100% Isn't Only for One Severe Condition — or for PTSD
VA adds ratings together using its own Combined Ratings Table, not regular math. Here are ten physical conditions, at ratings VA has already published, shown as one example of how a veteran can reach a 100 percent combined rating without any mental health rating in the mix.
VA math is not regular math
You do not add these percentages together by hand.
VA combines ratings using its Combined Ratings Table (38 CFR 4.25). Run the ten numbers below through that table, largest to smallest, and they combine to 96. VA then rounds to the nearest number ending in 0 — 96 rounds up to 100.
Ten physical conditions, no mental health rating
- Sleep apnea — 50%38 CFR 4.97, DC 6847 — requires use of a breathing assistance device such as a CPAP machine
- Migraines — 50%38 CFR 4.124a, DC 8100 — very frequent, completely prostrating and prolonged attacks
- Lumbar spine — 40%38 CFR 4.71a — forward flexion of the thoracolumbar spine 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine
- Right leg radiculopathy — 20%38 CFR 4.124a, DC 8520 — moderate incomplete paralysis, sciatic nerve
- Left leg radiculopathy — 20%38 CFR 4.124a, DC 8520
- Right shoulder — 20%38 CFR 4.71a, DC 5201 — arm limited to shoulder level
- Left shoulder — 20%38 CFR 4.71a, DC 5201
- Right knee — 10%38 CFR 4.71a
- Left knee — 10%38 CFR 4.71a
- Tinnitus — 10%38 CFR 4.87, DC 6260
Two footnotes before you rely on this list
Secondary service connection
Most of the conditions on this list are classically secondary to something else — radiculopathy secondary to a lumbar spine condition, sleep apnea or migraines secondary to a condition VA already service-connected. Under 38 CFR 3.310, a disability that is proximately due to, or aggravated by, a service-connected disease or injury is itself service connected. You do not have to prove every condition ties directly back to your time in service. Basic service connection itself is 38 CFR 3.303.
The bilateral factor
Three pairs on this list qualify — both legs, both shoulders, both knees. Under 38 CFR 4.26, VA combines a paired rating together first, then adds another 10 percent of that combined value on top, before combining it with everything else. And 4.26 protects you on the downside: if including a pair in the bilateral math would produce a lower number than leaving it out, VA is required to leave it out instead and combine it separately — whichever way works out best for you.
TDIU — you may already be at the 100% pay rate
Total Disability based on Individual Unemployability.
If your service-connected conditions keep you from holding substantially gainful work, VA can pay you at the 100 percent rate without a 100 percent schedular rating. Under 38 CFR 4.16(a), that door opens if one condition alone is rated 60% or more, or your combined rating is 70% or more with at least one condition at 40%. On this page's own example, the four leg ratings (radiculopathy and knees, both sides) count together as one disability toward that 60 percent door, and with the bilateral factor added they land close to it on their own — before the spine, shoulders or anything else is even counted.
If you don't meet those percentages, it is still not the end of the question. VA's own regulation states: "It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled." Under 4.16(b), your case must still be sent up for extraschedular consideration if you can't work because of your service-connected conditions.
100% is not the same as Permanent & Total
Reaching a 100 percent combined rating does not automatically make you Permanent and Total (P&T). Some Family benefits run on P&T status, not on the 100 percent number by itself — CHAMPVA health coverage and Survivors' and Dependents' Educational Assistance (Chapter 35) among them. Ask VA directly whether your 100 percent is also coded P&T.
Protect your effective date
File an Intent to File first, before your claim is ready, to lock in today's date so back pay can reach as far back as that date once you're rated. If VA gets a decision wrong, a Higher-Level Review or a Board Appeal must be filed within one year of the decision notice. A Supplemental Claim has no filing deadline of its own — but filing it within one year of the decision notice is what preserves your earlier effective date. File late, and the retroactive pay behind that earlier date is gone.
Get help without paying to file
Always verify information with VA or a VA-accredited representative. An accredited Veterans Service Organization (VSO) representative is free. An accredited attorney or claims agent may charge a fee, but only after VA has issued its first decision on the claim (38 CFR 14.636); a fee of 20 percent or less of past-due benefits is presumed reasonable, and a fee above one-third is presumed unreasonable. Separately, under 38 CFR 14.630, any one person you choose — a friend, a spouse, a former NCO — can help you prepare, present and prosecute a single claim without being accredited, using VA Form 21-22a and certifying that no fee is charged.