Veteran has to have a non-service connected amputation that removes something that was service connected, the Veteran's rating will continue in force and not be reduced or removed.
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Changes in the Schedule
In the event that the rating schedule changes, the Veteran will be grandfathered under the older schedule. Do know that in the event it is found that the Veteran has improved as per their grandfathered schedule, the Veteran will then have their rating reduced and rated per the current rating schedule.
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Aged over 55
IMPORTANT NOTE:
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This is a common misconception as it is NOT actually a form of rating protection.
What being aged over 55 or more does do is:
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The VA will not establish regularly scheduled reexaminations - in most cases. Effectively, making the condition static.
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Some cases that will require regularly scheduled reexaminations include:
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Surgery of a service connected disability
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Cancers
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Infectious diseases such as Tuberculous
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So, if the Veteran decides to file a claim on a Secondary basis. The VA CAN reevaluate the primary condition, and if appropriate - reduce the rating of the primary condition!
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Amputation Rule
A Veteran CANNOT get a Combined VA rating higher for musculoskeletal conditions for a limb than if it was amputated.
For example:
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If a Veteran had their right dominant arm amputated above the elbow they would be awarded a rating of 80%.
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Another Veteran could NOT have a Combined VA rating higher for ratings that involve their Elbow/forearm, Wrist, and/or Hand.
IMPORTANT NOTES:
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The amputation rule does NOT apply to evaluations of peripheral nerve disabilities of the extremities including, but not limited to, diabetic neuropathy, radiculopathy/sciatica due to a spinal disorder, or peripheral nerve injuries of non-musculoskeletal etiology.
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The amputation rule does NOT apply to bilateral evaluations assigned under single DCs found in 38 CFR 4.71a, such as those assigned for bilateral foot disabilities, EXCEPT when being compared to a bilateral amputation of the same extremities.
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Pyramiding Rule
The same disability/symptom CANNOT be rated twice.
An example would be a Veteran with two diagnosed issues in their knee that result in reduced range of motion. The Veteran could not get two separate ratings for each diagnosis for the limitation of motion.
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Common Pyramiding Errors
Newer raters are known to sometimes improperly rate disabilities. As such, sometimes they will rate something that they shouldn't. The following are common pyramiding errors. If you have active ratings for any of the following two disabilities. You should contact a VSO BEFORE you file any new claims or increases, as the VA may identify the error(s) and fix them - which could result in you ending up with a lower rating than when you started!
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Sleep apnea & Asthma
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Irritable Bowel Syndrome (IBS) & Gastroesophageal reflux disease (GERD)
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PTSD & TBI*
*Unless the examiner can differentiate the symptoms of both. The rater needs to give the Veteran a single rating for both.
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FAQ
What Happens When the Schedule Changes?
In the event that the rating schedule changes, the Veteran will be grandfathered under the older schedule. Do know that in the event it is found that the Veteran has improved as per their grandfathered schedule, the Veteran will then have their rating reduced and rated per the current rating schedule.
Further, if the new schedule just so happens to be more beneficial, the Veteran's rating will not automatically change.
Do I Need to Seek Treatment to Maintain My Ratings?
No, a Veteran does not need to seek treatment through the VA or otherwise to maintain their ratings. (Some Veterans get confused about this, because Social Security does have this requirement.)
Can My Disability Ratings be Lowered if my Disabilities Improve Due to Medications, other Treatments, or Surgeries?
CONTINUOUS Medication Usage:
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If the schedule specifically mentions medication usage - the Veteran will be rated as stated. This generally results in the Veteran getting a higher rating.
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If the schedule does NOT mention medication usage - so long as the Veteran continues to take their medication they should NOT be reduced. Ultimately, there is no consensus among senior raters - so if there is improvement, you could be reduced or you could stay at the same rating.
Non-Continuous Medication Usage:
The Veteran will be rated upon where their symptoms settle at.
Other Treatments/Surgeries
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Once treatment ends. The Veteran will be rated* upon where their symptoms settle at.
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After surgery the Veteran will receive a Convalescent rating of temporary 100%. After which, the Veteran will be Reevaluated. If the schedule dictates a minimum rating the Veteran will get that. Unless the Veteran's level of disability rates higher.
*If and when the Veteran has a Reevaluation.
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