The bilateral factor: why both knees or both arms add a little extra
· Claim Situation
The situation
When disabilities affect both arms, both legs, or paired skeletal muscles, VA adds a small bonus to the combined rating. It is automatic in theory, but it is worth checking your code sheet.
The rule
Under 38 CFR 4.26, VA first combines the ratings for the paired limbs, then adds 10% of that combined value before combining with everything else.
A simple example
- Left knee 10% and right knee 10% combine to 19%.
- 10% of 19 is 1.9, so the bilateral value is 20.9.
- That value then combines with your other ratings, and the final result is rounded to the nearest 10.
What qualifies
- Disabilities of both arms, or of both legs, or of paired skeletal muscles.
- It does not pair an arm with a leg. The regulation also lists exceptions in paragraph (d), so have a VSO check your code sheet.
- Paired organs such as eyes, ears and kidneys have their own rules, not the bilateral factor.
Check your rating
Look for "bilateral factor" on your code sheet. Try the WinnableClaims calculator with your own numbers. Combined ratings use 38 CFR 4.25.
Related
Get free help
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Educational only, not legal or medical advice. We are not VA-accredited. No one can promise an outcome; VA decides each claim on its own evidence. Rules and rates change; check the linked VA and eCFR sources.