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The “Bilateral Factor” in VA Ratings

When you receive a disability rating from VA, you need to make sure the rating has been calculated correctly.  One of the oldest tricks in VA’s book is to give a veteran a rating that is not as high as it should be.

Many times, the veteran is so happy to finally have some good news on his long-delayed claim.  This causes many veterans not to look at the VA rating closely enough.  Because of that, they do not receive all the VA benefits they should.

Cubes with numbers and percentagesYou especially need to consider the possibility of an incorrect low rating if you have disabilities that affect either both arm or both legs.  If you do have disabilities on the right and left side, you may be entitled to a “bump” in your rating based on what is known as the “bilateral factor.”

What is the Bilateral Factor?

In the context of your VA disability claim, the bilateral factor is an increase in the standard rating.  The law recognizes that a disability that affects both arms or both legs limits someone more than each of those disabilities considered alone.  In other words, if you already have a disability to your right arm, a disability to the left arm causes even more limitations than it otherwise would since you need the second arm to compensate for the first bad arm.

So How Much Is the Additional Rating for the Bilateral Factor?

Regardless of the body part in question, the bilateral factor is an additional 10% of the combined rating for the disability to each side.  To be clear, it is not a straight 10% additional rating.

To best illustrate, let’s look at an example.  Let’s say you have a left knee condition that VA rated at 30%, a right knee condition rated at 10%, and another 10% rating for tinnitus.  VA should consider the left and right knee conditions together for a combined rating.  A 30% left knee rating and a 10% right knee rating equal a 37% combined rating.  (If you don’t understand how 30% + 10% = 37%, you can read our previous article to learn how VA math is not like regular math since disabilities ratings are combined together).

Because both the right and left sides are affected, the veteran should receive an additional 10% of the 37%, which is an additional 3.7%.  What is the big deal about an extra 3.7%?

Why Does The Bilateral Factor Matter?

When added to the 37%, that gives a new combined rating of 41% (40.7% rounded up to 41%).  The 41% for the left and right knees is then combined with the 10% for tinnitus.  This gives an overall combined rating of 47%.  VA should round that 47% up to 50%.

In this particular example, that extra 3.7% was just enough to push the overall combined rating increased to 50%.   Without the additional benefit for the bilateral factor calculation, the veteran would have been stuck at 40%.  For a single veteran with no dependents, that is about a $245 per month difference.

Sometimes though, the bilateral factor may not push you to the next combined rating level.  But, it may come into play if you later have additional service-connected disabilities or get increased ratings on the ones you already have.

How Do I Know if VA Gave Me Credit for the Bilateral Factor?

The ratings decision should lay out how VA calculated the ratings.  It should also acknowledge the additional 10% for the bilateral factor.

Of course, there is a (small) chance that they gave you this additional 10% but did not explicitly state that they were doing so.  In that case, you have to be able to do “VA math” accurately to check their combined rating.

Bilateral factor ratings and combined ratings are not easy to understand. It may be difficult to comprehend VA’s math since it is not like regular math.  That is why we suggest having one of our knowledgeable veterans disability attorneys look over your ratings decision to make sure you get the full benefits you deserve.

We will check to make sure you got credit for the bilateral factor.  We will also look to see if the VA shorted you on the appropriate rating for any of your disabilities.


VA Math


Basic VA Math
The Bilateral Factor

Basic VA Math

Welcome to Mind-Boggling VA Math. Prepare yourself. Whoever thought of this was nuts! Seriously nuts.

VA Math is difficult, but simplified in our step-by-step walk through.

That being said, Don’t worry! You’ll be fine! We’ll help you through VA Math step-by-step with a few examples. You should now feel very reassured and ready to face VA Math head-on.

Let’s start at the beginning. What is VA Math? VA Math is the math used to combine the Military Disability Ratings of multiple conditions to give a veteran a single overall, or “combined”, rating. In other words, if a person has more than one condition that is rated for Military Disability, then each of the ratings are combined (note that the key word here is “combined” not “added”) together using VA Math to give one overall rating. This single rating is then used to determine the exact type and amount of Military Disability Benefits the veteran receives.  

VA Math is used for both DoD Disability and VA Disability.

So here’s how VA Math works. Each condition is a percentage of the disability of the service member. When combined together, however, each percentage is not a percentage of the entire service member but a percentage of what is left after other percentages have been subtracted. Got that? No? Well here’s an example:

Billy’s entire body is equal to 100%. Let’s say that Billy has three rated conditions. The first is a knee injury that is rated 30%. The second is a shoulder injury rated 20%. The last is a back injury rated 10%. Instinct would assume that the combined rating would be 60% (30 + 20 + 10 = 60). Unfortunately, that’s not the case with VA Math.

First start with the largest rating, 30%. This rating is then subtracted from the total body rating of 100%. Of the total body, now only 70% remains. So instead of simply subtracting 20 for the shoulder’s 20%, you can only subtract 20% of the 70 that is left, which is 14 (0.2 x 70 = 14). 70 minus 14 is 56. Now, since only 14 was subtracted from the total body, only 14 is added to the total combined rating. (Take a deep breath. Following along with the table below might help…)

Now for the last 10%. Again we can only subtract 10% of what is left of the total body. Thus, 10% of 56 is 5.6 (0.1 x 56 = 5.6). 56 minus 5.6 is 50.4. And again, since only 5.6 was subtracted from the total body, only 5.6 is added to the combined rating. So far, Billy’s rating is 30% + 14% + 5.6% = 49.6%.

Once all the conditions are counted, then the total combined rating is rounded to the nearest 10. 49.6%, therefore, equals 50% total disability.

Got VA Math now? If your answer is No, grab a pencil and a piece of paper and walk through the example above yourself. It really does help to do the steps yourself. If your answer is Yes, great! There’s more to come.

Depending on the veteran, the list of conditions can sometimes be pretty long, and the VA Math becomes even more confusing. So, here’s a more complex example. Remember, simply follow the format from the example above and focus on one condition at a time.

Michelle’s VA Rating Decision looks like the following:

VA Math time! Add the ratings from largest to smallest, regardless of the order they are listed on the Rating Decision, as follows:

Got it now? Well, we’re sure you’re doing great, and if this were an elementary math class, we’d give you a smiley sticker, but there’s one final kink to put into the VA Math equation.

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The Bilateral Factor

An additional 10% (the “Bilateral Factor”) is added to the VA Math equation if the veteran has both arms or both legs affected by two ratable conditions.

Note: A Bilateral Factor is added when both arms or both legs have a rated condition, even if one of them is only rated 0%.

So, if there is a right knee condition and a left knee condition that are both rated, then you get an additional 10%. The point of the bilateral factor is to take into account the fact that if you have a problem in your right leg, then a problem in your left leg will just make it worse and vice-versa. It is easier to deal with a condition if the opposite part of your body can compensate.

That being said, the conditions do not have to be identical for the bilateral factor to apply. If you have a left hip condition and a right foot condition, you still get that extra 10% since each condition affects the opposite lower extremity. If there are four conditions, one affecting each of the four extremities, then all four ratings are combined before the bilateral factor is calculated and added.

Here’s the VA Math catch: The key to adding that extra 10% is that it is not a 10% as though it were another condition, but is 10% of the combined rating of the two (or more) bilateral conditions. Once those conditions are combined, then 10% of that value is added, and the group of bilateral conditions is then treated as a single condition and combined with any other conditions. (We’ve already agreed that whoever thought of this was nuts.)  

If a bilateral factor is added, always calculate the bilateral factor with its conditions first, then rank the remaining conditions (the combined bilateral conditions now count as a single condition) from highest rating to lowest and continue with normal VA Math.   

So, if Sally has three conditions, a right foot rated 20%, a left foot rated 10%, and a back rated 40%, the foot conditions would be combined first since they are bilateral, even though the back condition is rated higher. The bilateral factor is then added to the combined rating of the foot conditions. That rating is rounded to the nearest whole number and then becomes the rating of a single bilateral condition that is then combined with the remaining back condition. 

As you can see, since all ratings are rounded to the nearest 10 at the end, the bilateral factor may not be very helpful in raising the overall rating. In this case, Sally would have received 60% even without the bilateral factor. But in other cases it may make a critical difference. Consider the example below which is only slightly different from Sally’s case.

Marcus has three conditions, a right shoulder rated 20%, a left arm rated 20%, and a back rated 10%. The two arm conditions are combined first, and then the bilateral factor is added to their combined rating. That rating is rounded to the nearest whole number and then becomes the rating of a single bilateral condition that is then combined with the back condition. 

Without the bilateral factor Marcus’ conditions would have combined to 43% which rounds down to 40% final rating.  So, not only did the bilateral factor get Marcus a 10% higher rating, it also pushed him to the 50% rating that qualifies him for CRDP.  That’s huge! Regardless, if you have two bilateral conditions, you get that extra 10%. Happy Birthday.  

That’s it. You have passed your VA Math class. If you haven’t already, go Find Your Conditions so you can practice your VA Math! Woo-hoo!

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What is VA Math?

VA Math is the math used to combine the ratings of multiple conditions to give a veteran a single overall combined rating.

Do I need VA Math in my case?

If you only have a single medical condition that qualifies for disability, then no, you do not need VA Math. If, however, you have multiple conditions, then you will need to use this math to combine your conditions to get your single overall rating.

How does VA Math work?

Each condition is a percentage of the disability of the service member. When combined together, however, each percentage is not a percentage of the entire service member but a percentage of what is left after other percentages have been subtracted. Definitely follow along with our examples to fully understand this concept.

Why does the VA use this math system?

The VA needed a way to combine the ratings for various conditions to get the veteran's overall rating. VA Math was created to combine the ratings in a way that reflects the diminishing effect additional conditions have on a veteran's overall functioning and ability to work.

What is the bilateral factor?

The bilateral factor is an additional 10% that can be factored into your equation if you have two or more conditions that affect the opposite limbs (i.e. legs, arms). The idea is if you have one condition on your right leg and another on your left, those are going to make each other worse and ultimately cause a worse disability.

How does VA Math affect the benefits I receive?

In order to find your overall combined rating, you must use VA Math. Your combined rating is then used to assign your monthly payment amount using the VA Disability Chart.

What if my combined rating is wrong?

The VA has calculators that does VA Math for them, so it would be very rare to have the wrong combined rating, but not impossible (though we've never seen it). If, however, it happens in your case, you can call your Regional VA and see if they can fix it through their system.

Can I receive the bilateral factor for conditions in one arm and one leg?

No. The bilateral factor only applies if the opposite limbs are involved. Both legs or both arms. An arm and a leg condition are not considered bilaterals of each other.

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VA TDIU Errors: Combining Extremity Ratings to Meet the \

The Bilateral Factor for VA Disability Compensation

Posted by Berry Law on April 19, 2019 in Uncategorized

One commonly misunderstood area of VA disability involves the way the VA combines individual ratings, especially in relation to the bilateral factor. When a veteran has two or more service connected disabilities, each unique disability gets its own rating or percentage of disability. One might think that the VA would simply add those ratings together to get the combined rating, but they do not. Instead, the VA employs a calculation, colloquially known as “VA math,” to combine the ratings using a descending efficiency scale. If you are confused by VA math, you are not alone. To help clients understand VA math, we have put together a 2019 VA disability calculator to help them determine their total disability percentage and monthly compensation.

How the Rating System Works

Before getting to the actual math, it’s important to understand the reasoning behind the combined ratings system. Theoretically, a combined rating represents how much the combined disabilities affect a veteran’s ability to work. In other words, approximately how much less efficient the veteran will be at work due to the combination of their individual disabilities.

The Math

The combined rating starts assuming a veteran has a 100% efficiency rate. The efficiency rate is multiplied by the disability rating, and the result of that calculation is subtracted from the efficiency rate. So, if a veteran’s highest rated disability were 50%, the first calculation would look liked this:

  • Efficiency rate of 100 x 50% = 50. Then 100 – 50 = 50.
  • If the second highest disability were 40%, the second calculation would look like this:
  • 50 x 40% = 20, then 50 – 20 = 30.

In this case, 30 becomes the new efficiency rate, and the veteran is considered 70 percent disabled.

Understanding the Bilateral Factor

The confusion about VA math gets even worse when one takes into consideration the “bilateral factor.” A bilateral factor is an additional 10 percent added to the combined rating because a veteran suffers from disabilities of both arms, both legs, or paired skeletal muscles. The bilateral factor does not abide by the same rules as the other disability percentages. It starts by finding the combined rating of the veteran’s bilateral conditions. That combined rating is then multiplied by 10% to find the bilateral factor.

The Bilateral Factor Example

Going back to our previous calculations, imagine that the 50 percent and 40 percent ratings represent the disability percentages for each of a veteran’s arms. In order to find the bilateral factor, take the combined rating of 70 percent and multiply it by 10 percent to get 7 percent. Then take the bilateral factor of 7 percent and add it to the combined overall rating of 70 percent to get 77 percent, which rounds up to 80 percent for the veteran’s combined rating.

Why the Bilateral Factor Exists

The bilateral factor represents a concession that having a disability in both of one’s limbs, be it the arms or the legs, causes an extra disability. If a person only had a disability in their right arm, for instance, it would cause them to rely more heavily on their left arm. However, if they could not rely on their left arm due to another disability in that arm, the combined effect of the two disabilities in their arms would decrease the veteran’s efficiency far more than represented by the individual ratings, even when combined using the rating table.

Many veterans wonder, does the bilateral factor only apply if the injuries on each limb are the same? It might seem logical to apply the bilateral factor for left and right wrist carpal tunnel, for instance. However, the bilateral factor extends beyond that. It would apply if the veteran suffers from a disability in the left and right arm, even if the disabilities are differnt (for instance, left wrist carpal tunnel and right shoulder disability).

Veterans Disability Attorneys

The VA appeals process can be difficult. It shouldn’t be. Our dedicated veterans appeals lawyers have handled thousands of claims before the VA and have helped our clients fight the VA for the disability benefits they were entitled to. If you or somebody you know has been denied VA disability compensation, contact Berry Law today.


Va bilateral factor

38 CFR § 4.26 - Bilateral factor.

§ 4.26 Bilateral factor.

When a partial disability results from disease or injury of both arms, or of both legs, or of paired skeletal muscles, the ratings for the disabilities of the right and left sides will be combined as usual, and 10 percent of this value will be added (i.e., not combined) before proceeding with further combinations, or converting to degree of disability. The bilateral factor will be applied to such bilateral disabilities before other combinations are carried out and the rating for such disabilities including the bilateral factor in this section will be treated as 1 disability for the purpose of arranging in order of severity and for all further combinations. For example, with disabilities evaluated at 60 percent, 20 percent, 10 percent and 10 percent (the two 10's representing bilateral disabilities), the order of severity would be 60, 21 and 20. The 60 and 21 combine to 68 percent and the 68 and 20 to 74 percent, converted to 70 percent as the final degree of disability.

(a) The use of the terms “arms” and “legs” is not intended to distinguish between the arm, forearm and hand, or the thigh, leg, and foot, but relates to the upper extremities and lower extremities as a whole. Thus with a compensable disability of the right thigh, for example, amputation, and one of the left foot, for example, pes planus, the bilateral factor applies, and similarly whenever there are compensable disabilities affecting use of paired extremities regardless of location or specified type of impairment.

(b) The correct procedure when applying the bilateral factor to disabilities affecting both upper extremities and both lower extremities is to combine the ratings of the disabilities affecting the 4 extremities in the order of their individual severity and apply the bilateral factor by adding, not combining, 10 percent of the combined value thus attained.

(c) The bilateral factor is not applicable unless there is partial disability of compensable degree in each of 2 paired extremities, or paired skeletal muscles.

The Bilateral Factor - VA Disability Group - Attorney Casey Walker

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