How the VA considers injuries to both arms, both legs or paired skeletal muscles.
Bilateral Factors - How are they rated
When it comes to rating disabilities involving both limbs or both legs, the VA generally rates them as bilateral conditions. This means that they are rated as a single disability, rather than as individual conditions.
The VA will rate the condition based on the severity of the symptoms and how much they interfere with the veteran's ability to function. The VA will also consider the impact of the condition on the veteran's ability to work and perform daily activities.
For example, if a veteran has a bilateral knee condition that makes it difficult to stand or walk for long periods, the VA may assign a higher disability rating. Similarly, if a veteran has bilateral arm conditions that make it difficult to use both arms, the VA may assign a higher rating to reflect the combined impact of both conditions on the veteran's overall quality of life.
It's important to note that the VA may also consider individual conditions separately if they are not related to each other. For example, if a veteran has a condition affecting only one arm and a separate condition affecting only one leg, the VA may rate these as separate disabilities rather than as a bilateral condition.
In summary, the VA generally rates disabilities involving both limbs or both legs as bilateral conditions, but will consider individual conditions separately if they are not related to each other.
Things that don’t get “bilateral factor” consideration:
Some disabilities like those of the ears and eyes are not considered in this way. Bilateral factors are primarily applied to the extremities only both arms, both legs, or paired skeletal muscles are implicated.
The Formula:
The VA uses a different formula for rating bilateral disabilities. For example, if a veteran is rated at 30% for the left arm, 20% for the right arm, and 50% for sleep apnea, the VA will first combine the arm ratings using a special bilateral factor formula. The bilateral factor for two disabilities rated at 30% and 20% is 56%. To calculate the combined rating for the two arm conditions, multiply the higher rating (30%) by the bilateral factor (56%), which gives 16.8%, and then add the lower rating (20%), resulting in a combined rating of 36.8%. The VA will then combine the bilateral condition (36.8%) with the rating for sleep apnea (50%) using the regular combined rating table to determine the overall disability rating.
§ 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.
💡This is a useful concept - to obtain the benefit of the bilateral factor, the injuries on each limb do not have to be the same.
(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.