The percentage on a VA decision letter is not a judgment of how much your condition matters. It is the output of a published schedule - and understanding the schedule explains almost every confusing rating decision. The VA summarizes the system on its about disability ratings page.
The rating schedule
Ratings come from the VA Schedule for Rating Disabilities in Title 38, Part 4 of the Code of Federal Regulations. The schedule organizes conditions by body system, and each condition gets diagnostic codes with criteria at specific percentage levels - 0, 10, 20, and so on up to 100.
The rater's job is matching the medical evidence in the file to those criteria. If the record shows the findings listed at the 30 percent level but not the 50 percent level, the rating is 30. This is why what gets documented - at treatment visits and at the C&P exam - drives the outcome.
What the percentage represents
Per the VA, the percentage represents how much the VA estimates the disability decreases your overall health and ability to function. It is not a measure of pain, effort, or deserving - it is a match to published criteria, and it sets the monthly compensation amount.
How multiple ratings combine
Veterans with several service-connected conditions are often surprised by the math: ratings are combined, not added. Under 38 CFR 4.25, the VA treats you as starting at 100 percent efficient. The largest rating is subtracted first, then the next rating applies to what remains, and so on. The result is rounded to the nearest 10.
So 50 plus 50 becomes 75, which rounds to 80. Three ratings of 30 combine to about 66, which rounds to 70. The combined ratings table in the regulation does the arithmetic.
When a rating seems too low
A rating that does not match your documented severity can be challenged through the same decision review options as a denial. And if a service-connected condition has genuinely gotten worse, the rating increase process is the path the VA built for that.
Where veterans start
Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:
- Medical records review
A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.
- Nexus letter
When the records support one, a licensed provider writes the medical opinion that addresses the link between your condition and your service.
The bilateral factor
When a veteran has service-connected disabilities affecting both arms, both legs, or paired skeletal muscles, 38 CFR 4.26 adds a small additional percentage - the bilateral factor - after the individual ratings for each side are combined. The regulation reflects that impairment affecting both sides of the body tends to be more disabling than the same impairment on one side alone.
The bilateral factor is applied automatically by the rater as part of the combined ratings calculation; it is not something a veteran requests separately.
Total disability based on individual unemployability (TDIU)
Some veterans whose combined rating is below 100 percent can still be paid at the 100 percent rate under 38 CFR 4.16 if their service-connected disabilities prevent them from maintaining substantially gainful employment. This is called total disability based on individual unemployability, or TDIU.
TDIU generally requires either one condition rated at 60 percent or more, or a combined rating of 70 percent with at least one condition rated 40 percent or higher, though the VA can also consider unemployability outside those thresholds on an extraschedular basis. The evidence has to show the service-connected conditions themselves - not age or a lack of education - are what prevents employment.
Staged ratings
When the evidence shows a condition's severity changed over time - for example, worsening after a specific event, or improving after treatment - the VA can assign a staged rating: different percentages for different periods covered by the same claim, each supported by the evidence documenting the condition during that period. Staged ratings appear most often on original claims that cover a long span of time between filing and decision.
This guide is educational. It summarizes the VA's own published rules and links to the exact sources it relies on. It is not legal or claims advice, and it is not a substitute for an accredited representative, who can advise you about your specific claim. Accredited help is free - search the VA's accreditation database to find a Veterans Service Organization, accredited agent, or attorney.
Frequently asked questions
How does the VA decide my disability percentage?
The VA assigns a percentage from the Schedule for Rating Disabilities in Title 38 of the Code of Federal Regulations. Each condition has diagnostic codes with criteria for each percentage level, and the rater matches the medical evidence to those criteria.
How do combined VA ratings work?
They are not added together. Under 38 CFR 4.25, the VA combines ratings with a formula: each rating is applied to the remaining efficiency. Two 50 percent ratings combine to 75 percent, which rounds to 80 - not 100.
What does a 0 percent rating mean?
It means the VA agrees the condition is service connected but rates it as noncompensable - no monthly payment. It still establishes service connection, which matters for future claims and for conditions that worsen over time.